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Arabian Journal of Business and Management Review (OMAN Chapter) Vol. 5, No.1; August. 2015

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INVESTIGATING EMPLOYEE PERCEPTIONS OF PERFORMANCE MANAGEMENT AT THE DEPARTMENT OF RADIOLOGY IN A PUBLIC

HOSPITAL IN GAUTENG

Shantel Lewis Graduate of the Regent Business School, Durban, Republic of South Africa

X. Linganiso Academic and Dissertation Supervisor, Regent Business School, Durban, Republic of South Africa

Anis Mahomed Karodia (PhD) [email protected]

Professor, Senior Academic and Researcher, Regent Business School, Durban, Republic of South Africa

Abstract The South African Department of Public Administration has been utilizing the Performance Management and Development System (PMDS) to ensure accountability of performance in the public sector for the last twelve years. However, challenges of poor performance remain rife. Since perception, notably influences successful implementation of any system, this study evaluates employee perception of performance management in an attempt to evaluate the effectiveness of the system. The Department of Radiology at a Gauteng Public Hospital was chosen as the research site. No known research on PMDS had been conducted at the site since the implementation of PMDS. A quantitative study method utilized purposive sampling to obtain data from the Department of Radiology at the Gauteng Public Hospital. The target population consisted of forty three employees of the Department and forty of these employees made up the sample population. A pilot study was conducted on ten percent of the population. A questionnaire was then administered to the sample population. The questionnaire consisted of two sections having a total of twenty five closed statements Participants were required to rate the statements according to a five point Likert scale. The response rate was ninety percent with only thirty six participants returning completed questionnaires. The data was analyzed using the Statistical Program for Social Science (SPSS) version 22. The findings indicated that support staff had a positive perception of PMDS compared to clinical staff. This correlated to a congruent perceived effectiveness of PMDS. In addition both support and clinical staff viewed PMDS as not working well, demotivating and needing change. Results showed that 41.67% of participants disagreed to feeling motivated after PMDS reviews, 50% disagreed that PMDS works well, 44.44% disagreed that PMDS did not need to change, 58.33% disagreed that participating in PMDS for the money while 66.67% of participants agreed that the expected outcomes are aligned to the organizations vision, mission and core values, 55.56% agreed that PMDS helps achieve the organization’s goal and 69.45% agreed that PMDS informs areas for development. Recommendations included providing of non-financial rewards and measures to increase interpersonal relationships were therefore recommended. Key Words: Employee Perceptions, Performance Management, Radiology, Public Hospital, Organizations, Participants, Relationships, Motivation


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Introduction In 2002, the Department of Public Service and Administration introduced the performance management and development system (PMDS). The aim of the system was to ensure accountability of performance. Ten years on, the premier of Gauteng stated “the management of poor performance remains a key challenge in the Public Service. Factors that contribute to this include work culture issues, person-to-person mismatch, lack of skills, lack of performance standards, and a failure to implement the Performance Management and Development System properly”(Mokonyane, 2012:1). This research attempts to establish the effectiveness of the current performance management system by focusing on the perception of performance management by clinical and support staff at the Department of Radiology in a public hospital in Gauteng. In this chapter, the background to the problem, research problem, and aim of the study, research objectives, research questions, hypotheses, study significance and the study format will be discussed.

Research Objectives • To investigate the perceptions of the clinical staff on performance management at the Department of Radiology • To investigate the perceptions of the support staff on performance management at the Department of Radiology • To assess the effectiveness of the performance management system • To provide recommendations to the management of the hospital and the health sector at large

LITERATURE REVIEW

Definition of Terms The terms performance management and perception will be defined before examining the performance management process.

Performance Management The Institute of Personnel Management in 1992 cited in Bhattacharyya (2011: 8) defined performance management as “a strategy which relates to every activity of the organisation set in the context of its human resources policies, culture, and style and communication systems. The nature of the strategy depends on the organisational context and can vary from organisation to organisation”. In addition Nel, Werner, Haasbroek, Poisat, Sono and Shultz (2009:493) mention that performance management is a holistic approach while Armstrong and Baron (2010:7) argue that performance management is imprecise and can only be defined in very broad terms. Armstrong and Baron (2010:7) further define performance management as a strategic and integrated approach to delivering sustained success to an organisation.

Perception Kuk, Banning and Amey (2010:87) state that perception is a fundamental attribute of each individual and it is the way in which one organises and attributes properties and characteristics and attribute cause and effect to it. Perception is a set of processes by which an individual regards, understands, or interprets information about the environment (Griffin and Moorhead, 2013:75).


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Robbins, Judge, Odendaal and Roodt (2009:119) explain that employees’ behaviour is based on perception of the reality and maybe influenced by the perceivers’ attitudes, motives, interests, experience and expectations, factors in the situation that is the work setting, social setting and time and factors in the target that is novelty, motion, sounds, size, background, proximity and similarity.

