ENTERPRISE EXECUTIVE PERFORMANCE MANAGEMENT & PLANNING EVALUATION

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1 ENTERPRISE EXECUTIVE PERFORMANCE MANAGENT & PLANNING EVALUATION INSTRUCTIONS (PLEASE READ): This Performance Evaluation is meant to promote individual and organizational effectiveness and to encourage ongoing, constructive communication. The objectives are (1) to assess performance (2) to ensure that efforts support the enterprise goals of education, clinical, research and business growth, operating margin, customer satisfaction and enterprise-wide leadership integration (3) to assist in identifying performance objectives for future accomplishment, (4) to promote individual development, (5) to provide opportunity for dialogue about support needed to advance GRU and Georgia Regents Health System s strategic objectives. Employee s Name: Position Title: Distribution of Effort: Instruction % Scholarship / Research % Patient Care % Service % Administration % Department: Primary Evaluator (Name & Title): Review Period: From: To: Review Date: Review Type: Mid-Year Review Annual Review Other Faculty Evaluation of Administrators Scores, if applicable (enter average value from report provided): Leadership Faculty & Program Development Fairness & Ethics Communication Administration Peer / Key Relationship Scores (if applicable): Scores from peer / key relationships includes input from people in matrix reporting (enter average value from report provided. EVALUATION LEVELS AND SAMPLE CRITERIA Exceeds Expectations () Meets Expectations () Below Expectations () Performance is clearly outstanding Performance is excellent Performance is not excellent Individual who significantly and consistently exceed expectations and role requirements Individual who regularly meet and sometimes exceed expectations and role Individuals who have not mastered key job responsibilities Exceeds goals and objectives set for the year Demonstrates exceptional depth and breadth of role knowledge, highly recognized by others requirements Meets goals and objectives set for the year Possesses full depth and breadth of role Inconsistently demonstrates role knowledge and does not yet fully perform all requirements and duties within the community knowledge Did not complete important objectives Demonstrates role model behavior consistent Perceived by peers, managers, students and Did not achieve important goals with enterprise values for other leaders and staff members to emulate other customers as collaborative, skilled and reliable Behaviors are consistent with enterprise values Behaviors are inconsistent with enterprise values

2 SECTION 1A: SELF AND MANAGER EVALUATION INSTRUCTIONS: THIS SECTION IS TO COMPLETED BY BOTH THE LEADER ING EVALUATED AND HIS/HER MANAGER, AND ALLOWS FOR BOTH A SELF - EVALUATION BY THE LEADER AND THE MANAGER S EVALUATION. THE EMPLOY SHOULD COMPLETE THE SELF - EVALUATION SECTION OF 1A, SECTION 1B (IF APPLICABLE), AND THE GOALS AND OBJECTIVES IN SECTION 1C. FOLLOWING THE COMPLETION THE SECTIONS, THE EVALUATED LEADER SHOULD ROUTE THIS FORM TO THEIR IMDIATE SUPERVISOR. ATTACH ADDITIONAL PAGES AS NECESSARY. EVALUATION OF PERFORMANCE OF JOB RESPONSIBILITIES SELF-EVALUATION MANAGER S EVALUATION THIS SECTION SHOULD DISCUSSED WITH THE IMDIATE SUPERVISOR AND MAY EDITED ACCORDINGLY FORE THE EVALUATION IS FINALIZED WITH SIGNATURES. *LEADERSHIP: FOSTERS EXCELLENCE IN CUSTOR SERVICE MTS COMMITNTS WORKS INDEPENDENTLY ACCEPTS ACCOUNTABILITY MANAGES CHANGE STAYS FOCUSED UNDER PRESSURE MTS ATTENDANCE REQUIRENTS COMNTS: QUALITY MANAGENT (IF APPLICABLE): ARTICULATES AND PRACTICES COMMITNT TO ENTERPRISE QUALITY AND SAFETY GOALS FOSTERS COLLABORATION AMONG DISCIPLINES WITH FOCUS ON GOALS SUPPORTS ENTERPRISE-WIDE CONTINUITY OF CARE INCORPORATES ST PRACTICES WITH FOCUS ON GOALS COMNTS: FINANCIAL MANAGENT: MANAGES RESOURCES EFFICIENTLY WITHIN BUDGET COMMUNICATES WITH STAFF ALIGNS PLANS WITH FISCAL RESOURCES PLANS EFFECTIVELY FOR FUTURE RESOURCE NDS ENGAGES APPROPRIATE OFFICERS AS NDED UNDERSTANDS SOURCES OF FUNDING AND ASSOCIATED REQUIRENTS MANAGES EXPENSES TO OPTIMIZE RESOURCES MTS FINANCIAL GOALS AND CONTRIBUTES TO MARGIN (IF APPLICABLE) COMNTS: 2

