Appropriating integrated performance management tools in healthcare: a sociomaterial work story

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Élizabeth Côté-Boileau ◽  
Mylaine Breton ◽  
Linda Rouleau ◽  
Jean-Louis Denis
Keyword(s):  
Health Care ◽  
Health System ◽  
Performance Management ◽  
Process Analysis ◽  
System Change ◽  
Data Driven ◽  
Management Tools ◽  
Content Type ◽  
Control Rooms ◽  
Integrated Performance

PurposeThe purpose of this paper is to explore the appropriation of control rooms based on value-based integrated performance management tools implemented in all publicly funded health organizations in Quebec (Canada) as a form of legitimate sociomaterial work.Design/methodology/approachMulti-site organizational ethnographic case studies in two Integrated health and social services centers, with narrative process analysis of triangulated qualitative data collected through non-participant observation (163 h), individual semi-structured interviews (N = 34), and document review (N = 143).FindingsThree types of legitimate sociomaterial work are accomplished when actors appropriate control rooms: 1) reformulating performance management work; 2) disrupting accountability work and; 3) effecting value-based integrated performance management. Each actor (tools, institutions and people) follows recurrent institutional work-paths: tools consistently engage in disruptive work; institutions consistently engage in maintaining work, and people consistently engage in creation work. The study reveals the potential of performance management tools as “effective integrators” of the technological, managerial, policy and delivery levels of data-driven health system performance and improvement.Practical implicationsThis paper draws on theoretically informed empirical insights to develop actionable knowledge around how to better design, implement and adapt tool-driven health system change: 1) Packaging the three agents of data-driven system change in health care: tools, institutions, people; 2) Redefining the search for performance in health care in the context of value creation, and; 3) Strengthening clinical and managerial relevance in health performance management practice.Originality/valueThe authors aim to stimulate new and original scholarship around the under-theorized concept of sociomaterial work, challenging theoretical, ontological and practical conceptions of work in healthcare organizations and beyond.

Performance management in public universities: overcoming bureaucracy

2018 ◽  
Vol 67 (4) ◽  
pp. 736-753 ◽  
Author(s):  
Nunzio Angiola ◽  
Piervito Bianchi ◽  
Letizia Damato
Keyword(s):  
Performance Management ◽  
Public Universities ◽  
Organizational Factors ◽  
Public University ◽  
Management Systems ◽  
Management Tools ◽  
Performance Levels ◽  
Content Type ◽  
Performance Management Systems ◽  
Adoption And Implementation

Purpose Considering a micro performance perspective, the purpose of this paper is to analyze whether and to what extent the adoption of better performance management systems could improve the performance levels of a public university. Design/methodology/approach With reference to a period of four years (2011-2014), the quality of performance management systems of 29 Italian universities (response rate: 48 percent) was examined and the possible effects on performance levels of these institutions were analyzed by means of statistical methodologies (multiple regression analysis). Outcome indicators were considered. Findings The findings indicate the need to go further “measurement,” and to take care of performance “management,” especially in complex organizations as universities, where academicians identify themselves more with their professions than with the organization and where technicians and administrative employees might look at the performance-based reform with “bureaucratic eyes.” A fruitful cooperation between the professional soul and the bureaucratic one is paramount. Originality/value Studies which analyze organizational factors that could affect the adoption and implementation of performance management systems are rare, and use in prevalence qualitative methods or refer to machine bureaucracies, not many to professional ones as public universities. Moreover, the performance management literature in a public university context deepens the topic of the selection of KPIs and the focus is mainly on macro performance or on management tools for gathering and analyzing performance measures.

scholarly journals Emerging challenges in the health systems of Kerala, India: qualitative analysis of literature reviews

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Manesh Muraleedharan ◽  
Alaka Omprakash Chandak
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Health System ◽  
Health Systems ◽  
Significant Proportion ◽  
Vital Statistics ◽  
The State ◽  
Future Research ◽  
Health Seeking ◽  
Content Type

PurposeThe substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.Design/methodology/approachA systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.FindingsChronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.Research limitations/implicationsThe present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.Originality/valueGiven the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.