Performance Management Systems Performance management began as simple applications of laboratory research results in experimental analysis of behaviour and applied behaviour to various organisations and evolved parallel to developments in the experimental analysis of behaviour, applied behaviour analysis, behavioural economics and verbal behaviour (Johnson, Redman and Mawhinney, 2005:8). Now, according to Aguinis (2014:18-22), the ideal performance management system must have strategic and contextual congruency, thoroughness, practicality, meaningfulness, specificity, identification of effective and ineffective performance, reliability, validity, acceptability and fairness, inclusiveness, openness, correctability, standardisation and ethicality. • Tell and Listen: manager expresses the identified weakness and allows the employee to discuss their opinions • Problem Solving: incorporates, listening, accepting, responding as well as developmental of the employee Rothman and Cooper ( 2013:204-205) note for an effective appraisal interview, there should be structured, controlled, the interviewer must establish and maintain rapport, remain calm, ask appropriate questions to obtain meaning information, provide feedback, resolve conflict, develop and motivate the employee. Problems that are experienced in appraisal interviews are the feeling of playing God, inability to give criticism, personality bias and inability to give feedback (Grobler et al., 2011:327-328) Rothman and Cooper (2013:203) note that research indicates the effects of performance appraisal interviews as:

Greater employee uncertainty after the interview Employees evaluate managers less favourably

RESEARCH METHODOLOGY

Target population and Sample Gomez and Jones (2010:78) state that the target population is a group possessing similar defining characteristics important for scientific query. The target population of this study was the clinical and support staff of the Department of Radiology at a Gauteng public hospital. The defining characteristic is that the population is employed at the same hospital in the same department. Clinical staff is the health professionals including radiographers, radiologists, nurses and ultrasonographers. Support staff includes the porters, cleaners and administrative clerks. At the time of the study the target population was forty three employees of this department. The sample according to Sekaran and Bougie (2010: 262) is the subset of the population. Gerrish and Lacey (2010:147-148) note that eighty to ninety percent sample rate of the population reduces errors. Therefore considering the size of the population ninety three percent of the population was sampled. The sample included all forty staff members of the Department of Radiology at the Gauteng public hospital.


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Sampling Strategy The sampling method used was the purposive sampling method. Trochim (2009: 58) describes purposive sampling as seeking for one or more predefined groups. Gerrish and Lacey (2010:149) mention that purposive sampling has over-representation of people in interest of the study forming rich sources of data. The study was interested in the Department of Radiology employees’ perception of performance management; therefore purposive sampling allowed rich data sampling of the area of interest. The sample includes all of the target population which consists of: 5 Consultant Radiologists 5 Registrar Radiologists 5 Cleaners 5 Porters 5 Administrative clerks 1 Enrolled nurse 2 Ultra sonographers 1 Assistant Director 2 Supervisory Radiographers

Limitations of the Research The research was conducted only in the Department of Radiography at the public hospital. The number of staff employed here is limited and may not afford generalisability. Furthermore, Leatherman (2008:261) mentions that perception questionnaires may lead an employee to identify needs which may in fact be only a perception of that need and not a real need.

RESULTS, DISCUSSION AND INTERPRETATION OF FINDINGS For the research was collected through questionnaires containing statements where

Response Rate Forty questionnaires were administered to the Department of Radiology employees. The response rate was 90% as 36 out 40 completed questionnaires were returned.

Demographics Participants were asked to indicate their category by either choosing clinical or support staff depending on which category they belong to.


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Figure 4.1 Clinical and Support Staff participating in the Study

Figure 4.1 above indicates that 63.89% of the participants were clinical staff and 36.11% were support staff.

Perception of Performance Management and Development System Section 1 of the questionnaire asked participants to rate 20 statements that evaluated the employee perception of performance management in the organisation under study. The scale rating was: 1 - Strongly agree 2 - Agree 3 - Neutral/don’t know 4 - Disagree 5 - Strongly Disagree. The statements in this section were adapted from Armstrong and Baron (2010:199-202).

The Performance Management and Development System helps me to do my job better Figure 4.2: PMDS helps me do my job better

Figure 4.2 above shows that 22.22% of employees strongly agreed with the statement, 11.11% strongly disagreed with the statement, 27.78% agreed and 33.33% disagreed indicating that the majority of participants agree that PMDS helps to their job better. In Armstrong and Baron (2009:202) only 7% strongly disagreed with the statement. Paile’s (2012:67) study of staff perceptions of PMDS at the Gauteng Department of Social Development, indicates that majority of


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respondents understood that the purpose of performance management was to improve their performance.

The Performance Management and Development System helps me to develop my potential Figure 4.3: PMDS helps me to develop my potential

As shown in figure 4.3 above, 27.78% of the participants agreed with the statement that PMDS helps develop their potential and 27.78% disagree. However 19.44% strongly agreed as opposed to 13.8% that strongly disagreed. Therefore majority of the participants fall in the upper quarter of the scale of agreement percentages. These findings are in keeping with Armstrong and Baron (2009:202) and Aguinis (2014: 14-18) statement that one of the purposes of performance management is development.

I receive useful feedback from my Performance Management and Development System review Figure 4.4: I receive useful feedback from my PMDS review

Figure 4.4 above indicates that the largest percentage of ratings fell in the category that disagreed at 38.89%, followed by 25% of participants that agreed with the statement. However, considering that a larger rating is in the last quarter of the percentage scale there is a larger disagreement with the statement. Similar findings where documented by Letsoalo (2007:91) where 71% indicated no feedback was given from supervisors. These findings differ from Armstrong and Baron (2009:202) where 42% of participants slightly agreed with the statement. These findings are further at odds with


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the multitude of methods used to appraise performance where feedback forms an integral part of the development process (Venclová et al., 2013:24-25; Bhattacharyya, 2011: 61-65; Khurana, Khurana and Sharma, 2010:115; Lussier, 2012:255).

