A survey questionnaire (see Appendix - A) was designed as a part of the principal author’s doctoral (PhD) study, to collect data to validate the performance measurement (PM) framework (Figure 1) that was developed by them through case studies. Six New Zealand and three Australian nonprofit healthcare organisations were involved in the detailed case studies. The PM framework, particularly the measures that define the nine concepts that constitute it, is specifically intended for nonprofit organisations (NPOs) in the Australasian healthcare sector. Each survey questionnaire item in part two of the questionnaire was developed to mirror each potential measure under each concept belonging the PM framework (see the nine boxes in Figure 1).
27 Read more
integration between aspects of economic, environmental and social. Furthermore, SHSCPM research is feasible to develop in Indonesia. Besides, the main characteristic of services sector are intangibility assets which related with human resources –, so the SHSCPM implementation must attend intangibility assets on coordination process, performance measurement and customer relationship to meet the customer satisfaction.
We used the same analytical method as was used by Pinder and Price (2005); an approach called data envelopment analysis or DEA. In brief it compares the efficiency of units in a sample on two or more performance measures, weighting the results to present each unit in the best possible relative position. Units whose efficiency cannot be bettered by others in the sample are assigned an efficiency of 100%. The relative efficiency of other units can then be computed. Pinder and Price (2005) describe the method in more detail and provide references to original textbooks. DEA can be used to contrast more than two ratios at a time. Unfortunately since the resulting 'envelope' is multi-dimensional we have restricted the analysis to two dimensions separately. There are inevitably potential errors in either ratio. We discuss them below.
11 Read more
Health professionals’ approaches to breastfeeding during antenatal care are crucial to promote exclusive breast milk feeding. Our results highlight that exclusive breast milk feeding significantly increased in women who underwent prenatal tests; probably this practice contributed in encour- aging increasing educational activities in physician-patient relationship also regarding breastfeeding. Also, avoiding in-hospital formula supplementation appears to be a key step for breastfeeding success, together with the appropri- ate implementation of the other Baby Friendly Hospital Initiative (BFHI) steps . As highlighted by recent meta-analyses, the BFHI approach by steps requiring imple- mentation at the maternity ward, followed by home and family support through counselling, appears to be crucial for breastfeeding success in expectant and/or nursing mothers [39, 40]. The significantly lower adherence to PC-05 of newborns with a birth weight < 2500 g as well as in women with previous cesarean section, AROM and, as previous mentioned, with cesarean delivery, are important concerns of our results. These findings suggest the involve- ment of several non-clinical factors that would seem to be attributable to the overly cautious attitude of the physician concerning patients’ management, suggesting the need for improvement in the training of healthcare professionals.
Constant monitoring on effectiveness of strategy, external and internal environments, and progress of strategy implementation is required to ensure successful execution (Sterling 2003). Senior managers advance the strategic plan by keeping implementation on track and adjusting quickly to challenges and obstacles. One way to achieve this is to conduct a structured set of meetings including operational review meetings to assess short-term performance and respond to problems that have arisen recently and need immediate attention and strategy review meetings to ensure that the successful execution of strategy by effectively monitoring and managing strategic initiatives and Key Performance Indicators.
24 Read more
consistent with the literature. Bititci et al (2002) reviewing three research projects (Bourne and Neely, 2000; Hudson et al, 1999; Bititci and Carrie, 1998) summarise the main reasons for the failure of performance measurement systems; their time consuming and static nature and the lack of integrated IT infrastructure. This research identified the greatest problems with operational performance measurement at the department as: i) the time consuming manual analysis of computer generated performance information, ii) the lack of structured reporting system, and iii) the inability to connect the performance at different levels. Moreover, the outpatient department of the hospital lacks a performance measurement system. It rather tries to adapt the already existing performance reports to fit its needs.
19 Read more
The decision regarding the choice of organisational measures is reportedly one of the major considerations for framework design as the metrics chosen should re- late directly to the “organisation’s planned processes and targeted outcomes” (, p. 11). Any theoretical frame- work for performance measurement requires reference points such as measures to assess success or perform- ance to be developed (, p. 6). These reference points or measures are fundamental and the lack of published literature across any of the performance tools specifically relating to the measures of organisational performance of non-acute charities suggests measures for the sector have not yet been created, adapted or tested. The diffi- culty in determining appropriate measures that integrate accountability with sustainability (, p. 51), and the time consuming need for flexibility to suit individual or- ganisations (, p.79), are likely to be a challenging barriers to the introduction of an organisational per- formance measurement model in the sector. Authors in- cluding Gurd and Gao , Gomes and Liddle , Zimmerman , Bisbe and Barrubes , and Boateng et al.  suggest variations to organisational perform- ance measures for healthcare organisations or charities.
12 Read more
Alexander (1996) identifies measurement of performance as one of “three essential issues for the effective implementation of a facilities strategy. Thus performance measurement has become increasingly important both for reason of justification to general management and to support management and practise within facilities management organisation. The measurement of facilities has three main components, namely, physical, functional and financial (Williams 1996). Physical performance relates to the behaviour of the building’s fabric and embraces physical properties such as structural integrity, heating, lighting, energy efficiency, maintainability, durability etc. Functional performance concerns the relationship of the building with its occupiers and embraces issues such as space, layout, ergonomics, image, ambience, communication, health and safety and flexibility, etc. Finally, financial performance arises from the physical and functional performances of the building and comprises capital and recurrent (life-cycle) expenditures, depreciation and efficiency of use etc.