Value-based integrated performance management tools in healthcare: A sociomaterial work story

2021 ◽  
Vol 2021 (1) ◽  
pp. 13215
Author(s):  
Élizabeth Côté-Boileau ◽  
Mylaine Breton ◽  
Linda Rouleau ◽  
Jean-louis Denis
Keyword(s):  
Performance Management ◽  
Management Tools ◽  
Integrated Performance

Public-private: unequal competition Israeli public hospitals vs the private health-care system following government reforms

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lior Naamati Schneider
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care System ◽  
Data Gathering ◽  
State Regulation ◽  
Public Hospitals ◽  
Content Type ◽  
Creative Solutions ◽  
Government Reforms ◽  
Care System

Purpose This study aims to map perceptions and changes in public hospitals in response to competition with the private health system, describes solutions adopted by the public hospitals and considers their implications for the business and strategic management of those hospitals. Design/methodology/approach This paper opted for a qualitative study using the open-ended approach of grounded theory, including 40 in-depth interviews with key figures in the health system and administrators at various levels of management. Findings Public hospitals are constantly adopting changes because of state-mandated reforms and growing competition with private hospitals. Notable measures include making hospitals customer-oriented and adopting business-oriented behaviors and competitive and marketing strategies. However, because public hospitals are unable to institute radical changes, they typically introduce hybrid services (private services within public services) and other creative solutions such as business-funded research foundations operating alongside them. Research limitations/implications The main methodological limitation of this study was the difficulty in obtaining data because of the limited cooperation and lack of transparency of Israel’s health-care system. The interviewees expressed concerns that their department or hospital would appear in a negative light, especially as motivated solely by financial considerations. In anticipation of this difficulty, requests for participation were addressed individually and contained extensive detail regarding the study, the ethics committee’s approval, the data gathering and the strict maintenance of anonymity and confidentiality. Originality/value Adopting business-oriented behaviors in public hospitals is somewhat contrary to the principles of public medicine. Their adaptation to the market is partial, and their creative hybrid solutions require state regulation. The absence of controls leads to duplication and waste, causing various problems, including increased social inequality, costs and deficits.

The public’s trust and information brokers in health care, public health and research

2019 ◽  
Vol 33 (7/8) ◽  
pp. 929-948 ◽  
Author(s):  
Jodyn Platt ◽  
Minakshi Raj ◽  
Sharon L.R. Kardia
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Information Sharing ◽  
Health Information ◽  
Health Care Providers ◽  
Care Providers ◽  
Content Type ◽  
The Public ◽  
Information Brokers

Purpose Nations such as the USA are investing in technologies such as electronic health records in order to collect, store and transfer information across boundaries of health care, public health and research. Health information brokers such as health care providers, public health departments and university researchers function as “access points” to manage relationships between the public and the health system. The relationship between the public and health information brokers is influenced by trust; and this relationship may predict the trust that the public has in the health system as a whole, which has implications for public trust in the system, and consequently, legitimacy of involved institutions, under circumstances of health information data sharing in the future. This paper aims to discuss these issues. Design/methodology/approach In this study, the authors aimed to examine characteristics of trustors (i.e. the public) that predict trust in health information brokers; and further, to identify the factors that influence trust in brokers that also predict system trust. The authors developed a survey that was administered to US respondents in 2014 using GfK’s nationally representative sample, with a final sample of 1,011 participants and conducted ordinary least squares regression for data analyses. Findings Results suggest that health care providers are the most trusted information brokers of those examined. Beliefs about medical deceptive behavior were negatively associated with trust in each of the information brokers examined; however, psychosocial factors were significantly associated with trust in brokers, suggesting that individual attitudes and beliefs are influential on trust in brokers. Positive views of information sharing and the expectation of benefits of information sharing for health outcomes and health care quality are associated with system trust. Originality/value This study suggests that demonstrating the benefits and value of information sharing could be beneficial for building public trust in the health system; however, trust in brokers of information are variable across the public; that is, knowledge, attitudes and beliefs are associated with the level of trust different individuals have in various health information brokers – suggesting that the need for a personalized approach to building trust.

