Complete this section of the form when evaluating job performance

Employee Name
Overall Performance Rating
Business Unit/Department / Total Score
Type of Evaluation: Annual Supplemental / Position Behaviors Score
Evaluation Period: from _____ to ______ / Position Duties Score
Total Score / 0.00
The following ratings are used to score the employee’s performance in Position Behaviors and Duties.
0, 1, 2, 3, 4
REFER TO PERFORMANCE RATING DEFINITIONS / (Multiply Total Score times 100 if not using whole numbers)
Overall Performance Rating
At least 100 points MUST be obtained from the Position Behaviors Score. A Total Score of 200 or greater qualifies the employee to participate in the Scripps Salary Program / 0


My signature indicates that the contents of this document were discussed with me and I was given the opportunity to make written comments. It does not necessarily imply that I agree with this evaluation.

Employee / Date / Evaluator / Date
Check One:
Director (If Applicable) / Date / Self
Supervisor / Customer
Peer / Other


Include only the “Essential Functions” of the position and related performance standards. Essential functions and standards should reflect Scripps’ mission, goals and commitment to quality patient care and operational efficiencies.

Title: / Dir, Systemwide Emergency Management / Reports to: / Chief Medical Officer
Date: / 3/29/04 / X Written Revised
Approved by:
Original Signed by / Date
I. / POSITION SUMMARY (Scope/Purpose): Under the general direction of the Chief Medical Officer, has twenty-four hour responsibility for systemwide emergency management. Identifies, evaluates and establishes planning, development and implementation of strategies for systemwide emergency preparedness. Provides administrative expertise in management of the complex aspects of the integration of emergency preparedness within the healthcare organization. Develops and maintains relationships with affiliated regional, state and national emergency management community.
II. / POSITION QUALIFICATIONS AND REQUIREMENTS: List the minimum qualifications/requirements necessary to adequately perform this position.
Experience/Specialized Skills: Minimum five years recent progressive leadership and management experience in a a healthcare organization. Working knowledge of current strategies (including performance improvement processes) and concepts regarding related planning, operations, collaboration with or development of educational training and research in emergency management.
Requires excellent skills in written and verbal communication, complex problem solving abilities, team development, planning and follow-through.
Understands the fundamentals of information systems and working knowledge of computer use and concepts.
Required Education/Course(s)/Training: Baccalaureate degree in related field preferred. Master of Science in health related field preferred.
Required Certification/Registration: Maintains current licensure and current certification in specialty area preferred
Impact of Decisions: Impact to Healthcare systems emergency management response capabilities
Internal/External Contacts: Internal contacts include patients, visitors, physicians, healthcare staff, regional, state and local emergency management community.
Supervision Given/Received: Receives minimal supervision from Chief Medical Officer and Administrator
Job-Specific Safety Rules: Refer to attached Job Specific Safety Rules.
Physical Requirements: Refer to attached Physical Requirements for the Job Classification.
IV. / AGE OF PATIENTS SERVED: Patient population served is identified in departmental Scope of Service. Age specific competency is documented on unit/role specific competency assessment form.


This Position Description/Performance Evaluation includes the “Essential Functions” of the position and the performance standards associated with the functions. This description is not exhaustive and may be modified on a temporary or regular basis at the discretion of Scripps. Scripps expects that its employees will need to assume other “Non-Essential Functions” not listed herein which support company business objectives; this may include duties which fall outside of normal position scope.

V.POSITION BEHAVIORS: Behaviors represent 50% of the Overall Performance Score. The following behaviors contribute to the organization’s and department’s mission, vision and values. Listed behaviors must be demonstrated 100% of the time. Evaluator must provide a comment when the employee’s performance falls below or exceeds the standard.
Position Behaviors: use one of the following ratings to indicate the employee’s performance.
0, 1, 2, 3, 4 (Refer to Performance Rating Definition) /


