Performance Appraisal Feedback Tool

Instructions: Using the following scale, please indicate the degree to which you believe each individual relates to the following questions:

1- To little or no degree 2- To some degree 3-To a moderate degree
4- To a considerable degree 5- To a very great degree

1. Planning and Organizing: Demonstrates ability to plan and accomplish work; prioritizes job duties; sets and meets goals; ensures that equipment, supplies and materials are available for subordinates; follows through; controls flow of projects and obstacles to getting the job completed on time; observes budgetary constraints.

2. Leadership: Delegates effectively; displays confidence; demonstrates job growth; has ability to motivate employees; promotes team-building activities; is resourceful; maintains high quality standards.

3. Technical Ability: Demonstrates competency in job skills (technical, professional, and administrative); demonstrates good judgement and decision-making based on professional expertise; knows and understands current activities, practices and concepts in field; applies and keeps current with changing concepts and technologies.

4. Working Relationships: Demonstrates ability to get along with others; shows empathy for others; has effective interpersonal skills; demonstrates appropriate knowledge of and shows sensitivity to cultural diversity of patients and co-workers.

5. Development and Training Skills: Has effective communication skills; selects and develops capable subordinates; has ability to teach and coach others regarding job skills; disciplines when warranted and enforces job rules; takes appropriate steps to reduce absenteeism; completes performance appraisals appropriately.

6. Decision-Making: Has problem analysis and problem solving skills; shows common sense; exhibits creative thinking, good judgement, and decisiveness.

7. Dependability: Accepts responsibility; follows instructions willingly; is adaptable to change; is able to meet deadlines; exhibits loyalty to the health care facility; demonstrates honesty and integrity; is punctual and has good attendance record.

8. Controls Costs: Contributes to profitability; forecasts and maintains budgeting projections, demonstrates ability to keep down costs.

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