A conceptual framework for integrated performance management systems

2019 ◽  
Vol 31 (3) ◽  
pp. 309-324 ◽  
Author(s):  
Ulf Johanson ◽  
Roland Almqvist ◽  
Matti Skoog
Keyword(s):  
Conceptual Framework ◽  
Performance Management ◽  
Design Methodology ◽  
Present Form ◽  
Management Systems ◽  
Content Type ◽  
Performance Management Systems ◽  
Integrated Performance ◽  
Further Development ◽  
Practical Implications

Purpose The purpose of this paper is to further develop a conceptual framework for analysing performance management systems (PMS). The framework aims to be useful for a rich understanding of a specific organisation’s PMS. At the same time, it should preferable be simple so that it could be used even in practice. The framework adds to earlier work by Malmi and Brown (2008), Ferreira and Otley (2009), Broadbent and Laughlin (2009), Bedford and Malmi (2015) and Johanson et al. (2001). Design/methodology/approach The paper is theoretical but has also been applied to a Swedish municipality. The purpose of the latter was to understand if the framework is feasible so far. Findings The authors hold that the framework in its present form is useful to use as an analytical tool even if it needs to be subjected to further development. Research limitations/implications The paper addresses an issue that is continuously changing. This means that the suggested framework may suffer from theoretical weaknesses in some respects. To balance between a theoretically deep and exhaustive framework and a framework that is simple enough to use is a tricky question that needs further investigation. Practical implications The ambition with the framework is that it shall be useful even in practice. Originality/value The need for further research in the PMS area has been emphasised by the above researcher but also by, e.g., Van Helden and Reichard (2016). They hold that the authors need rich European cases to improve the understanding of how PMS works. The authors hold that the present framework has the potential to meet the demands from Van Helden and Reichard.

Advancing health care quality and safety through action learning

2017 ◽  
Vol 30 (2) ◽  
pp. 148-158 ◽  
Author(s):  
Simon Mathews ◽  
Sherita Golden ◽  
Renee Demski ◽  
Peter Pronovost ◽  
Lisa Ishii
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Quality ◽  
Design Methodology ◽  
Action Learning ◽  
Care Quality ◽  
Quality And Safety ◽  
Content Type ◽  
Learning Health System ◽  
Academic Medical

Purpose The purpose of this study is to demonstrate how action learning can be practically applied to quality and safety challenges at a large academic medical health system and become fundamentally integrated with an institution’s broader approach to quality and safety. Design/methodology/approach The authors describe how the fundamental principles of action learning have been applied to advancing quality and safety in health care at a large academic medical institution. The authors provide an academic contextualization of action learning in health care and then transition to how this concept can be practically applied to quality and safety by providing detailing examples at the unit, cross-functional and executive levels. Findings The authors describe three unique approaches to applying action learning in the comprehensive unit-based safety program, clinical communities and the quality management infrastructure. These examples, individually, provide discrete ways to integrate action learning in the advancement of quality and safety. However, more importantly when combined, they represent how action learning can form the basis of a learning health system around quality and safety. Originality/value This study represents the broadest description of action learning applied to the quality and safety literature in health care and provides detailed examples of its use in a real-world context.

scholarly journals Determinants Of Integrated Performance Measurement Systems Usage: An Empirical Study

2010 ◽  
Vol 26 (5) ◽  
Author(s):  
Mojca Marc ◽  
Darja Peljhan ◽  
Nina Ponikvar ◽  
Aleksandra Sobota ◽  
Metka Tekavcic
Keyword(s):  
Performance Measurement ◽  
Performance Management ◽  
Contextual Factors ◽  
Company Size ◽  
Market Position ◽  
Management Tools ◽  
Financial Measures ◽  
Measurement Systems ◽  
Performance Measurement Systems ◽  
Integrated Performance