The Performance Management and Development System is a two way process, with both parties expressing their views Figure 4.5: PMDS is a two way process, with both parties expressing their views

Figure 4.5 above indicates that 38.89% of participants agreed and 16.67% strongly agreed that PMDS is a two-way process, with both parties expressing their view. 22.22% disagreed and 8.33% strongly disagreed with the statement while 13.89% indicated a neutral/don’t know response. The majority of participants agreed with this statement, in keeping with Armstrong and Baron (2009:199) findings and Scott-Lennon and Barry’s (2008:7-54) DEFT model of performance management, the core requirement being honest and meaningful dialogue between the manager and the employee.

I am satisfied with the way my manager conducts my Performance Management and Development System Figure 4.6: I am satisfied with the way my manager conducts my PMDS

Figure 4.6 above indicates that 19.44% strongly agreed and 36.11% of participants agreed with the statement while 25.00% disagreed and 8.33% disagreed. 11.11% responses were neutral/don’t know. Majority of the participants are satisfied with the way the manager conducts their PMDS. Russell


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and Russell (2009:10-16) mention that buy in and satisfaction alludes to a change in mind set, this change in mind set is a prerequisite for great performance management.

Assessments of my performance are consistently fair Figure 4.7: Assessments of my performance are consistently fair

Figure 4.7 above indicates that 13.89% of participants strongly agreed and 44.44% agreed that assessments of their performance are consistently fair while 25.00% disagreed and 5.56% strongly disagreed. 11.11% responses were neutral/don’t know. The majority of participants agreed that assessment of their performance is consistently fair. The rater errors as identified by Aguinis (2009: 163-164), Mathis and Jackson (2010:346-349), Grote (2011:104) and Wilson, Bennett, Gibson and Alliger (2012:433) may be inferred as minimal with more that 50% of the participants rating in the upper quarter of the percentage scale.

I feel motivated after my Performance Management and Development System review Figure 4.8: I feel motivated after my PMDS review

Figure 4.8 above indicates that 30.56% of participants disagreed with the statement while 25% agreed, however on either side of the neutral/ don’t know scale 41.67% of participants were in agreement and the same percentage represented was for those who were not in agreement. Rothman and Cooper (2013:203) indicate that the effects of an appraisal interview maybe greater uncertainty and less favourable manager evaluation. Further indicated in Xipu’s (2010:65) study respondents


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were not motivated because feedback was given only during performance reviews and there was a lack of objectivity. Armstrong and Baron (2009:202) found that 58% of the participants did feel motivated after performance management review. Notable is that motivation is identified as one of the determinants of performance by Aguinis (2014:89).

Time spent on performance management is worthwhile Figure 4.9: Time spent on performance management is worthwhile

Figure 4.9 above indicates that 19.44% participants strongly agreed and 30.56% agreed that time spent on performance management was worthwhile while 19.44% disagreed, 13.89% strongly disagreed and 16.67% indicated neutral/don’t know. The majority of participants fall in the agreement rating of the statement in keeping with Armstrong and Baron (2009:202). Aguinis (2014:18) notes that the perception that performance management is time consuming may hinder its’ implementation. With a greater majority of participants perceiving performance management as worthwhile in the study, this factor may be therefore considered as less of a hindrance to the implementation of performance management.

I understand how my manager decides on my score Figure 4.10: I understand how my manager decides on my score


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Figure 4.10 above indicates that 11.11% of participants strongly agreed, 38.89% agreed, 25% disagreed and 8.33% disagreed with understanding how the manager decides on their score. The results also show that 16.67% of the participants indicated neutral/don’t know. The majority of participants agreed with the statement, in keeping with Armstrong and Baron’s (2009:202) findings. This majority agreement differs with Coen and Jenkins (2010: viii-x) statement that performance management undermines the openness that development requires and with academics cited in the literature review 2.11 viewing performance management as problematic because of one person’s opinion of another’s performance. In addition the participants agreeing with understanding the scoring indicate understanding of the method used to appraise performance.

Managers give the best score to everyone Figure 4.11: Managers give the best score to everyone

Figure 4.11 indicates that 2.78% of participants strongly agreed, 13.89% agreed, 33.33% disagreed and 13.89% strongly disagreed that managers give the best score to everyone. The results also show that 36.11% of participants rated the statement Neutral/don’t know, the “don’t know” portion of the rating is in discord with the previous statement, statement 10, and where majority of participants agreed that there understood of the scoring process. Brace (2013:61) explains that the use of neutral rating option in a questionnaire may increase the number of neutral responses. However, 47.22% of responses fall into the disagreement section of the percentage scale. This disagreement reduces the effect of leniency or may tend to strictness/severity as identified by Aguinis (2009: 163-164), Mathis and Jackson (2010:346-349), Grote (2011:104) and Wilson, Bennett, Gibson and Alliger (2012:433) common rater errors. In addition pusillanimity as identified by Armstrong and Baron (2010: 86-100) may be also ruled out.


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The Performance Management and Development System works well Figure 4.12: PMDS works well

Figure 4.12 indicates that 13.89% of participants strongly agreed, 27.78% agreed and 33.33% disagreed and 16.67% strongly disagreed that PMDS works well. The majority of participants disagreed that PMDS works well. These findings concur with Armstrong and Baron (2009:202) where majority where 72% of respondents choose to disagree that performance management works well and with Rajeev (2014:1) mentioning university teachers incensed by the management of their performance. Holpp (2012:5) and Gordon and Miller (2012:17) mention that the choice of performance management system must best fit the organisation to yield optimal results. These findings oppose Hafiz et al (2009:484) whose study found performance management to be effective.

