Probation Development Plan
It is the Manager’s responsibility to create a probation plan with each new staff member to the Royal Children’s
Hospital, including those on a fixed term contract (Note: the probation plan is not for current RCH staff who have
transferred from another department). The plan is valid for a duration of 6 months, and should be used even if the
staff contract is shorter than this timeframe. The plan should be developed within the first 4 weeks of the staff
member’s commencement, and formal follow-up meetings and documentation of outcomes should be made at
intervals of 4 weeks-10 weeks-18 weeks-24 weeks throughout the probation period.
If any issues arise throughout the probation period, such as a change in environment, strategic direction of the
department or performance issues, the Human Resources (HR) department should be contacted no later than the
18 week mark, prior to the end of the probation period (Note: it is recommended that the Manager record the
meeting dates and key date to contact HR in their calendar at the time of setting up the probation plan).
Employee Name
Employee Number
Position Title
Employment Status
FT
PT
C
Department
Manager
Date of Plan:
Date of Probation Review:
PART 1: Key Service Deliverables
INSTRUCTION:
Manager should first provide an overview of the Departmental Plan and expectations of the role.
1. Service Deliverables: Record specific areas the staff member will be responsible for (these should be more
specific than the high level priorities set out in the Position Description)
2. Performance Measures: How will the staff member know they are succeeding in the area of delivery?
3. Set the timeframe each goals is expected to be achieved
NOTE: Goals can be amended throughout the year as the environment, or operational requirements change
CLINICAL NOTE: If quantitative performance indicators are required, an over-arching goal of “Achieve a minimum
of 90% key performance indicators (KPI’s) as required by X and documented in Y“ can be written
1. Service Deliverables
2. Performance Measures
3. Comments
e.g.
Update internal patient onboarding policy and
procedure in line with
departmental hospital
requirements
e.g.
e.g.
Attend to all allocated
patients
e.g.







Consult with relevant stakeholders
Write up new operating procedures
Obtain sign-off from Policy and
Procedure Committee
Disseminate information to all
impacted staff
Maintain clinical patient records
Update Patient hand over notes
prior to end of shift
Manage parent expectations &
provide detail of key contact
PART 2: RCH Values in Action: Respect, Unity, Integrity, Excellence
INSTRUCTION:
1. Values/Behaviours: The Performance Reviewer and/or staff member can identify what behaviours are required to
achieve the goals set out in Part 1.
2. Key Actions: Identify how the staff member will embed these behaviours into practice.
Important! How we behave and treat others in the workplace is equally as important as to how we perform
tasks.
1. Values/ Behaviours
2. Key Actions
e.g.
Completion of tasks on time
e.g.
Receive positive feedback regarding ability to deliver quality outcomes on time
e.g.
Interaction with others
e.g.
Will be mindful to consult with key stakeholders and listen to their feedback prior to
implementing changes
PART 3: Development Plan
INSTRUCTION:
1. Development Area: What Skills or Knowledge will you enhance?
2. Activity: What activities will you undertake to develop in this area?
3. Cost: If there is a cost involved, have you attached approval from your cost centre manager/ funding source?
4. Progress/ Comment: Was the development activity undertaken. If not, what else was done instead?
5.
1. Development Area
2. Activity
3. Professional
Mentor/ Lead
e.g.
Knowledge of National
Standards
e.g.
Skills in CLARA system
Read standards and
identify how they will
impact my work
Attend in-house training
X will show where to find
information on the
Intranet
IT Department
Ongoing Support and
Questions
Buddy up with X
4. Progress/Comment
PART 4: Indicative Leave Plan
Note: Below is an indicative leave planner and formal approval of leave will still need to be submitted via the online leave form.
Month
Events
Start Date
End Date
Type of Leave
(e.g. Annual)
TOTAL
Current Annual
Leave Balance
Total Planned Leave to be Taken
Forecast Balance at End of
Calendar Year
PART 5: Scope of Practice Review (Medical, Nursing, Allied Health, Dentistry only)
INSTRUCTION:
1. Copy of Scope of Practice Provided?: Staff member should attach a copy to this probation plan. If not, then
contact the relevant Credentialing Committee to obtain a copy.
2. Has Approval been sought from Credentialing Committee?: Staff member should have documented approval. If
not, contact the relevant Credentialing Committee to obtain a copy.
3. Assigned Professional Lead: Provide the name of the staff member’s professional Lead during probation
period.
2. Has approval
1. Copy of Scope of
been sought from
3. Assigned Professional Lead
Credentialing
Practice Provided?
Committee?
Please circle: Yes / No
Please circle: Yes / No
Name:
Part 6: Performance Feedback
INSTRUCTION:
Please date comments made by each party, and identify to which section of the plan comments pertain (e.g.
12.02.13 Part 5: Scope of Practice). Ensure review comments are completed prior to the end of the calendar year,
and signatures from both the Staff member and the Manager are obtained.
Performance Feedback
Meets Requirements to move to PDAP
Overall does not meet requirements (Contact HR)
Overall Reviewer
Feedback/ Comments:
Overall Employee
Feedback/ Comments:
Employee:
Signature:
INSERT NAME HERE
Manager:
Signature:
INSERT NAME HERE
PLEASE ATTACH ANY DOCUMENTATION (E.G. SCOPE OF PRACTICE, MANAGER APPROVAL FOR
TRAINING)
A signature in the above fields indicates consultation & feedback has taken place with both parties. Original to be
retained by Reviewer for follow-up Conversation. Staff member may also retain a copy.