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The essence of a process lies not in what we label it but rather in how we apply it. This conclusion followed the renaming, within one particular organization, of performance evaluation as performance management. As one party said in response to another's use of "performance evaluation" in a statement, "Oh, no, no. We don't evaluate or appraise performance. That's a relic of the past, that's old authoritarian management. Today we manage performance. We don't just criticize and tell people why they need to change. We work with them, show them how to change, help them improve. We really manage performance."


Surely, it is no secret that the way a great many organizations evaluate employee performance leaves much to be desired. Many evaluation systems have been applied in such a way that they actually have done little more than criticize and tell people they need to do better. Some evaluation systems, however, have long been used to help employees improve and learn and grow.


Whether a specific evaluation approach generates positive or negative results, or whether it is applied in punitive fashion or as an encouragement technique, has nothing whatsoever to do with its name. Traditional performance evaluation, at least that which has prevailed since most business managed to get away from personality-based evaluations, has always had as its fundamental purpose the improvement or maintenance of performance in the job one now holds and developing individuals for advancement for their sake and the sake of the organization. If the growth and development aspects of any particular evaluation system have not been evident, surely this is not simply because of the label applied to the process that this system represents.


There presently seems to be a belief that the more palatable, more politically correct labels can actually change the nature of a process or even a concept. This belief is played out in the way certain terms that have been with us for many years, and especially those that have become tarnished over the years, are replaced with "nicer" terms, as though doing so can actually change the image or reputation of the process.


If performance evaluation has had a bum rap for years in some organizations, it is not because of "evaluation" in its name. A bum rap that attaches to any organizational process is usually earned by the way the process is applied. Changing performance evaluation or performance appraisal to performance management does nothing to change the way the process is applied, and without fundamental change in how people use the process, the new name will eventually acquire the same bum rap.


Specific to performance evaluation, the tarnish left by years of misuse will not be removed by changing the name of the process to performance management. Similarly:


* deciding that we do not delegate but rather we now "empower" plays the same kind of word game, substituting a more politically correct synonym for a word besmirched through misunderstanding and misapplication;


* speaking of downsizing, rightsizing, and more recently reengineering when we still simply mean reducing the size of the workforce;


* attempting to sharply differentiate between management and leadership (again, synonymous words), somehow contending that management is something considerably less than leadership, which it cannot be without the use of adjectives or qualifiers. (It is interesting to note that, in performance management versus performance evaluation, "management" is the "good" word, but in management versus leadership "management" is the "bad" word.)



Fortunately, we can consign most label changes to the status of fads destined to cycle in and out every now and then. We must recognize that a new label attached to an important management concept does not alter the concept itself. A process will or will not serve us well depending on how we apply it. What we call it has nothing to do with what we make of it.


This issue of The Health Care Manager (32:1, January-March 2013) offers the following for the reader's consideration:


* "Bringing Knowledge to Action in the Context of a Major Organizational Transition" reports on a study conducted during a major organizational transition for the purpose of examining within the body of literature the perceived nature of "evidence" as potentially applicable in health care decision-making processes.


* "In a Niche of Time: Do Specialty Hospitals Outperform General Services Hospitals?" reports on research undertaken to address the question of whether niche hospitals-those that engaged primarily in what appear to be the most profitable services, such as the treatment of cardiac or orthopedic conditions-are better or worse financial performers than general service institutions.


* "A New Costing Model in Hospital Management: Time-Driven Activity-Based Costing" presents the Time-Driven Activity-Based Costing System as a means of increasing productivity and more appropriately identifying product costs and describes a case-study application of the system in a private hospital in Cyprus.


* "Redesigning Medical Education to Improve Health Care Delivery and Outcomes" addresses some significant disparities in health care delivery and outcomes that can only intensify in the future unless certain adjustments are made in medical education so that future generations of physicians will be able to provide high-quality, patient-centered, and culturally sensitive care in the constantly changing health care environment.


* "Solve the Puzzle of Electronic Health Record Implementation Budgeting" uses a hypothetical hospital to illustrate how to prepare an electronic health record implementation budget, including estimating the cost of each project element, aggregating all costs, and revising the budget as necessary to conform with the budget baseline.


* The Case in Health Care Management: "Assignment and Reassignment," asks the reader to consider what one might do when the manager of one's immediate supervisor bypasses that supervisor, changes the employee's assignment, and leaves it to the employee to explain the change to the supervisor.


* "Impact of Community Capacity on the Health Status of Residents: Understanding With the Contextual Multilevel Model" reports on a study of community capacity, concluding that the key to community capacity resides in how actively the capacities of individuals and their communities are able to interact with one another.


* "Health Care Mergers and Acquisitions: Implications of Robbers Cave Realistic Conflict Theory and Prisoner's Dilemma Game Theory" seeks to explain a primary cause of less successful mergers or acquisitions through the prism of a multiscale, iterative Prisoner's Dilemma that arises between department managers.


* "Chief Executive Officers in US Hospitals: A Reexamination of Workforce Demographics and Educational Issues" reports on a survey of hospital chief executive officers undertaken to identify educational and demographic information of individuals holding top management positions in US health care institutions and suggests how this information may have changed over a period of 5 years.


* "Framing, Agenda Setting, and Disease Phobia of AIDS-Related Coverage in the South Korea Mass Media" reports on a study undertaken to analyze the thematic frames and news sources implied by AIDS-related coverage, primarily addressing the 2 major media representing conservatism and progressivism across South Korea.


* "Does the Planetree Patient-Centered Approach to Care Pay Off?" addresses the economic agenda of the Planetree patient-centered approach to care and attempts to determine whether the advantages of this special approach to patient care justify its costs.