<p class="MsoNormal" style="text-align: justify; margin: 0in 0.5in 0pt; mso-pagination: none;"><span style="color: black; font-size: 10pt; mso-bidi-font-weight: bold; mso-ansi-language: EN-GB; mso-themecolor: text1;" lang="EN-GB"><span style="font-family: Times New Roman;">Performance management literature has been advocating the balanced use of non-financial measures alongside traditional financial measures, possibly within integrated performance measurement systems, since the early 1990&rsquo;s. The purpose of this paper is to explore how contextual factors (such as company size, industry, and market position), business objectives and knowledge about contemporary management tools influence the decision to implement Balanced Scorecard or similar integrated performance management systems. We tested our research propositions regarding the influence of these factors by using survey data and a logistic regression model. The study is based on a survey conducted in 2008 on a sample of 323 Slovenian companies. The sample consists of large, medium, and small firms from different industrial sectors, including manufacturing and service. Overall, our results confirm contextual factors, such as company size and industry, and knowledge about management tools as most important determinants of integrated performance measurement systems usage. Although market position and business objectives also receive some support for their influence, the results are generally weaker and more ambiguous.</span></span></p>

scholarly journals A maturity model for the servitization of product-centric companies

2020 ◽  
Vol 31 (4) ◽  
pp. 775-797
Author(s):  
Federico Adrodegari ◽  
Nicola Saccani
Keyword(s):  
Performance Management ◽  
Design Methodology ◽  
Process Management ◽  
Measurement Scale ◽  
Maturity Model ◽  
Dimensional Approach ◽  
Management Tools ◽  
Model Application ◽  
Content Type ◽  
Forklift Truck

PurposeThe purpose of this paper is to contribute to the understanding of the servitization phenomenon of product-centric companies, by identifying the resources, capabilities and organizational aspects needed to successfully deploy a servitized business model (BM).Design/methodology/approachBy adopting a literature-based approach, this paper develops a servitization maturity model (SeMM) aimed at assessing and positioning companies in the servitization journey. The paper also illustrates the model application to two small and medium-sized enterprises (SMEs), a machinery and a forklift truck company.FindingsThe SeMM identifies a set of 85 critical requirements that are used to evaluate the servitization level of product-centric companies, through a specific five-stage measurement scale. The requirements are categorized into: five maturity dimensions (organizational approach, process management, performance management, tools, capabilities) and nine BM Canvas components. The empirical application exemplifies how the SeMM can support managers in identifying and bridging the gaps in their servitization journey.Originality/valueThe SeMM adopts an original bi-dimensional approach and provides an operationalization of the servitization process through the identification of specific critical requirements framed on established BM and maturity dimensions taken from the literature. Moreover, the model responds to a call for research to develop practitioner-oriented tools and guidelines to support the servitization process, in particular for SMEs, and to the need to go beyond to measures of servitization based on indicators about number of services offered or their turnover.

Lessons from mandated implementation of a performance management system

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jean-Sebastien Marchand ◽  
Mylaine Breton ◽  
Olivier Saulpic ◽  
Élizabeth Côté-Boileau
Keyword(s):  
Performance Management ◽  
Management System ◽  
Large Scale ◽  
Management Systems ◽  
Public Healthcare ◽  
Performance Management System ◽  
Management Tools ◽  
Content Type ◽  
Performance Management Systems ◽  
Organisational Context

PurposeLean-inspired approaches and performance management systems are being implemented in public healthcare organisations internationally. However, the literature is inconclusive regarding the benefits of these management tools and there is a lack of knowledge regarding processes for large-scale implementation of these tools. This article aims to describe the implementation process and to better understand how this process influences the mandated performance management system.Design/methodology/approachThis research is based on a comparative case study of three healthcare organisations in Canada. Data consist documents, non-participant observation and semi-structured interviews with key actors (n = 30). Analysis is based on a sociotechnical approach to management tools that considers organisational context, and the tool's technical substrate, theory of action and managerial philosophy.FindingsResults show that despite a standardised national mandate, the tool as implemented varied between organisations in terms of technical substrate and managerial philosophy. These variations are explained by the flexibility of the technical substrate, the lack of clarity of the managerial philosophy, and some contextual elements. Successful implementation may rest upon high hybridization of the tool on these different dimensions. A precise and prescribed technical substrate is not sufficient to guarantee implementation of a managerial philosophy.Practical implicationsMandated implementation of management tools may be more successful if it is explicit on the managerial philosophy, the technical substrate and the link between the two, and if it provides some leeway to adapt both to the organisational context.Originality/valueThis is one of the few studies to describe and analyse the process involved in mandated large-scale implementation of performance management systems in public healthcare organisations.

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