3 EVALUATION OF PERFORMANCE OF JOB RESPONSIBILITIES MANAGER S SELF-EVALUATION EVALUATION THIS SECTION SHOULD DISCUSSED WITH THE IMDIATE SUPERVISOR AND MAY EDITED ACCORDINGLY FORE THE EVALUATION IS FINALIZED WITH SIGNATURES. ACADEMIC/TEACHING (IF APPLICABLE): PROVIDES LEADERSHIP AND GUIDANCE ENSURES CURRICULUM MTS ACCREDITATION STANDARDS FACILITATES THE TEACHING MISSION ENSURES APPROPRIATE SUPPORT AND DEVELOPNT OF FACULTY SUPPORTS ACADEMIC MISSION COMNTS: PATIENT CARE (IF APPLICABLE): ENSURES APPROPRIATE SUPPORT FOR PATIENT CARE STAFF INTEGRATES PATIENT CARE STAFF INTO STRATEGIC PLANNING FOR THEIR AREA OF RESPONSIBILITY INTEGRATES PATIENT CARE STAFFING PLANNING AND MANAGING OF DAY TO DAY OPERATIONS ENCOURAGES COLLABORATION AMONG PATIENT CARE STAFF SUPPORTS PATIENT CARE MISSION ENSURES DEPARTNTS MTS ESTABLISHED PATIENT SATISFACTION GOALS COMNTS: SCHOLARSHIP / RESEARCH OVERSIGHT (IF APPLICABLE): ENSURES COMPLIANCE WITH RESEARCH ADMINISTRATION POLICIES AND PROCEDURES MAINTAINS AND SHARES KNOWLEDGE OF REGULATIONS ENSURES STAFF ARE PROVIDED ACCESS TO AND PARTICIPATE IN RESEARCH COMPLIANCE TRAINING ENSURES COMMUNICATION OF POLICIES SUPPORTS RESEARCH MISSION COMNTS: 3

