Governing Patients' Mobility to Pursue Public Value

Author(s):  
Francesca Costanza

This chapter combines traditional performance management and system dynamics simulation modelling to address patients' mobility issues and pursue public value. The Italian case study is a first illustration of travelling flows' causal structure; however, the perspective is to introduce such methodological approach also at European level. After a literature review about the main factors inducing healthcare mobility, the phenomenon is explored in light of public management theories. Then, a model portrays the causal structure of the phenomenon in terms of system dynamics and performance management items. There follows a discussion of theoretical and managerial implications of the study, as well as ideas and issues for next research steps.

This chapter proposes an application of simulation modelling to frame the relationships between healthcare, patient organization management, and patient co-created healthcare. For the purpose, it presents a case study within the Italian context, for which it adopts a methodological approach combining performance management and system dynamics. After background information, the chapter introduces the methodology and explains the modelling steps, undertaken assuming the privileged perspective of a patient organization. The model building goes by progressive approximations. A tailored dynamic performance management framework identifies key variables and links within the system. Then a stock-and-flow structure deepens the analysis by depicting processes of accumulation of material, money, and information; a comprehensive loop analysis describes the system's dynamics in terms of interacting feedback structures. Finally, quantitative simulations concerning the mutual development of patient organizations and healthcare allow graphing behavior patterns according to alternative scenarios.


Author(s):  
V. Venkatakrishnan

New public management (NPM) conceptualised public administration as a business, to be managed with business-like techniques. Since services had to be assessed by the criteria of quality, efficiency, and satisfaction of citizens, the public sector had to reorganize its processes. As strong emphasis was on the services, improving their delivery was expected to facilitate achieving the above criteria. The terms of the NPM approach such as “customer focus, managing for results, and performance management” have become part of the standard language of public administration (Ali, 2001; Bekkers & Zouridis, 1999; Crossing Boundaries, 2005; Spicer, 2004).


Author(s):  
Chan Kah Wai ◽  
Chooi-Leng Ang

Competitiveness is one of the factors successful organizations excel in, and they will do anything necessary to gain an edge over their competitors. The system dynamics approach to simulation modelling is being considered as one of the methods to increase competitiveness. System dynamics is essentially a methodology suited to studying and managing complex feedback systems and provides a means for understanding the causes of industry behaviour. This research builds a complete system dynamics model for internal supply chain events (from order to ship-out) from the perspectives of a semiconductor company. System dynamics models are simulation-based models that allow the investigation and identification of discrepancies between the business policy and the actual practice of key events as well as provide a better visibility of the company’s system. With the understanding of the internal workings of the supply chain system, experiments with the simulation model could provide alternative configurations to achieve better performance. This research utilizes system dynamics to better understand the supply chain system and with it, to find better solutions through experimentations with a few key variables in the supply chain system. The result of this research reveals that the company could achieve 25% reduction in inventory cost should the recommendations be followed.  


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Guido NOTO

In a global context characterized by a growing and rapid urbanization, achieving a good performance in the urban transportation domain is closely linked to the pursuit of sustainability, seen as the ability to satisfy social needs - i.e. improving quality of life - without compromising the ability of the future generation to satisfy theirs. Addressing sustainability assumes to deal with certain social characteristics - namely pluralism, institutional fragmentation and uncertainty - that makes the challenge complex. In order to deal with this complexity, literature embarked the road of developing detailed models to support planning activities and decision-making processes. However, a number of limits raised with reference to the usefulness of these models to planning processes. This paper suggests an innovative planning approach tailored to complex urban transportation systems. This approach is based on the Performance Management theory and the System Dynamics modelling.


2016 ◽  
Vol 6 (1) ◽  
pp. 47 ◽  
Author(s):  
Jette Ernst

Danish hospitals are major sites of healthcare reform, and new public management accountability and performance management tools have been applied to improve the quality and efficiency of services. One consequence of this is that nurses’ work in hospitals is increasingly standardized through medical evidence. Using Bourdieu’s theory of practice in combination with an ethnographic field study, it is analyzed how the nurses of a Danish Integrated Emergency Department respond to the changing conditions of work. It is illuminated how two opposing approaches to nursing of humanistically and pluralistically oriented caring, and evidence-based scientifically oriented curing inform nursing in the department. The curing approach is however trumping the caring approach. Curing creates new nursing career pathways and is by some nurses embraced with enthusiasm. For others, the new situation creates tension and distress. It is illustrated how the nurses position their practice in relation to the changing working conditions taking sides for either curing or caring, or finding a way to maneuver in between the two. The article argues that the normative enforcement of the curing approach may carry unintended side effects to the goals of quality and efficiency enhancements.