/ Rating / Score
A.Behaviors proactively support quality & performance improvement efforts within the organization.
 Identifies problems with patients care and/or work processes and utilizes continuous quality improvement tools and techniques to implement improvements.
 Maintains quality control programs and ensures that staff are trained in, understand and practice continuous quality improvement techniques and tools.
 Completes problem-solving cycle from identification to resolution so as to maximize opportunities and minimize problems
 Initiates and participates in business unit/department based projects or teams which support the CQI efforts of the operations and Scripps business goals.
 / 7% / 0 / 0.00
Measurement: Participates in at least two projects or team efforts per year. Leadership observation.
B. Behaviors demonstrate understanding and appropriate utilization of resources (i.e., materials, financial, etc.).
 Prepares and/or participates in the budget process, involving others as appropriate.
 Manages labor, supply and service budgets to ensure cost containment and efficient utilization of resources.
 Allocates and utilizes staff, equipment and supplies so that time, energy and/or financial resources are expended in the most effective and efficient manner.
 Demonstrates flexibility and willingness to support the changing needs and priorities of the organization.
 Collaborates with others to consolidate, streamline, conserve and maximize resources.
 / 7% / 0 / 0.00
Measurement: Leadership (Peer, Director, Administration) observation and verification.
C.Behaviors demonstrate management and administrative abilities.
 Develops short and long range goals and objectives that are realistic and compatible with the Mission, Vision and Values of Scripps and educates staff regarding their role in achieving the goals.
 Identifies contingency plans that support the attainment of goals and initiatives.
 Plans, organizes and manages projects of varying size and complexity to achieve desired outcomes within established timeframes.
 Develops, implements and communicates policies and procedures that guide and support the assigned area(s).
 Implements and monitors recruitment and selection processes that result in high quality staff and acceptable retention rates.
 Identifies employee training and developmental needs and effectively mentors, supports and counsels staff to ensure optimal performance, productivity and competency.
 Delegates work assignments to staff and other resources ensuring the accuracy, timeliness, follow through and completion of projects. / 7% / 0 / 0.00
Measurement: No more than two valid complaints (as verified by management) regarding timeliness of work completion.
D. Behaviors demonstrate Scripps’ Mission and Values.
 Demonstrates effective interpersonal skills that reflect respect, concern and empathy for the spiritual, cultural, emotional and informational needs of patients, physicians employees and all other customers.
 Consistently models and communicates Scripps’ Mission and Values in a professional manner.
 Evaluates the services and work processes of the assigned area(s) and regularly reinforces the importance of responsive, respectful and courteous customer service to staff.
 / 8% / 0 / 0.00
Measurement: Demonstrates positive interpersonal conflict resolution and coaching..
E.Behaviors proactively contribute to meeting team goals.
 Demonstrates a team approaches and facilitates team efforts by interacting cooperatively with others and empowering staff to achieve department and system goals and objectives.
 Analyzes goals, objectives and actions from a systemwide perspective and considers the ramifications of individual actions on strategic initiatives of the enterprise.
 Actively participates in business unit and system teams and/or offers expertise as needed.
 Supports final decision even if it does not represent the individuals own viewpoint.
 Supports the concept of the enterprise as a cohesive team and provides opportunities that encourage and build effective teams.
 / 7% / 0 / 0.00
Measurement: Observation and Verification
  1. Behaviors support department, business unit and system compliance with legal, regulatory and accreditation-related issues and programs.
 Understands and supports the Corporate Compliance Program and incorporates requirements outlined in the Code of Conduct into departmental operations.
 Develops and implements methods for auditing departmental operations to ensure compliance with Scripps’ policies and procedures, federal and state laws, and regulatory requirements.
 Ensures that staff understands compliance policies that affect their work as well as the personal and organizational risks of noncompliance.
 Keeps informed of compliance matters and, as appropriate, reports issues in a timely manner.
 Collaborates with management from other departments to resolve overlapping compliance issues.
 Maintains a proactive and non-retaliatory work environment where staff are encouraged and expected to identify and resolve problems with compliance.
 Addresses compliance problems with staff, providing counsel, education, and if warranted, disciplinary action in order to resolve problems.
 / 7% / 0 / 0.00
Measurement: Leadership (Peer, Director, Administration) observation and verification.
No more than one valid complaint regardng management of employee issues.
G.Behaviors demonstrate effective leadership skills.
 Accurately assesses problems/concerns and resolves in an effective and timely manner.
 Obtains and considers input from patients, physicians, employees and other customers, as appropriate, and weighs alternatives as part of the decision making process.
 Is accountable for individual decisions and actions as well as those of the staff.
 Make decisions without vacillating needlessly once viable options have been identified.
 Follows-up on matters that require attention; deals directly and openly with conflict.
 Supports point-of-service decision making efforts within the department and system.
 Able to apply the appropriate leadership styles in different situations.
 Actively seeks to understand how all parts of the organization interact to meet organizational goals.
 Effectively facilitates and present information to small and large groups.
 Provides a motivating work environment where staff is inspired to achieve established goals and where personal and professional growth is encouraged.
 / 7% / 0 / 0.00
Measurement: Attends 90% of mandatory meetings unless excused by Chief Medical Officer/ Administrator or designee.
Leadership (Peer, Director, Administrator) observation.
Position Behaviors (Add scores for Position Behaviors and write total score here and on page one) / Total Score: / 0.00
VI.POSITION DUTIES: Position Duties (Essential Functions) represent 50% of the Overall Performance Score. List the position duties and the average percent of time spent on each duty. The percent of time spent performing all position duties must total 100%. Keep in mind how these duties contribute to the department’s goals and operational needs. The evaluator may list specific measurements for the listed performance criteria, and must comment to explain when the employee’s performance falls below or exceeds the standard performance criteria.
% Time
Spent / Position Duties and Performance Criteria (Essential Functions)
Use one of the following ratings to indicate the employee’s performance.
0, 1, 2, 3, 4 (Refer to Performance Rating Definitions) / Weight
(Enter as Decimal) / Rating / Score
25% / 1. Fiscal Accountability – System, Business Unit and Cost Center(s)
  • Prepares and administers Emergency Management operations annual budget.
  • Conducts budget planning for operational, educational and capital equipment needs.
  • Controls operational expenses within established budget parameters.
  • Maintains adjusted budget within acceptable variance.
  • Adjusts labor and supply expenses, as appropriate.
  • Evaluate and monitor revenue opportunities, if applicable.
Achieves the established budget targets for hospital operations per fiscal year .
Timely completion of monthly expense/revenue variance reports. / 10% / 0 / 0.00
30% / 2. Leadership
  • Collaborates with hospitals in the integration of the Scripps HealthCare’s role in the community-wide Emergency Response Plan, as it applies to Scripps System readiness and the environment of care.
  • Represents Scripps System to external agencies in the establishment of Scripps System and community related emergency management and preparedness plans, strategies and initiatives.
  • Motivates and encourages the organizational actions in contingency planning, to include areas such as financial and business stabilization and long term recovery post disaster
  • Represents Scripps System on varied local, regional, State and National committees and task forces.
  • Liaison to local hospital systems, Red Cross, DMAT, Police and Fire Agencies
  • Fosters communication for and participates in work groups, with the County of San Diego, the State of California Emergency Medicine Services Authority (EMSA) and the National disaster Medical System as it relates to Scripps Healthcare
  • Participates in and/or develops strategic planning initiatives that support the system and hospital-based leadership teams.
  • Represents Scripps HealthCare’s mission and values in all relevant activities.
Supervisory observation (Peer and/or Administration). / 15% / 0 / 0.00
30% / 3. Emergency Preparedness Management
  • Serves as the primary administrative point of contact for Scripps System with preparedness issues
  • Participates in Scripps NBC Task Force, Hospital Disaster Council and Decontamination Team Task Force
  • Establishes and implements goals and objectives, facilitating, prioritizing, evaluating the functional area of emergency preparedness.
  • Coordinates efforts in developing system wide Emergency management policy and procedures.
  • Coordinates system wide participation in local, regional and State Disaster Exercises/Drills.
  • Fosters Emergency Preparedness program development, implementation, mentoring and evaluation of individual units within the Scripps System.
  • Works in partnership with relevant health activities based on community needs assessment to enhance community benefit.
  • Collaborates with the leadership team to assure consistent interpretation and implementation of policies and procedures.
Provides documentation of involvement on department, facility and organization-wide committees, task forces and employee recognition programs. / 15% / 0 / 0.00
5% / 4. Regulatory
  • Assures compliance with standards, regulations and competencies within designated areas of emergency preparedness.
  • Actively participates in ongoing preparation for JCAHO/DHS visits within hospital/organization and maintain survey readiness at all times.
  • Mentors staff to ensure regulatory readiness.
Observation and Verification. / 5% / 0 / 0.00
5% /
  1. Research
  • Monitors availability of research projects related to emergency preparedness and distributes information to appropriate administration
  • Coordinates, participates or collects research data for projects related to emergency preparedness.
Observation and verification / 2% / 0 / 0.00
5% /
  1. Specialized Skills
  • Strong demonstrated competency in the area of emergency preparedness, and the HEICS Process.
  • Possesses documented experience with County, State, or Federal emergency response teams.
Measurement: / 3% / 0 / 0.00
100% / Position Duties (add scores for Position Duties and write total score here and on page 1) / Total Score / 0.00
VII. EMPLOYEE COMMENTS: The employee may provide comments on the performance review in the space provided below.
Together with the employee, determine specific action plans designed to maintain, improve or optimize the employee’s work performance. Action items should be specific to the individual’s work performance. Indicate the actions to be taken by both the supervisor and the employee. Place time frames on each specific action item to be accomplished to aid in assessing progress. AN ACTION PLAN IS REQUIRED IF THE EMPLOYEE RECEIVES A PERFORMANCE RATING OF “0" IN ANY TASK OR RECEIVES LESS THAN 200 POINTS AS THE OVERALL PERFORMANCE RATING.