The Performance Management and Development System does not need to change Figure 4.13: PMDS does not need to change

Figure 4.13 above indicates that 16.67% of participants strongly agreed, 19.44% agreed, 25% disagree and 19.44% strongly disagreed that PMDS does not need to change. This infers that 44.44% of participants agreed that PMDS does need to change. This finding is in keeping with responses for statement 11 with a majority of participants disagreeing that PMDS works well. Grobler et al. (2011:294) agree that research in South Africa shows a problematic performance management system. Letsoalo’s (2007:90) study indicated that majority of responses were negative attitude


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towards PMDS. Juxtaposingly, Paile (2012:67) notes that majority of the respondents agreed to the effectiveness of PMDS.

I have received adequate training in the Performance Management and Development System Figure 4.14: I have received adequate training in PMDS

Figure 4.14 indicates that 13.89% of participants strongly agreed, 41.67% agreed, 22.22% disagreed and 11.11% strongly disagreed having received adequate training in PMDS. The majority of participants agreed that adequate training for PMDS was given. The findings are in keeping with Paile (2012:71); Armstrong and Baron (2009:202) however differ from Xipu (2010:78) were adequate training was lacking. Letsoalo (2007:83) found that understanding of PMDS was dependent upon salary levels and whether the employee was a supervisor or subordinate. Grote (2011: 6-12) mentions that performance management done well would produce beneficial result the first step of which is training and understanding.

Performance Management and Development System is a way of keeping record of my progress and performance Figure 4.15: PMDS is a way of keeping record of my progress and performance

Figure 4.15 indicates that 19.44% of participants strongly agreed, 44.44% agreed, 19.44% disagreed and 11.11% strongly disagreed that PMDS is a way of keeping record of their progress and performance. Only 5.56% responded neutral/don’t know. The majority of participants agreed with this statement. This is in keeping with transparency, identification of poor and good performance as


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purposes of performance management as identified by Aguinis (2014:14-18); White Paper on Human Resource Management in the Public Service (1997:42); Baloyi (2008:1) and Human Capital Management (2011:7-8). Further the various models mentioned in chapter two, 2.3.3 all concur that performance management must record employee performance and acknowledge employee progress, reward this progress.

The Performance Management and Development System is about me and my long-term development Figure 4.16: PMDS is about me and my long-term development

Figure 4.16 above indicates that 19.44% of participants strongly agreed, 38.89% agreed, 16.67% disagreed and 13.89% strongly disagreed that PMDS is about them and their long-term development. The results also revealed that 11.11% of the respondents chose neutral/don’t know. The majority of participants agreed with the statement, in keeping with Armstrong and Baron’s (2009:199) findings and the ratings given to statement two of the questionnaire. Armstrong and Taylor (2014:17) recognise opportunities for development as one of the factors that engage employees in their work. Aguinis (2014:14-18) does also mention that performance management does have a developmental purpose. Concurringly Human Capital Management (2011:7-8) and Pal (2011:205-206) agree that personal development is a fundamental purpose of performance management.

Performance Management and Development System has no value for me Figure 4.17: PMDS has no value for me

Figure 4.17 above indicates that 5.56% of participants strongly agreed, 25.00% agreed, 38.89% disagreed,13.89% strongly disagreed that PMDS has no value for them and16.67% of the responses


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were neutral/don’t know. The majority of participants disagreed with the statement in congruence with Armstrong and Baron’s (2009:203), Hafiz et al (2009:484) findings and Cardy and Leonard’s (2011:3) statement that performance management is critical. However Xipu (2010: 66) mentions all but one respondent expressed a negative attitude to performance reviews. Xipu (2010:66) findings resonates with Pulakos (2009:3) where only thirty percent of workers valued performance management and other academics in chapter two, 2.11 where performance management is viewed as a “deadly disease”

Performance Management and Development System is about managers assisting people Figure 4.18: PMDS is about managers assisting people

Figure 4.18 above indicates that 8.33% of participants strongly agreed, 47.22% agreed 19.44% disagreed,11.11% strongly disagreed that PMDS is about managers assisting people and 13.89% indicated neutral/don’t know. The majority of the participants agreed with the statement, in keeping with Armstrong and Baron’s (2009:200) findings. Human Capital Management (2011:7-8); Armstrong (2010:259) and Pal (2011: 205-206) mention that performance management purpose is to enhance manager-employee relationship. From Paile’s (2012:75) study 57% of respondents indicated that supervisors motivated subordinates to improve performance.

Performance Management and Development System helps develop my career Figure 4.19: PMDS helps develop my career


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Figure 4.19 above indicates that 13.89% participants strongly agreed, 33.33% agreed, 30.56% disagreed and 13.89% strongly disagreed that PMDS helps develop their careers and8.38% responses were neutral/don’t know. Majority of participants indicated that PMDS helps develop their careers. This is aligned to career progression and planning as purposes of performance management as identified by Human Capital Management (2011:7-8) and Pal (2011: 205-206). Furthermore the findings are in keeping with Armstrong and Baron’s (2009:200) study.

I participate in Performance Management and Development System for the extra money Figure 4.20: I participate in PMDS for the extra money

Figure 4.20 indicates that 11.11% of participants strongly agreed, 19.44% agreed, 50.00% disagreed and 8.3% strongly disagreed that they participate in PMDS for the money. The majority of participants disagreed with the statement. These findings concur with Armstrong and Baron’s (2009:199) study and with Armstrong’s (2012:36) literation that an effective performance management process should provide non-financial rewards which has a more powerful long lasting impact than financial reward systems. Financial rewards then become the very reason for engaging in performance management. Despite the fact that the reward of the current performance management system, PMDS, is primarily financial, the majority of respondents disagree, that their participation in the system, is for money.