2019 ◽  
Vol 9 (4) ◽  
pp. 80
Author(s):  
Jan-Erik Johanson ◽  
Åge Johnsen ◽  
Elias Pekkola ◽  
Stephen Affleck Reid

The purpose of this article is to analyse the design and implementation of strategic planning and performance management in governmental agencies in two Nordic countries, Finland and Norway. Nordic countries are an interesting study from a comparative perspective because while they are commonly assumed to have been high-intensity new public management reformers, they are also commonly assumed to have a distinct public management tradition. Moreover, these two countries are interesting to study because within the Nordic public management tradition, Finland and Norway specifically represent two different public management traditions. Finland belongs to the Eastern Nordic public management tradition, with an emphasis on decentralisation and agency autonomy, while Norway belongs to the Western Nordic public management tradition, with an emphasis on hierarchical governance, and hence, much performance management and reporting. Therefore, we expected to find more decentralised strategic management and an emphasis on evaluation in Finland, and more central, planning-like strategic management and reporting in Norway. Our comparison shows that both countries had mandatory strategic planning and utilised decentralised strategic planning in government agencies. The stronger legal orientation in the public administration in Finland, however, made strategic changes more complicated in Finland than in Norway.


2019 ◽  
Vol 32 (7) ◽  
pp. 721-740
Author(s):  
Giorgio Giacomelli ◽  
Nora Annesi ◽  
Sara Barsanti ◽  
Massimo Battaglia

Purpose The purpose of this paper is to contribute to the scholarship on public management models and to advance the theoretical conceptualization of the complexity of performance management systems (PMSs). The paper explores how the characteristics of PMSs vary within and across different organizational units in common institutional context, based on the case of a regional authority in Italy. Design/methodology/approach A framework of analysis considering both objective and subjective factors was derived from a combination of performance typologies in the public sector, namely ideal types of managing performance (Bouckaert and Halligan, 2007) and performance regimes (Jakobsen et al., 2017). The combination of the characteristics of these two models across different Directorates General (DGs) has also been explored through a nested case study (Starman, 2013). Data were gathered via a desk analysis of official documents regarding the planning and programming of a regional authority along with in-depth interviews with top-level managers. Findings The results highlighted a clear differentiation of PMSs, both within and across DGs. The findings of the study reveal the hybrid nature of PMSs within a common institutional context. Originality/value Drawing on the theoretical frameworks of Bouckaert and Halligan (2007) and Jakobsen et al. (2017), the paper provides an integrated approach for analysing PMSs, considering both objective and subjective dimensions. Insights and indications for future research on hybridity at a meso level of public organizations are highlighted.


2020 ◽  
Vol 18 ◽  
Author(s):  
Michelle Govender ◽  
Mark H.R. Bussin

Orientation: To remain competitive South African organisations must improve their operational efficiency by lowering manufacturing and service costs, and the key is the performance of its employees.Research purpose: The purpose of the study was twofold: firstly, to establish if there is a relationship between performance management and employee engagement; and secondly to ascertain if performance management can be rebooted through increased employee engagement.Motivation for the study: Organisations that measure and manage performance generally outperform those that do not. Organisations need to understand what drives employee engagement and performance to outperform their competitors.Research approach, design and method: A qualitative approach was employed that included a review of research articles and interviews with employees from various functions across all levels within operations of a fast-moving consumer goods organisation based in Gauteng. A sample size of 20 employees was used.Main findings: The results suggest that a relationship exists between performance management and employee engagement and that an increase in employee engagement would result in improved performance of employees and subsequently the organisation. The study revealed that whilst engagement and communication occur across all levels within the organisation, there is still a significant gap. The messages and expectations are not simple enough to be understood. Employees are not empowered to have a voice which causes them to be demotivated. Supportive management, which is fundamental to the success of performance management, is lacking.Practical/managerial implications: The insight from this study may be used to change the way organisations engage with employees and manage performance to ensure it is a beneficial exercise that adds value to all stakeholders.Contribution/value-add: This study will contribute towards organisations understanding the relationship between performance management and employee engagement and how to leverage this towards improving operational efficiency and organisational effectiveness.


2015 ◽  
Vol 8 (2) ◽  
pp. 69-88 ◽  
Author(s):  
Dagmar Špalková ◽  
David Špaček ◽  
Juraj Nemec

Abstract Managing and measuring performance became an important part of administrative reforms motivated by the New Public Management ideology. However, a badly implemented system designed for measuring and managing performance may distort the behaviours of actors. The goal of this paper is to outline the preliminary picture of the current situation of performance management generally and particularly of performance appraisal at the level of the Czech local and regional self-governments. The presented data, despite the fact that our field research covers only a non-representative samples of the “best” self-government bodies, show first that performance and quality management is not a neglected area in the Czech Republic. Its practice is rather decentralized, and the central government focuses on methodical support and coordination rather than on being strict and requiring certain tools to be implemented. The core problems revealed by the interviews are that the implementation of new instruments is usually based on a trial-and-error approach in its beginnings and that the implementation is award- and project-driven. Our preliminary data clearly indicate that the performance-appraisal situation is even more problematic - they indicate that performance-appraisal systems are introduced in only a limited number of self-government authorities. The set of criteria used in the evaluation is problematic, and the objectives of the performance appraisal are unclear for managers. As a general rule, a performance-appraisal system is not directly linked with implemented performance management and especially not with a payment system.


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