Final answer:
Possible issues with a new performance appraisal system at L.I.J.M.C. include employees' understanding of the system, the impact of external factors on patient satisfaction and infection rates, and manager utilization rates.
Step-by-step explanation:
Several problems might arise with the implementation of a new performance appraisal system at L.I.J.M.C. (A) Employees may struggle with understanding the new system, which could impede its effective usage. (B) Patient satisfaction ratings, often used as a performance metric, could be impacted by factors unrelated to an individual employee's actions, thus misrepresenting their performance. (C) Similarly, supposedly objective rates such as infection rates could be influenced by external factors beyond the staff's control, making such metrics unreliable for precise performance assessment. Lastly, (D) is less likely because if managers find the new system too complex or time-consuming, they may be reluctant to utilize it fully.