The Most Important Thing About my job is the Pay Figure 4.21: The most important thing about my job is the pay


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Figure 4.21 indicates that 5.56% of the participants strongly agreed, 22.22% agreed, 52.78% disagreed,5.56% strongly disagreed that the most important part of their job was the money and13.89% responded neutral/don’t know. The majority of respondents disagreed that the most important part of their job was the pay. This concurs with Armstrong and Baron’s (2009:200) findings and when Armstrong (2012:36) notes that non-financial rewards have a greater impact than financial rewards. Bateman and Snell (2009:477) concur that non-financial rewards motivate employees when pay and progression opportunities are limited. The high percentage of disagreement that pay is the most important part of the job may also be attributed to the intrinsic and altruistic motivation of health care workers (Friederike, 2009:6).

Effectiveness of the Performance Management and Development System Five statements formulated using literature review on the purpose of performance management evaluated the effectiveness of PMDS. Participants rated the statements from strongly agree to strongly disagree on a five point scale. The scale rating was: 1 - Strongly agree 2 - Agree 3 - Neutral/don’t know 4 - Disagree 5 - Strongly Disagree The data collected is analysed below.

4.5.1 My Expected Outcomes are aligned to the Organisations Vision, Mission and Core Values Figure 4.22: My expected outcomes are aligned to the organisations vision, mission and core values

Figure 4.22 above indicates that 16.67% participants strongly agreed, 50.00% agreed, 11.11% disagreed, 5.56% strongly disagreed that their expected outcomes are aligned to the organisations vision, mission and core values and16.67% indicated neutral/don’t know. The majority of respondents agreed that the expected outcomes are aligned to the organisations vision, mission and core values. These findings concur with literature that performance management depends on organisational context, and the organisation’s mission, objectives and core values are prerequisites for performance management (Aguinis, 2014:38). Russell and Russell’s (2009:10-16) reiterate the importance of defining the performer’s purpose in terms of benefit to the organisation, customers and the team, in the “great” performance management cycle.


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The Performance Management and Development System helps achieve the goals of the organisation Figure 4.23: PMDS helps achieve the goals of the organisation

Figure 4.23 above indicates that 13.89% of the participants strongly agreed, 41.67% agreed, 16.67% disagreed, 11.11% strongly disagreed that PMDS helps achieve the organisations goals and16.67 indicated neutral/don’t know. The majority of participants agree that PMDS helps achieve the goals of the organisation. These findings concur with the purpose of performance management to link with organisational goals (Aguinis, 2014:14-18).

The Performance Management and Development System informs workplace planning Figure 4.24: PMDS informs workplace planning

Figure 4.24 indicates that 2.78% of participants strongly agreed, 55.56% agreed, 25.00% disagreed and 11.11% strongly disagreed that PMDS informs workplace planning. The figure also shows that 5.56% indicated neutral/don’t know. The majority of respondents agreed that PMDS informs workplace planning. Aguinis (2014:14-18) notes organisational maintenance, where performance management informs planning and allocation of human resources, as one of the purposes of performance management.


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The Performance Management and Development System informs allocation of human resources Figure 4.25: PMDS informs allocation of human resources

Figure 4.25 above indicates that 5.56% of participants strongly agreed, 44.44% agreed, 33.33% disagreed and 5.56% strongly disagreed that PMDS informs allocation of human resources. The results also show that 11.11% indicated neutral/don’t know. The majority of participants agreed that PMDS informs allocation of human resources. These findings are in keeping with Aguinis (2014:14-18) statement that allocation of human resources one of the purposes of performance management.

The Performance Management and Development System informs areas for development Figure 4.26: PMDS informs areas for development

Figure 4.26 indicates that 16.67% of participants strongly agreed, 52.78% agreed, 19.44% disagreed and 5.56% strongly disagreed that PMDS informs areas for development. The figure also shoes that 5.56% indicated neutral/don’t know. The majority of respondents agreed that PMDS informs areas for development. These findings concur with statement 2 and 19 where participants agreed that PMDS helps in their development and career development. Aguinis (2014:14-18) notes that performance management has a developmental purpose. Human Capital Management (2011:7-8) agree that career progression and personal development are purposes of performance management.

Inferential Statistics Spatz (2011:3), (Mendenhall, Beaver and Beaver, 2013:4) notes that inferential statistics considers chance factors when inferring data obtained from the sample to the population. McKenzie (2014:43)


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elaborates further noting that inferential statistics, is a logical, scientific use of accepted statistical methodology and principles to inform generalisations, predictions, estimates, reasoning or decisions about a population from sample data. 90% of the population was sampled and according to Gerrish and Lacey (2010:147-148) reduces errors in inference.