Definition of Performance Ratings

Rating / Characteristics / Definition
Requires Action Plan for Improvement / Unacceptable performance. Did not meet a majority of the critical performance standards associated with the behavior or position duty. Demonstrated less initiative and/or required more supervision than is consistent with the performance standards. Work is inconsistently performed. Work results are perceived by others as inconsistently meeting their needs.
Requires Action Plan for Improvement / Failed to meet all of the performance standards associated with the behavior or position duty. Met the majority, but not all of the performance standards. Demonstrated little initiative and/or needs more supervision than typically is required of the position description. Most of the work efforts accomplish desired results. Work results are generally perceived by other as inconsistently meeting their needs.
2 / Met all of the performance standards associated with the behavior or position duty. Able to independently perform duty attaining desired performance standards. Work is consistently performed within accepted standards. Responsibilities are carried out with minimal supervision. Work results are perceived by others as meeting their needs.
Requires Supporting
Comments / Met all the performance standards for the behavior or position duty and in some cases exceeded it. Employee is highly proficient in skills required of the job. Able to independently perform all of the behaviors or position duties required of the job. The employee functions at this level at least 75% of the time. Responsibilities are carried out without supervision. Works results are perceived by others as meeting their needs.
Requires Supporting
Comments / Exceeded all performance standards for the behavior or position duty. Able to independently perform all clinical or technical or service skills required of the job. Serves as a mentor to others in the behavior or position duty.

Page 1 of 6 (REV 10/02)