Use of comparative performance indicators in rehabilitation

BACKGROUND

The development of performance indicators that enable benchmarking between organizations is an important mechanism for accountability, organizational learning, and performance improvement. In the province of Quebec (Canada), 21 rehabilitation organizations developed a common set of performance indicators through interorganizational collaboration.

PURPOSE

The aims of this study were to describe the rehabilitation organizations' use of a common set of performance indicators and to identify the factors influencing such use.

APPROACH

A qualitative survey was performed. Individual semistructured interviews were conducted with executives (n = 18) working at 16 rehabilitation organizations using a common set of performance indicators. A thematic analysis of the factors of use was performed according to the Consolidated Framework for Implementation Research. The use of performance indicators was categorized as purposeful, political, or passive.

FINDINGS

Our results showed that all organizations used the common set of performance indicators. Four factors were identified as important to all the rehabilitation organizations to explain their interest in comparative performance indicators: the need to develop their own performance indicators, the compatibility of performance information with organizational needs, complexity/simplicity of performance information, and the support offered by their common association. Sixty-three percent of rehabilitation organizations made purposeful or political use of performance indicators. Three main factors contributed to typify those organizations from the others: the perceived quality of the performance indicators, the leadership of decision makers, and the resources available.

PRACTICE IMPLICATIONS

Our results showed that use of performance indicators can support the initiation of projects for improving the quality of care. Key recommendations are proposed to decision makers that may enhance performance indicators' use.

Performance assessment process model for international manufacturing networks

Purpose

Multinational companies have manufacturing operations in various countries; however, there is scarce evidence on how they assess performance of the network-based operations of their factories, called international manufacturing networks (IMN). The purpose of this paper is to propose a process model for the performance assessment of IMNs.

Design/methodology/approach

The IMN performance assessment process model was developed from the extant literature and was empirically verified in its congruency and usefulness via a multiple case research. For that, in each case the general process model was derived into a specific application that fit the type of IMN on focus. Qualitative and quantitative data were collected from the case companies’ reports, profiling forms and interviews, followed by within-case and cross-case analyses.

Findings

Evidence suggest that the process model, along with its derivations, is a valuable tool to describe and explain how IMN performance assessment unfolds in real organizational environments. Additionally, three propositions emerged: IMN performance assessment has distinct characteristics depending on the type of IMN adopted, which in turn depends on the company’s internationalization strategy; IMN performance assessment has more strategic value and importance for companies that are globally coordinated and adopt “rooted” manufacturing strategies; and companies design their IMN performance assessment on a trial-and-error basis.

Research limitations/implications

As all case-based research, this paper has generalizability limitations. Thus, next steps may include a large-scale survey and an action research that will develop and implement a full-fledged IMN performance assessment.

Practical implications

The process model and descriptive insights provide a diagnostic tool and subsidies that may encourage managers to review and improve their current IMN performance assessment.

Originality/value

The process model contributes to addressing a 20-year gap concerning how to approach IMN performance assessment in a holistic and systematic manner.

Methods and Tools for Performance Assurance of Smart Manufacturing Systems

The emerging concept of smart manufacturing systems is defined in part by the introduction of new technologies that are promoting rapid and widespread information flow within the manufacturing system and surrounding its control. These systems can deliver unprecedented awareness, agility, productivity, and resilience within the production process by exploiting the ever-increasing availability of real-time manufacturing data. Optimized collection and analysis of this voluminous data to guide decision-making is, however, a complex and dynamic process. To establish and maintain confidence that smart manufacturing systems function as intended, performance assurance measures will be vital. The activities for performance assurance span manufacturing system design, operation, performance assessment, evaluation, analysis, decision making, and control. Changes may be needed for traditional approaches in these activities to address smart manufacturing systems. This paper reviews the current methods and tools used for establishing and maintaining required system performance. It then identifies trends in data and information systems, integration, performance measurement, analysis, and performance improvement that will be vital for assured performance of smart manufacturing systems. Finally, we analyze how those trends apply to the methods studied and propose future research for assessing and improving manufacturing performance in the uncertain, multi-objective operating environment.

Can enhanced performance management support public sector change?

Purpose

– The purpose of this paper is to focus on the potential role that performance management could play in enabling employees’ adaptability to change and, therefore, successful change implementation.

Design/methodology/approach

– This research adopted a qualitative case study research design, focussed on seven case studies within the Australian Public Service (APS). This study utilized documentary analysis, semi-structured individual and group interviews.

Findings

– The findings of this research demonstrate that adaptability to change is integral for high performance; however, the constant change faced by many public servants is disruptive. The authors posit that applying a performance framework developed by Blackman et al. (2013a, b) to change implementation will help overcome, or at least mitigate, these issues. The authors argue that applying this framework will: enable adaptability to change; and provide an ongoing management function that enables change to occur.

Research limitations/implications

– This research has been limited to seven organizations within the APS, yet it does reveal interesting implications in terms of the apparent role of performance management in both developing change capacity and supporting espoused outcomes.

Practical implications

– This research identifies the potential role that performance management can play in supporting effective change implementation through enabling employees to cope better with the change through enabling clarity, purpose and alignment with the organizational direction.

Originality/value

– The originality of this paper stems from the synthesis of different strands of literature, specifically high performance, performance management and change management, and empirical research in the public sector to provide a new way of looking at performance management as a change enabler.

Effects of performance measure implementation on clinical manager and provider motivation

BACKGROUND

Clinical performance measurement has been a key element of efforts to transform the Veterans Health Administration (VHA). However, there are a number of signs that current performance measurement systems used within and outside the VHA may be reaching the point of maximum benefit to care and in some settings, may be resulting in negative consequences to care, including overtreatment and diminished attention to patient needs and preferences. Our research group has been involved in a long-standing partnership with the office responsible for clinical performance measurement in the VHA to understand and develop potential strategies to mitigate the unintended consequences of measurement.

OBJECTIVE

Our aim was to understand how the implementation of diabetes performance measures (PMs) influences management actions and day-to-day clinical practice.

DESIGN

This is a mixed methods study design based on quantitative administrative data to select study facilities and quantitative data from semi-structured interviews.

PARTICIPANTS

Sixty-two network-level and facility-level executives, managers, front-line providers and staff participated in the study.

APPROACH

Qualitative content analyses were guided by a team-based consensus approach using verbatim interview transcripts. A published interpretive motivation theory framework is used to describe potential contributions of local implementation strategies to unintended consequences of PMs.

KEY RESULTS

Implementation strategies used by management affect providers' response to PMs, which in turn potentially undermines provision of high-quality patient-centered care. These include: 1) feedback reports to providers that are dissociated from a realistic capability to address performance gaps; 2) evaluative criteria set by managers that are at odds with patient-centered care; and 3) pressure created by managers' narrow focus on gaps in PMs that is viewed as more punitive than motivating.

CONCLUSIONS

Next steps include working with VHA leaders to develop and test implementation approaches to help ensure that the next generation of PMs motivate truly patient-centered care and are clinically meaningful.