Single Sample Chi-Square Analysis Single Sample Chi-Square analysis is used in this study to compare the data obtained from the two categories of staff. The literature reviewed on motivation of health workers( chapter two, 2.10) infers that the current PMDS maybe not be perceived as effective because it is primarily a financially rewarding system (Friederike, 2009:1; Mutale, Ayles, Bond, Mwanamwenge and Balabanova, 2013: 1). In addition Paile (2012:85) study found that the perception of performance management differs between the “lowest” and “those higher up in the hierarchy” A series of Single Sample Chi-Square analyses were conducted to determine if there were significant differences between the responses of the participants’ across the categories that were assessed in each of the particular questions within the Section 1: Perception of Performance Management and Development System and Section 2: Effectiveness of the Performance Management and Development System portion of the questionnaire. The results for each of the Single Sample Chi-Square tests are presented below in Table 4.1. For each question that was examined, the null hypothesis tested was that there would not be a significant difference between the response frequencies across each of the categories. A p-value below 0.05 denotes a rejection of the null hypothesis and a significantly greater number of responses across one or more categories as compared to the others. Except for the Section 1: Perception of Performance Management and Development System questions 2, 5, 7, 8, 11, 12, 15, and 18, which did not evidence statistically significant differences between the frequencies of the responses per question category, the remaining questions were significantly different in the response frequencies for each category within each question. The statements which participants greatly disagreed with include, feeling motivated after PMDS review, PMDS works well and PMDS does not need to change. These findings are keeping Armstrong and Baron’s findings (2009:199-202). A reason for this response may be answered by Lewis, Passmore and Cantore (2011:16-17), noting, that constructive feedback induces negative reactions which often forms the propellant for change, however over time, this may have severe and long term effects. Employees would decrease innovation, volunteering and risk taking in order to ensure self-preservation and blame avoidance. The feedback given during performance management may create emotions that greatly inform the results of these statements. The statements which were in agreement that is, satisfaction with the way manager conducts PMDS and PMDS assisting with development, is in keeping with the findings of Armstrong and Baron (2009:199-200) and the purpose of performance management as stated by Aguinis (2014:14-18). The statements that evidenced statically different ratings could be explained by the different motivating factors of clinical and support staff. The determinants of performance according to Aguinis (2014:89) are motivation, declarative and procedural knowledge. As discussed in the literature, prior to health workers commencing work, stringent training measures are enforced by the


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Health professionals Council of South Africa to ensure declarative and procedural knowledge. Continually basing clinical staff performance management on behavioural criteria may create a sense of micro management. In addition clinical staff joins their profession for altruistic reasons (Friederike, 2009:6), work itself becomes the motivator as opposed to fulfilling biological and social needs according to Hull’s drive reduction theory and the Cognitive Evaluation Theory warns that excessive extrinsic rewards may decrease intrinsic motivation levels. PMDS is primarily a financially rewarding system. Therefore the performance management strategy used for different category of staff has to be considered. Considering the clinical and support staff category, and following ERG theory, each of these categories of staff members maybe at different levels of need. Therefore different performance management strategies must be employed in order for the process to be deemed effective (Kandula, 2011:19). A cleaner or porter earn considerably less that clinical staff and may in fact see the financial performance rewards as attractive. According to Vroom’s Valence-Expectancy Instrumentality Theory, connecting the outcome and reward attractiveness will likelihood increase the desire to achieve the outcome inferring an improved performance (Armstrong, 2009:38). Paile (2012:70-71) further arguably notes, that if using the example of a cleaner, Can the cleaner provide proof that their cleaning is above average? Erbasi et al. (2012:1) concurs with findings that income level and education status had a significant effect on employee attitude to performance management. In addition, the support staffs at the department has a lower education status than clinical staff hence their perceptions according Erbasi et al (2012:1) may differ from the higher educated clinical staff. Nzuve and Njeru (2013:59) note integration of knowledge, skills, experience and perspectives of a variety of employees is vital to the success of performance management. Table 4.1 - Chi-Square Results for Questionnaire Items Variable Statistics

x2 Df P

Perception of PMDS

Question 1 9.556 4 .049

Question 2 4.278 4 .370

Question 3 10.389 4 .034

Question 4 9.833 4 .043

Question 5 9.000 4 .061

Question 6 17.056 4 .002

Question 7 4.278 4 .370

Question 8 2.889 4 .577

Question 9 10.944 4 .027

Question 10 14.556 4 .006

Question 11 7.611 4 .107


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Question 12 .667 4 .955

Question 13 12.056 4 .017

Question 14 15.944 4 .003

Question 15 8.722 4 .068

Question 16 11.500 4 .021

Question 17 17.889 4 .001

Question 18 9.000 4 .061

Question 19 21.500 4 < .001

Question 20 27.611 4 < .001

Effectiveness of PMDS

Question 1 21.778 4 < .001

Question 2 10.944 4 .027

Question 3 33.722 4 < .001

Question 4 22.889 4 < .001

Question 5 27.056 4 < .001

Correlational Analysis The following variables were generated and were used to calculate the subsequent Pearson correlations. A variable, Perception of Performance Management and Development System, was created from combining the Section 1: Perception of Performance Management and Development System questions 1 to 20. The Effectiveness of the Performance Management and Development System variable was developed from summating the Section 2: Effectiveness of the Performance Management and Development System questions 1 to 5. Prior to computing the Perception of the Performance Management and Development System variable, Section 1: Perception of the Performance Management and Development System questions 16, 19, and 20 was reverse scored to coincide with the directional trend of the questions in the section. The Pearson correlation between Perception of Performance Management and Development System (M = 63.11, SD = 18.21) and Effectiveness of the Performance Management and Development System (M = 16.72, SD = 5.26) was positive and statistically significant, r = .761, p < .001. This indicates that perceptions of the performance management and development system have a strong positive relationship with the perceived effectiveness of the performance management and development system. In other words, more positive perceptions of the performance management and development system are associated with higher perceived levels of effectiveness of the performance management and development system. Letsoalo (2007:101), Monis and Sreedhara (2010: 215-224), Xipu (2010:72), Paile (2012: 85) and Nzuve and Njeru (2013:67) all concur with these findings. Kuk et al (2010:87)


