Question DescriptionThe senior management of a large Midwestern nursing home gathered data on its quality ofpatient care and patient safety. They found that the quality of patient care and safety in thenursing home was deficient. To solve the problem, the managers, with the help of a totalquality management expert, implemented a sophisticated continuous quality improvement(CQI) process with structured monthly meetings to review relevant data.Except for the senior nurse manager, other clinical employees did not participate or receiveinformation on the deliberations of the meetings. While the top managers were verysatisfied that the CQI addressed the problem in a systematic and formal manner, theclinical staff employees were very frustrated in their efforts to report medical errors. Thiswas because, for every medication error, staff members were assigned one point anddisciplined after three points. They could even be terminated as the disciplinary processprogressed. The points accumulated over the year were also used to determine the annualsalary increases and promotions of the nurses.Based on the above performance appraisal system, the nursing home reported animprovement in the reduction of medication errors. However, adverse clinical outcomes for patients remained unchanged. To investigate this problem, the top management team hireda new HR consultant. After promising that all information would be strictly confidential, theconsultant was able to convince the clinical staff to talk freely about the problem of patientswith adverse outcomes. In fact, the clinical staff admitted not filling out incident reportsbecause of the punitive reporting system and expressed concern about the disconnectionbetween the nursing home’s goal of improving medication safety practices and the nursinghome’s approach to error.1. What would you do when implementing a CQI process to reduce medical errors?2. How would you change the incident reporting and performance appraisal systems?Present your ideas in a 2-3 page APA-formatted paper with a minimum of three referencesplus the textbook. Additional references must be reliable sources retrieved from thelibrary, Internet, or elsewhere.Requirements• Understand the important role that performance appraisal plays in managinghuman resources (HR) in health care organizations.• See the connection of performance management function with other key HRfunctions of recruitment/selection, training/development, and compensation andrewards.• Have an appreciation of the legal implications of performance appraisal.• Paper utilizes materials presented in the textbook and a minimum of three outsidesources in a 2-3 page document.