Developing a strategic performance scoring system for healthcare nonprofit organisations

Applying the Balanced Scorecard to Build Service Performance Measurements of Medical Institutions: An AHP-DEMATEL Approach

The main purpose of this study is to explore the application of the balanced scorecard (BSC) to service performance measurements of medical institutions using the analytic hierarchy process (AHP) and decision making and trial evaluation laboratory (DEMATEL). According to the concept of BSC, a total of four evaluation dimensions and twenty-two indicators of medical service performance measurements were developed. To collect data, this study delivered expert questionnaires to medical-related professional supervisors, deans, and heads of medical institutions in Taiwan. By combining the AHP and DEMATEL, the priority and causality of service performance standards in medical institutions were obtained. The results of this study show that the customer dimension is the most important service performance measurement dimension for medical institutions. The seven key service performance measurement indicators that are most important for medical institutions, in order, are "complete and comfortable equipment", "competitiveness of the medical profession", "continuity of patient-to-hospital treatment", "classification of medical profession according to customers (VIP system)", "complete medical service", "complete salary, remuneration, and policy", and "medical incomes of institutions". In terms of causality, provided the complete services of medical institutions are improved, the continuity of patient-to-hospital treatment, the competitiveness of the medical profession, and the medical incomes of institutions would be influenced.

The Evolution of Balanced Scorecard in Healthcare: A Systematic Review of Its Design, Implementation, Use, and Review

During the last few years, the interest in performance measurement increased within the healthcare sector. Due to the COVID-19 pandemic, healthcare systems needed to boost performance measurement systems to become more resilient and improve their capability in monitoring key performance indicators. Since the 1990s, the Balanced Scorecard (BSC) model has been widely used among private and public organizations as it is the most adopted model to measure performance. The current paper aims at understanding the evolution of BSC in healthcare. The systematic literature review has been carried out by searching keywords according to PRISMA guidelines. By analyzing papers through one classification of BSC adoption phases, the results reveal that studies focused mainly on the BSC design process, rather than BSC implementation, use, or review. However, there is no agreement about the perspectives to be adopted in healthcare. Concerning BSC implementation and use, on one side especially leadership, culture and communication enable the BSC implementation. On the other side, monitoring and strategic decision-making are the most widespread objectives for using BSC. Concerning BSC review, however, the paper highlights a need for additional research. Finally, the paper provides further research opportunities concerning the phases suitable for implementing a BSC in healthcare.

An application of quality function deployment and SERVQUAL approaches to enhance the service quality in radiology centres

Purpose

Meeting the patients' requirements as customers of the health care sector is crucially important as a social responsibility. According to the resource constraints, only an efficient utilisation of health services can provide that purpose. This study aims to develop a quantitative assessment framework for radiology centres as a vital section in healthcare to translate the patients' requirements into service quality specifications. This would help to achieve quality improvement by emphasising the voice of customers.

Design/methodology/approach

A literature review is conducted to specify the service quality criteria and the patients' requirements related to healthcare and hospitals. Based on the experts' opinions, these criteria and requirements are later customised for the radiology centres. Moreover, the requirements are categorised into five dimensions of SERVQUAL. The interrelations between service elements are also determined through expert group consensus using Pearson correlation. Afterwards, by applying the QFD method, the relations between the requirements and criteria are explored. Additionally, a customer satisfaction survey is executed in Tehran public hospitals to prioritise these requirements and provide an importance-satisfaction analysis.

Findings

Based on the result of the case study, service elements are prioritised for improvement, and practical suggestions are provided using the Delphi technique for quality improvement. In addition, a cause-and-effect diagram is presented to highlight the improvement area and provide enhancement suggestions.

Originality/value

This study is the first empirical attempt to benefit from the VOC in evaluating and enhancing the quality of service delivered to radiology patients. In doing so, the study applies a hybrid approach of QFD and SERVQUAL as well as other tools to highlight the improvement area and provide enhancement suggestions. The findings can be readily used by the practitioners.

What Role Do Design Factors Play in Applying Performance Measurement Systems in Nonprofit Organizations?

Recent research on management control and performance measurement and management (PMM) points towards a concern to provide suitable systems in nonprofit organizations (NPOs). However, few attempts have been made to understand these organizations and how their peculiarities influence this process. This research empirically discusses NPOs’ features through the lens of performance measurement and how these features influence performance measurement system’ design, the first step for an iterative PMM. A case study with two NPOs in the United States of America and Brazil provides valuable insights into the design factors. Results indicate that various factors related to purpose, stakeholders, and management influence the design of the performance-measurement system. Their unique organizational characteristics impact the usability and viability of the application of performance-measurement systems.