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attribution of cause and effect to properties and characteristics may explain the positive perception of performance management affecting the higher perceived levels of effectiveness. Porter-Lawler Model (Armstrong, 2009:38) explains that facilitating correct job perceptions and aligning rewards will ensure a sharp association between performance and satisfaction. Mone and London (2010:42) explains that employee perception, which may or may not match reality, ultimately determines the success of the organisations performance management system. Cardy and Leonard (2011:4) notes that negative perceptions of the performance management may result in distrust, slowdowns, sabotage and grievances about the performance management system. Therefore to ensure perceived higher levels of effectiveness, employee perception of the performance management must be positive. Mone and London (2010:42) does advise that increased employee engagement is based on perceptions of power differences, trusting behavior, process, procedures, expectations, managerial trustworthy behaviors and individual propensities.

Independent Samples T-test for Perception of Performance Management and Development System An independent samples t-test was calculated with position of employment as the grouping variable and perception of performance management and development system as the dependent variable. The result indicated a statistically significant difference between the perception of performance management and development system of the support staff (N = 13, M = 72.23, SD = 18.43) and the clinical staff (N = 23, M = 57.96, SD = 16.29), t (34) = 2.409, p = .022. In particular, examining the mean scores of each of the groups, the support staff responded with higher positive perceptions of the performance management and development system as compared to the clinical staff. The reason for these findings include the different motivating factors for clinical and support staff. In addition Erbasi et al (2012:1) note that income level and education status has a significant effect on employee attitude to performance management.

Reliability

Perception of Performance Management and Development System As a measure of internal consistency, Cronbach’s alpha was computed for Section 1: Perception of Performance Management and Development System (PMDS) questions 1 to 20. The finding indicated strong internal consistency and reliability for the Perception of Performance Management and Development System (PMDS) portion of the questionnaire, α = .931.

Effectiveness of the Performance Management and Development System Cronbach’s alpha was computed for Section 2: Effectiveness of the Performance Management and Development System questions 1 to 5. The finding indicated excellent internal consistency and reliability for the Effectiveness of the Performance Management and Development System (PMDS) portion of the questionnaire, α = .949.


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CONCLUSIONS AND RECOMMENDATIONS

Findings from the Literature Review Performance management is defined as an integrated, strategic ongoing process that involves collaboration to achieve the ameliorated performance aligned to the organisations vision, mission and objectives (Nel et al., 2009:493, Armstrong and Baron, 2010:7). The perception of performance management greatly determines the success of its implementation in organisations (Robbins et al., 2009:119; Mone and London, 2010:42). One of the key determinants of performance is motivation. Clinical and support staff in the health establishment, due to education status and income level differ in their motivational drivers. Therefore performance management will be perceived differently by the clinical and support staff (Friederike, 2009:1; Xipu, 2010:72). Any performance management process should begin with the organisations vision, mission, objectives, core values and job analysis in order to satisfy the congruency to organisational context (Cardy and Leonard, 2011:3; Aguinis, 2014:38). There are many models of performance management, however choosing the model that best fits the organisations is imperative to its effectiveness (Holpp, 2012:5; Gordon and Miller, 2012:17). Common aspects of the varying models is the performance is a performance agreement, review, feedback, improving performance and development (Cardy, 2011:45-48; Armstrong, 2009:639; Aguinis, 2014:39). To establish the effectiveness of any performance management system, the question to be asked is: Is the performance management system achieving its purpose. The purpose of performance management includes strategic, administrative, informational, developmental, organisational maintenance and documentation categories. Accountability, expectations of performance, identification of poor and good performance, career progression and development all for parcel of the non-exhaustive purpose of performance management (Baloyi, 2008:1; Armstrong, 2010: 259; Aguinis, 2014:14-18). Performance appraisals are one part of performance management. Methods used to appraise performance vary and again should be selected wisely so as to prevent rater errors (Aguinis, 2009: 163-164); Bhattacharyya, 2011: 61-65; Snell and Bohlander, 2011:358). A structured, controlled and motivating appraisal interview based on ethical principles will ensure a more effective performance management system. (Rothman and Cooper, 2013:203; Armstrong 2010:93). Kandula (2011:15-17) and Armstrong (2009: 38) indicate Maslow’s Hierarchy of Needs Theory, Alderfer’s Existence-Relatedness-Growth (ERG) Theory, Herzberg’s Hygiene-Motivator Factors Theory must be considered when selecting a performance management strategy. Perception of performance management varies from highly effective to diseased (Pulakos, 2009:3; Coen and Jenkins, 2010: viii-x; Guoin, 2011:481). However at the crux is the decision of the performance management system that best fits the organisations. A discussion of the findings from the primary research follows.