4 EVALUATION OF PERFORMANCE OF JOB RESPONSIBILITIES MANAGER S SELF-EVALUATION EVALUATION THIS SECTION SHOULD DISCUSSED WITH THE IMDIATE SUPERVISOR AND MAY EDITED ACCORDINGLY FORE THE EVALUATION IS FINALIZED WITH SIGNATURES. CONTROL AND OVERSIGHT: ESTABLISHES APPROPRIATE INTERNAL CONTROLS FOR AREA OF RESPONSIBILITY WORKS EFFECTIVELY WITH AUDIT STAFF ENSURES APPROPRIATE DOCUNTATION OF BUSINESS PROCESSES COMNTS: *INITIATIVE, INNOVATION AND PROBLEM SOLVING: IDENTIFIES OPPORTUNITIES FOR IMPROVENT AND TAKES ACTION LOOKS FOR CREATIVE SOLUTIONS ANTICIPATES AND PREVENTS PROBLEMS DEFINES PROBLEMS, IDENTIFIES ROOT CAUSE GENERATES ALTERNATIVE SOLUTIONS HELPS SOLVE TEAM PROBLEMS COMNTS: PEOPLE MANAGENT: WORKS WELL WITH AND THROUGH OTHERS TO ACCOMPLISH GOALS. ASSESSES TALENT EFFECTIVELY; USES GOOD JUDGNT WHEN RECRUITING FOR TEAM INSPIRES OTHERS TO MT CHALLENGES EFFECTIVELY GUIDES STAFF TO SUCCESSFULLY COMPLETE WORK ASSIGNNTS, PROVIDING CLEAR EXPECTATIONS AND ASSISTING WITH PROBLEM SOLVING WHEN NECESSARY. FAIRLY EVALUATES STAFF. ADDRESSES PERFORMANCE CONCERNS WHEN NECESSARY, EFFECTIVELY APPLYING UNIVERSITY POLICY INCLUDING DOCUNTATION. COMNTS: PROFESSIONAL DEVELOPNT: PARTICIPATES IN PROFESSIONAL DEVELOPNT ACTIVITIES SKS OUT OPPORTUNITIES TO ENHANCE KNOWLEDGE MAINTAINS MRSHIP IN RELEVANT PROFESSIONAL ORGANIZATIONS STAYS ABREAST OF CURRENT DEVELOPNTS IN FIELD OF EXPERTISE COMNTS: 4

5 EVALUATION OF PERFORMANCE OF JOB RESPONSIBILITIES SELF-EVALUATION SELF-EVALUATION THIS SECTION SHOULD DISCUSSED WITH THE IMDIATE SUPERVISOR AND MAY EDITED ACCORDINGLY FORE THE EVALUATION IS FINALIZED WITH SIGNATURES. *CUSTOR SERVICE QUALITY & ORIENTATION: IS ATTENTIVE TO DETAIL AND ACCURACY IS RESPONSIVE TO CUSTORS ACTIVELY SUPPORTS QUALITY STANDARDS MAKES CONTINUOUS IMPROVENTS MONITORS QUALITY LEVELS OWNS AND ACTS ON QUALITY PROBLEMS DEMONSTRATES COMMITNT TO EXCELLENT CUSTOR SERVICE AREAS OF RESPONSIBILITY PROVIDE EXCELLENT CUSTOR SERVICE ENSURES DEPARTNTS MTS ESTABLISHED PATIENT SATISFACTION GOALS COMNTS: *TEAMWORK: CONTRIBUTES TO TEAM PROJECTS EXCHANGES IDEAS, OPINIONS HELPS PREVENT, RESOLVE CONFLICTS WORKS WITH OTHER DEPARTNTS DEVELOPS POSITIVE WORKING RELATIONSHIPS IS FLEXIBLE AND OPEN-MINDED PROMOTES MUTUAL RESPECT COMNTS: PLANNING AND ORGANIZING EFFECTIVENESS: DEVELOPS REALISTIC PLANS BALANCES SHORT AND LONG-TERM GOALS ALIGNS PLANS WITH DEPARTNT/UNIVERSITY GOALS PLANS FOR AND MANAGES RESOURCES CREATES CONTINGENCY PLANS COORDINATES AND COOPERATES WITH OTHERS COMNTS: 5

6 *COMMUNICATION: LISTENS EFFECTIVELY RESPONDS CLEARLY AND DIRECTLY SKS TO CLARIFY AND CONFIRM THE ACCURACY OF THEIR UNDERSTANDING OF UNFAMILIAR OR VAGUE TERMS MAKES ORAL AND WRITTEN COMMUNICATION CLEAR AND EASY TO UNDERSTAND COMNTS: OTHER: MANAGER COMNTS: ADDITIONAL COMNTS: 6