The Association Between French Veterinary Practice Characteristics and Their Revenues and Veterinarian's Time Use

The provision of healthcare by veterinarians consists of a blend of activities ensuring welfare for animals. It also contributes in the control of infectious diseases and food safety. In general practices, most of the activities generate incomes for veterinarians, notably acts (consultations, surgery, etc.) and sales (drugs, pet food, etc.). Increased size of veterinary practices and the arrival of corporate companies modify the veterinary landscape in many countries. In a context of rapid growth of the companion animal health market, the question of the profitability of veterinary activities is relevant. Indeed, beyond a certain threshold, veterinarians may be tempted to leave behind food-producing animals' acts and focus on companion animals' acts, which are generally recognized to be more profitable and more attractive for new generations of veterinarians. A survey was conducted in French veterinary mixed practices, and a regression analysis was used to quantify the relationships between the turnover and the characteristics of veterinary practices, the time to perform veterinary acts, and the characteristics of veterinarians. We found that the characteristics of veterinary practices are positively associated with the turnover and the price of acts, and that there was an association between the status of veterinarians (associate, collaborator, or employee) and the time required to perform companion animals' and food-producing animals' acts. The present study is the first study showing the association between the characteristics of veterinary practices and the turnover, by investigating the price of veterinary acts and the time required.

Exploring integrated supply chain performance in healthcare: a service provider perspective

Purpose

The paper identifies the antecedents and consequences of integrated supply chain performance (ISCP) in healthcare systems.

Design/methodology/approach

Based on a review of the literature constructs of supply chain flexibility (SCF), employee relationships (ERs), organizational orientation (OO) and knowledge exchange (KE) were identified as antecedents of ISCP, and patient centricity (PC) emerged as its consequence. This structural relationship was tested using partial least square structural equation modeling (PLS-SEM).

Findings

ERs, SCF, OO and KE positively impacted the performance of an integrated healthcare supply chain. Furthermore, enhanced ISCP in operational processes of the hospital positively influenced patient centeredness and care quality.

Research limitations/implications

Paper contributes by identifying antecedents and consequences of ISCP. Future researchers may explore the inter-relationships among the antecedents of ISCP.

Practical implications

Insights from this study will help practitioners in enhancing hospital operations by integrating processes along the healthcare service supply chain and developing a patient-centric approach.

Social implications

This paper highlights how PC may be achieved by focusing on a facilitative internal environment. This understanding may help in designing processes that deliver health as a social good in an effective manner.

Originality/value

The empirical evidence from this study can help hospitals integrate their functions, thus, enabling them to deliver quality care.

Benchmarks for INGOs’ effective responses during COVID-19 pandemic

Purpose

This paper aims to formulate COVID-19 benchmarks that international nongovernmental organizations (INGOs) have considered to recover from the sudden stopping of operations swiftly and consequences of COVID-19 pandemic; thus, to move forward toward readiness for both, the unpredictable spreading or disappearing of the virus (case of INGOs operating in Jordan).

Design/methodology/approach

This exploratory research has been informed by the broader social constructivism paradigm and the basics of grounded theory method to identify the common themes. Six semistructured interviews have been conducted with INGOs’ leaders. The findings have been categorized, triangulated and prioritized toward the final identification of benchmarks.

Findings

Seven COVID-19 benchmarks for INGOs’ effective responses during COVID-19 pandemic have been proposed, comprising of (1) donors’ policies and regulations, (2) needs, expectations and relevancy, (3) coordination, (4) staff management, (5) business continuation plans, (6) balanced short-term and long-term planning and (7) permanent adoption of successful modalities.

Social implications

INGOs play a vital role in the lives of vulnerable people around the world through their international development and aid (IDA) projects. However, the restrictions of movements associated with COVID-19 pandemic drive more burden on these communities and interrupted their access to assistance and support. This paper helps to sustain the crucial support of INGOs to those people who need it.

Originality/value

COVID-19 pandemic has interrupted the implementation of IDA projects, which added further obstacles toward the achievement of quality implementation of these projects. The proposed COVID-19 benchmarks help INGOs to overcome the consequences of pandemic on the near longer-term alike.

The relationship between quality and governance mechanisms

Purpose

Recent literature has highlighted the importance of quality and governance in supply networks. Usually, the relationships between the actors are complex, comprising both formal and informal interactions. Despite recent advances in quality and governance in supply networks, extant literature highlights the lack of quality in healthcare supply-chain networks in relation to governance mechanisms. This paper aims to investigate the role of governance mechanisms and their influence on the quality of healthcare supply networks, and assumes that governance instruments can support quality performance.

Design/methodology/approach

A multiple-case research approach was employed. Six organisations in the Brazilian healthcare sector were analysed (four operate only with renal replacement therapy, one is a material supplier, and one operates with renal replacement therapy and collective procurement).

Findings

Findings showed that there is no formalised supply network structure in these organisations. A possible consequence of this is that the supply-network governance is dominated by informal relationships. In the quality dimension, managers' awareness is limited, but there are mechanisms in place to control the quality of the materials.

Practical implications

Healthcare managers can actively invest in the social aspects of the relationship between buyer and supplier, such as trust and commitment, thus increasing responsiveness in patient care. However, this informal procedure can lead to problems with tracking and reliability, ultimately leading to quality problems. Therefore, it is recommended that formal and informal governance instruments be used jointly to improve service quality.

Originality/value

This study suggests that the integration of formal and informal mechanisms of governance can improve the quality of supply networks. Additionally, if the administrative process is purely formal, network relationships and their efficiency will be impaired.