Performance Evaluation of Laboratory Staff

Part of the compliance under JCI Standard (SQE.3 & SQE.11) is to have a performance evaluation of staff annually to assess their competency and ensure patient safety. Below is a sample template for performance evaluation

To prevent any bias, any score below 3 should be supported by a document why such score was given to a laboratory staff. The evaluator should also note the number of correct behavior or competencies that the laboratory staff has provided that would invalidate any wrongdoing except of course when the action compromises patient safety. 

I.D. No.	FULL NAME		POSITION
COVERAGE PERIOD:			CONTRACT DATE:

 

Score	Equivalent	Interpretation
5	Excellent (E)	Demonstrates excellence in the expectation and/or requirements of the competency
4	Very Good (VG)	Meets the expectations and/or requirements of the competency
3	Good (G)	Has identified knowledge, skill and attitudes for the required competency
2	Fair (F)	Needs improvement on the knowledge and skills to meet the required competency
1	Poor (P)	Requires education and/or orientation to meet the expectations and/or requirements of the competency

 

No.	C O M P E T E N C I E S	E	VG	G	F	P	N/A
1	Correctly and independently performs cross–matching and ABO Typing and confident with the result
2	Correctly identifies parasite in urine or stool or blood sample
3	Correctly reads antibiotic sensitivity from agar plate
4	Correctly classifies different White Blood Cell on peripheral smear or presence in urine or stool or CSF samples
5	Correctly identifies abnormal Red Blood Cell on peripheral smear or presence in urine or stool or CSF samples
6	Correctly interprets hematocrit value and can preempt the need for blood transfusion
7	Correctly identifies cut–off limit for Viral Markers and can proceed with the precautionary steps and report
8	Correctly identifies vein for extraction
9	Collect blood samples using appropriate container
10	Correctly identifies quality & quantity of sample for processing and informs concerned parties if repeat collection is necessary
11	Correctly instruct the patient of preparations prior to specimen collection (e.g. urine, stool, FBS)
12	Practices aseptic technique in performing venipuncture
13	Applies post-extraction care for patient and can identify patient needs during adverse reaction.
14	Processes samples to meet the required turnaround time
15	Identifies patient correctly prior to blood collection
16	Appropriately ask question (such as NPO, medications, etc.) from patient prior to specimen collection
17	Correctly preserves specimen as needed using the correct technique/solution
18	Advises the patient of the expected availability of result
19	Releases report within the turnaround time
20	Knows how to identify erratic results and can identify the source of error
21	Relays panic result in a timely manner
22	Correctly charges/bill patient for requested examination
23	Performs machine calibration prior to use
24	Performs basic troubleshooting of machine when guided or instructed by a Biomedical Technician
25	Archives quality control charts for future reference and applies/calls for corrective measures when needed
26	Orderly documents all Lab results for easy access and reference
27	Properly disposes sharp materials to appropriate container
28	Properly disposes specimen/materials to an appropriate color–coded bags
29	Stores reagents/supplies on appropriate room/temperature
30	Endorses specimen after cut-off to the next shift
31	Endorses pending samples after end of shift
32	Requests supplies upon reaching PAR level
33	Declutters area after end of shift
34	Adherence to Universal Safety Precaution (wearing of gloves and mask)
35	Stays on assigned post during duty hours
36	Adheres to assigned schedules and punctually comes to work
37	Polite and courteous when dealing with patient
38	Polite and courteous when dealing with Physicians
39	Polite and courteous when dealing with Colleagues
40	Attends huddle to discuss pertinent laboratory issues
41	Comes to work wearing appropriate clothes
	TOTAL ITEMS
	MULTIPLIER	x 5	x 4	x 3	x 2	x 1
	TOTAL SCORE (NUMERATOR)
	CALCULATIONS			x 100		%
		205

 

95 % to 100 %	80% to 94%	60% to 79%	50% to 59%	49% Below
Excellent	Very Satisfactory	Satisfactory	Needs Improvement	Unsatisfactory

Employee’s Name & Signature	Evaluator’s Name & Signature

 

Recommended Action:

□ Retain for Contract Renewal / Continuation

□ For Repeat Evaluation after 3 months

□ Not Eligible for Contract Renewal

 

Human Resource Manager Signature

Recommended Action: □ Eligible for ____ % Salary Increment □ Not eligible for Salary Increment □ Transfer to Another Unit/Department □ Termination of Contract □ Others: __________________