Towards a balanced performance measurement system in a public health care organization

The Innovativeness and Usage of the Balanced Scorecard Model in SMEs

By using the balanced scorecard model, a company is able to identify its advantages, as well as its deficiencies, and thus improve its business. The introduction of innovations and the implementation of innovative activities in companies are key for gaining a competitive advantage. There is no ideal model that would measure the non-financial, non-tangible perspectives of a company (such as customer perspective, the perspective of research and innovation, and the perspective of internal processes). The main goal of this paper is researching the applicability of the balanced scorecard model in small- and medium-sized companies as the basis for a model for assessing innovative activities in the Republic of Slovakia and the Republic of Serbia. First, a hypothetical model was created based on theoretical data from world scientific articles. Then, the structural equation model (SEM model) was created, based on the conducted research in 223 companies and the obtained results.

Proposal of a multidimensional strategic-management dashboard for use in a rehabilitation respiratory unit

Health information systems are the core support to decision-making in health organizations. Economic and clinical managements often function separately, while a governance system for quality and safety functions with quality checks and performance accountability, could improve efficiency. The aims of this study were, within a respiratory rehabilitation unit (RRU), to: develop a management-strategy dashboard based on key performance areas (KPAs), identify key performance indicators (KPIs) for each KPA which allow multidimensional assessment; estimate the expected results from the implementation of this dashboard using the balanced score card (BSC) method.In December 2017, a working group was set up at the RRU to develop the dashboard by selecting criteria for KPA and determining the KPIs with their rationale, weight, calculation method, measurements, supply system, target values, and working rules.After 3 meetings, 6 KPAs and 12 KPIs for the financial area, 3 KPAs and 15 KPIs for internal processes, 6 KPAs and 8 KPIs for innovation and growth, and 4 KPAs and 5 KPIs for the Clients' Perspective were approved. A strategic map showing the cause/effect relations between the different KPAs was drawn.A BSC-based quality measurement integrating economic and clinical management dimensions is possible also in an RRU. The proposed dashboard can improve communication, strategy, information dissemination, information communication technology management, budget negotiations, organizational quality, and accountability to stakeholders.

Use of Balanced Indicators as a Management Tool in Nursing

Objective:

to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard.

Method:

a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators.

Results:

we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient's average revenue per day and patient's revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation).

Conclusion:

although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.

Slack resources and quality performance: case of a mega health care organization

Purpose

Prior studies have examined the relationship between budgetary slack and short-termism of management within a profit-seeking business environment. The purpose of this paper is to examine the dynamics of slack resources in relation to quality performance of heath care services delivered by a publicly funded organization.

Design/methodology/approach

A longitudinal regression analysis of resource utilization, productivity and the quality of health care services delivered is performed to reveal evidence about the underlying dynamics of heterogeneous slack resources. It attempts to study slack resources in the case of a “mega” health care service provider based in Hong Kong.

Findings

The results suggest that the organization’s cost containment culture, with a strategic focus on productivity measures, has augmented cost effectiveness; however, not all slack resources would enhance quality performance.

Originality/value

This study of a mega health care service provider complements the prior studies of slack resources and points out the challenges of proactively managing any slack resources toward quality performance beyond productivity.

A fuzzy MICMAC analysis for improving supply chain performance of basic vaccines in developing countries

INTRODUCTION

In recent years, demand to improve child immunization coverage globally, and the development of the latest vaccines and technology has made the vaccine market very complex. The rise in such complexities often gives birth to numerous issues in the vaccine supply chain, which are the primary cause of its poor performance. Figuring out the cause of the performance problem can help you decide how to address it. The goal of the present study is to identify and analyze important issues in the supply chain of basic vaccines required for child immunization in the developing countries.

RESEARCH DESIGN & METHODS

Twenty-five key issues as various factors of the vaccine supply chain have been presented in this paper. Fuzzy MICMAC analysis has been carried out to classify the factors based on their driving and dependence power and to develop a hierarchy based model. Further, the findings have been discussed with the field experts to identify the critical factors.

RESULTS & CONCLUSION

Three factors: better demand forecast, communication between the supply chain members, and proper planning and scheduling have been identified as the critical factors of vaccine supply chain. These factors should be given special care to improve vaccine supply chain performance.