Findings from the Primary Research

Clinical and Support Staff Perceptions of Performance Management at the Department of Radiology The primary research showed that 44.44% of participants disagreed that PMDS helps to do their job better, 47.22% agreed that PMDS helps to develop their potential, 50% disagreed that they receive useful feedback from PMDS reviews, 55.56% agreed that PMDS is a two-way process, with both


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parties expressing their views, 55.55% agreed that they are satisfied with the way the manager conducts PMDS 58.33% agreed that assessments of their performance is consistently fair, 41,67% disagreed feeling motivated after PMDS reviews, 50% agreed time spent on performance management is worthwhile, 50% agreed to understanding how managers score, 47.22% disagreed that managers give the best score to everyone, 50% disagreed that PMDS works well, 44.44% disagreed that PMDS does not need to change, 55.56% agreed having received adequate training in PMDS, 63.88% agreed PMDS is a way of keeping record of progress and performance, 58.33% agreed that PMDS is about long-term development, 52.78% disagreed that performance management has no value, 55.55% agreed that PMDS is about managers assisting people, 47.22% agreed PMDS helps develop careers, 58.33 disagreed participating in PMDS for the money, 58.34% disagreed money being the most important part of the job. Please note that where indicating agreed, the percentage is the total sum of strongly agreed and agreed responses and where indicating disagreed, the percentage is the total sum of participants that strongly agreed and agreed to the statements. Eight statements in the questionnaire were answered with no evidence of statistical difference. Clinical staff and support agree that PMDS does help to develop their potential and career, is concerned with their long-term development and are happy with the way the manager conducts the PMDS. Clinical staff and support staff disagree feeling motivated after PMDS; PMDS works well and does not need to change. Seventeen remaining statements evidenced statistical different answers. The perception of the system therefore varies among support and clinical employees.

Effectiveness of the Performance Management System Results indicated that 66.67% of participants agreed that their expected outcomes are aligned to the organization’s vision, mission and core values, 55.56% agreed that PMDS helps achieve the goals of the organization, 58.34% agree that PMDS informs workplace planning, 50% agreed that PMDS informs allocation of human resources and 69.45% agreed that PMDS informs areas for development. Please note that the percentage here is the total sum of participants that indicated strongly agree and agree as responses to the statement. Therefore the majority of the participants agree that PMDS is effective. However, the five statements used to access the effectiveness of the PMDS evidenced statistically different for clinical and support staff. The Pearson correlation between the perception and effectiveness of PMDS indicates that the greater the positive perception of PMDS, the greater the perceived effectiveness of PMDS. Furthermore the Independent Samples T-test indicates that support staff had a higher positive perception that clinical staff. Showing that support staff perceives PMDS to be more effective than support staff.

Conclusions The aim of the research was to investigate the employee perceptions of performance management at the Radiology Department at a public hospital in Gauteng. The research objectives where to investigate the clinical and support staff perceptions and the effectiveness of the performance management in the department. The literature reviewed showed that the varied perceptions of performance management and the findings from the primary research are congruent. Clinical staff have a less positive perception of PMDS hence congruently rate the effectiveness of PMDS. Support staff has a higher positive perception of PMDS and rate the effectiveness of PMDS as being higher. The statements that where statistically similar show that the participants agreed with way PMDS is conducted by the manager and its impact on their development and participants disagreed that


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PMDS works well, is motivating and does not need to change. If participants are not perturbed greatly by the way the managers conduct PMDS and development issues, the question then arises as to why the same participants rate PMDS as not working well, demotivating and needing to change. Lewis et al. (2011:16-17) note that constructive feedback over time may in fact be demotivating and may in fact effect the perception of PMDS Literature on the motivational drivers of the participants provides further insight into the different perception of clinical and support staff. Health workers are found to be altruistic and intrinsically motivated. A financially rewarding performance management system may hinder positive perception and perceived effectiveness of performance management. Majority of participants agreeing that PMDS is effective is incongruent that majority of responses indicate disagreement that PMDS works well and needs to change. Therefore careful selection of the performance management system utilized to yield optimal performance, across all sectors of the population, must be considered.

Recommendations The Department of Radiology of the public hospital should consider the outcomes of this study as a propellant of change for further amelioration of performance. PMDS is a generic tool administered by the public health administrator to ensure accountability. The Department should consider the following recommendations to address the discrepancy in perceptions and perceived effectiveness of PMDS:

Non-financial rewards for clinical staff for example time off to complete research, to attend continuous professional development seminars and to attend international conferences. Respect, interpersonal relationships and job meaningfulness was identified by (George et al., 2013:1) as motivating factors. Regular multi-disciplinary consultations, may diminish inter departmental boundaries and enhance these motivational drivers. Team building activities including both clinical and support staff may increase inter-personal relationships. Feedback sessions focusing on improved performance rather than constructive criticism may ensure a long standing desire to improve

Areas for Further Research The limitations of the study discussed in chapter three, 3.8 indicate that generalisability of the study is limited. The study could be researched using a larger population of health care workers and support staff. The areas of disagreement in this study may further be researched by a qualitative study which would eliminate directing participants to respond to specific statements but rather explore their reasoning for their perceptions and effectiveness of PMDS.

Conclusion PMDS was introduced to ensure accountability of performance. However the perception of PMDS has greatly affected the effectiveness of its intentions. The dissertation consisted of five chapters. Chapter five looked at the conclusions and findings of the study. The findings from the literature review, the primary research, conclusions, areas for further research and recommendations was discussed.


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The research has found that in the Department of Radiology at a Gauteng public hospital, clinical staff has a less positive perception of PMDS as compared to support staff. Motivating drivers for the clinical staff provide reasoning that a financially rewarding PMDS may be ill equipped in remunerating the altruistic and intrinsic motivational drivers of clinical staff. In addition feedback continually based on constructive criticism may lead to self-preservation and the avoidance of blame. The recommendations include providing non-financial rewards, focus on areas of achievement and enhancing inter-personal relationships. The research concludes that alignment of a performance management system must be inclusive of all categories of staff.

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