7 SECTION 1B: ADMINISTRATIVE FACULTY WITH RANK INSTRUCTIONS: THIS IS TO USED FOR ADMINISTRATIVE FACULTY WITH RANK WHO MAY HAVE TEACHING, SCHOLARSHIP / RESEARCH AND/OR PATIENT CARE PRODUCTIVITY ASURES. ACTIVITY/AREA DESCRI ACCOMPLISHNTS FOR EACH ACTIVITY/AREA, I.E., SUBMITTED THR NIH GRANT PROPOSALS, TWO WERE AWARDED. PATIENT CARE PRODUCTIVITY COMMITT WORK PAPERS/PRESENTATIONS SCHOLARSHIP/ RESEARCH / GRANTS OTHER: OTHER: 7

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9 SECTION 2A: MANAGER S OVERALL EVALUATION (REQUIRED SECTION) INSTRUCTIONS: ENTER OVERALL RATING* FOR THE YEAR. SUMMARIZE THE EMPLOY S PERFORMANCE, DISCUSSING AREAS OF STRENGTH AND AREAS FOR IMPROVENT. EXCDS EXPECTATIONS MTS EXPECTATIONS LOW EXPECTATIONS *REQUIRED FOR VARIABLE PAY PLAN SECTION 2B: GOALS AND OBJECTIVES FOR COMING YEAR* INSTRUCTIONS: GOALS SHOULD DEVELOPED IN SUPPORT OF THE GRU ENTERPRISE MISSION, VISION AND VALUES. GOALS SHOULD SPECIFIC, ASURABLE, ATTAINABLE, REALISTIC AND TILY (OR SMART). GOALS MAY ALSO EXPRESSED AS TARGETS FOR REVENUE, I.E. REVENUE GENERATED FROM RESEARCH, REVENUE GENERATED FROM PATIENT CARE PRACTICE, ETC. GOAL/OBJECTIVE/TRIC THRESHOLD TARGET HIGH PERFORMANCE *IF MORE THAN 5, ATTACH ADDITIONAL PAGE(S) TO LIST GOALS, OBJECTIVES AND TRICS, AND THE DESCRIPTION AND ASURES. 9

10 SECTION 2C: LEADERSHIP DEVELOPNT PLAN* INSTRUCTIONS: IF THE LEADER ING EVALUATED IS ALSO A FACULTY MR WITH RANK, REFER TO GRU PROMOTION & TENURE GUIDELINES AND DESIGN PLAN TO ALSO SUPPORT GOAL OF PROMOTION AND/OR TENURE. AREA FOR DEVELOPNT DESCRI DEVELOPNT ACTIVITIES *IF MORE ROOM IS NDED, ATTACH ADDITIONAL PAGE(S). SECTION 2D: IMPROVENT PLAN (IF NDED)* AREA FOR IMPROVENT DESCRI IMPROVENT ACTIVITIES *IF MORE ROOM IS NDED, ATTACH ADDITIONAL PAGE(S). 10

11 3A INSTRUCTIONS: THE SUPERVISOR AND THE LEADER ING EVALUATED WILL REVIEW AND DISCUSS ALL EVALUATION RATINGS AND COMNTS IN A FACE-TO-FACE MTING. SIGNATURES ARE RECORDED LOW. LEADER S POST PERFORMANCE EVALUATION COMNTS: 4A INSTRUCTIONS: THE EVALUATED EMPLOY AND IMDIATE SUPERVISOR SHOULD REVIEW AND DISCUSS ALL EVALUATION COMNTS IN A FACE-TO-FACE MTING. FOLLOWING THE MTING, BOTH PARTIES SHOULD SIGN LOW. FINAL SIGNATURES: MANAGER S NA MANAGER S SIGNATURE DATE (PRINT NA) On the next pages, please summarize specific accomplishments, at least for suggested applicable areas, NA OF LEADER ING EVALUATED EVALUATED LEADER S SIGNATURE DATE including (PRINT NA) special recognition by students and peers, academic promotion, board certification, etc., and attach copies for each evaluated area. Specifically indicate areas of deficiency. A copy of this form will be returned to the individual after review by the dean. PLEASE SUBMIT TO HUMAN RESOURCES 11