Performance management of the public healthcare services in Ireland: a review

PURPOSE

Performance Management (PM) processes have become a potent part of strategic and service quality decisions in healthcare organisations. In 2005, the management of public healthcare in Ireland was amalgamated into a single integrated management body, named the Health Service Executive (HSE). Since then, the HSE has come up with a range of strategies for healthcare developments and reforms, and has developed a PM system as part of its strategic planning. The purpose of this paper is to review the application of PM in the Irish Healthcare system, with a particular focus on Irish Hospitals and Emergency Services.

DESIGN/METHODOLOGY/APPROACH

An extensive review of relevant HSE's publications from 2005 to 2013 is conducted. Studies of the relevant literature related to the application of PM and of international best practices in healthcare performance systems are also presented.

FINDINGS

PM and performance measurement systems used by the HSE include many performance reports designed to monitor performance trends and strategic goals. Issues in the current PM system include inconsistency of measures and performance reporting, unclear strategy alignment, and deficiencies in reporting (e.g. feedback and corrective actions). Furthermore, PM processes have not been linked adequately into Irish public hospitals' management systems.

RESEARCH LIMITATIONS/IMPLICATIONS

The HSE delivers several services such as mental health, social inclusion, etc. This study focuses on the HSE's PM framework, with a particular interest in acute hospitals and emergency services.

ORIGINALITY/VALUE

This is the first comprehensive review of Irish healthcare PM since the introduction of the HSE. A critical analysis of the HSE reports identifies the shortcomings in its current PM system.

Development of Balanced Scorecard for healthcare using Interpretive Structural Modeling and Analytic Network Process

Purpose

– The purpose of this paper is to develop a Balanced Scorecard-based performance measurement framework for health care system.

Design/methodology/approach

– An integrated ISM-ANP-based quantitative approach is used for the development of balance scorecard for health care system. The necessary insights are drawn from the secondary literature.

Findings

– This research identifies Key Performance Indicators and their interrelationships for health care system. An integrated approach of ISM and ANP is employed for the development of balance scorecard.

Research limitations/implications

– The findings of the research are based on insights gained from secondary literature and an analysis of five cases in health care segment and hence generalization of proposed framework is limited to the system representing some commonalities with chosen cases.

Practical implications

– Health care is the diagnosis, treatment and prevention of disease, illness, injury and other physical and mental impairments in humans. Access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as the health policies in place. The changing nature of today's health care organizations, including pressure to reduce costs, improve the quality of care and meet stringent guidelines, has forced health care professionals to re-examine how they evaluate their performance.

Originality/value

– The Balanced Scorecard health care expanded organization measures beyond financial analysis. It was first proposed by Robert S. Kaplan and David P. Norton in their book “The Balanced Scorecard (1996, Harvard Business School Press).” This research reports a development of Balanced Scorecard for health care using an integrated approach of Interpretive Structural Modeling and Analytic Network Process is used.

The fundamentals of performance measurement systems

Purpose

– The purpose of this paper is to identify the fundamentals of a performance measurement system (PMS) as discussed in the literature for the past 32 years in an attempt to provide a research agenda (RA) for future research.

Design/methodology/approach

– The paper uses a systematic review of the business, public and non-profit sector literature in examining what constitutes the fundamentals of PMS, and how these fundamentals have influenced the use of data (especially on non-financial data), development of measuring methods, measuring attributes and measuring process.

Findings

– The paper finds that there are a small number of articles providing that can be considered to have provided substantial discussion of the fundamentals of PMS. While there is no consensus on what constitute the fundamentals of PMS, using content analysis, citation analysis and on the strict criteria of necessary and/or sufficient for the existence of a PMS, this paper managed to characterize the fundamentals into six categories. This paper found that the field of PMS has not change much during the past 30 or more years, and there remains various pragmatic and research gaps that need to be addressed.

Practical implications

– The results, outcomes, and analysis of this paper have both practical and academic implications. The gaps and recommendations for future research is consolidated into a RA that provides practitioners to evaluate existing PMS, avoid issues and seek ways to develop a conceptual (theoretical) PMS that is of greater practical significance.

Originality/value

– The results of this study contribute toward providing an update of the current state of development and research into PMS; and managed to identify existing practical issues and research gaps of PMS, and provided a RA on which ongoing and future research efforts on this topic can be built upon.