20 Read more
While opportunities and advantages of the use of BI & A are identified by both employees and senior management, the current usage is limited. The main cause of minimal use is the lack of perceived problems with the current methods. Identification of these problems in combination with explanation of BI&A opportunities should inspire investment in BI&A. Examples of Business Intelligence that can be used for the specific problems with data gathering and analysing identified are Data Warehousing and Extract, Transform and Load. Where Data Warehousing can be implemented for data gathering and storage of information. ETL is implemented for the processing and analysing of the data. In a DW information is gathered in one larger system rather than across departments and sources where multiple employees are responsible for updating the data sources, hence DW eliminates the issues with decentralized information storage and consistency. Where Extract, Transform and Load diminish the issues with reliability, consistency and dynamically available as the extracting and transforming is not done manually but automatically which is less time consuming and more consistent and less room for errors. Concluding, Company X should invest in IT technologies and centralize the multiple data sources they currently use, solving the problems with data gathering and unavailability of data. Furthermore, the process of implementation is currently complex and time consuming, as a BI&A system is already in use for calculation of one of the measures, this should be extended to include all the measures eliminating the time, consistency and reliability issues and improving the overall performance of the PMS.
88 Read more
1. We define our measures from the communities point of view 2. Our current M&E system measures all the right things 3. Responsibilities for assessing different measures are clearly defined 4. Our M&E system does not produce more paperwork than is necessary 5. Results form our M&E system informs decisions on budgetary allocations 6. Our system always gives us the information we need when we need it 7. We are only accountable for measures over which we have control 8. Everyone in our organisation understands the measures used to assess performance 9. Senior management built our M&E system with a plan - it did not evolve by chance 10. Our M&E system contains a " well-balanced" set of measures that reflects the different levels of objectives in our strategic plan 11. We assess client satisfaction of the outputs we deliver with and for them 12. We have a way of to summarise all our outputs easily 13. We pay as much attention to the non-financial measures as we do the financial measures 14. We track performance for internal operations as well as the delivery of outputs 15. We act on results quickly
105 Read more
Healthcare systems play a very important role in society and their role is becoming increasingly important in regard to the phenomenon of population ageing. The issue of the performance of healthcare systems should be at the forefront in terms of the interest of academic research studies and discussions among the scientifi c community. The proper functioning of the healthcare system should also be a priority in regard to public policy. These facts should encourage governments to regularly evaluate the performance of their healthcare systems and create international comparisons. Many indicators are used to measure and evaluate performance of healthcare systems – e.g. those created by the WHO, Eurostat, or OECD Health Statistics and OECD Health Policy Studies. For our paper, data from the OECD Health Policy Studies was used as a primary source. V4 states were chosen for the evaluation of the performance of healthcare systems. The reasons for this are as follows: V4 countries are transitive economies of the CEE with a poorer state of health of their populations than in more developed countries of the OECD or EU; the given systems have long been underfi nanced; and reforms are focused exclusively on economic goals and lack a broader concept in terms of long-term sustainability. For the purposes of this paper, a composite indicator of the performance of healthcare systems was designed and includes ten variables for the studied ten-year period. In order to establish a comparison of the performance of healthcare systems, three methods were used to model them: (i) using the area of a radar chart, (ii) determining performance based on order, and (iii) determining performance based on distance from the reference unit. These three methods for determining the performance of healthcare systems allow us to compare the performance of healthcare systems in V4 countries specifi cally. The goals of this paper are as follows: compare and evaluate the performance of healthcare systems among V4 countries using selected indicators from the fi eld of healthcare and establish what position the Czech Republic’s healthcare system holds in comparison with other V4 countries.
14 Read more
design and implementation of the performance measurement system. It is well known that promoting managers’ ownership of and commitment to a performance measurement system is fundamental for its successful implementation. Management is ultimately responsible for developing, implementing and using performance measurement systems and this research suggests a framework that can assist them in these tasks. In addition to promoting ownership and commitment, the framework proposed in this research provides in depth support to improve understanding regarding the key interlinkages between the different factors that drive organisational performance and helps decision makers identify an appropriate set of performance indicators. Rather than viewing these as independent, stand-alone elements, the proposed approach allows decision makers to identify the relationships between indicators and the need for co-ordination between the different parts of the system assessed. This exercise can prove highly effective in communicating and explaining to others the key performance drivers that appear to be critical to the success of operations, and the need for their monitoring. Further to helping decision makers define what to measure and why, the proposed framework also offers a structured way to: synthesise the available performance information into a few key indicators of performance and/or into a single indicator of overall performance; highlight areas of performance strength and weakness that can form the basis for improvement initiatives; and explore the robustness of the results to changes in the relative importance of the performance indicators. Overall, the integrated used of the OR/MS techniques proposed may prove invaluable to increase the legitimacy of the performance measurement system as a decision-supporting tool, and consequently, to ensure its successful implementation.
29 Read more
The unrestricted nature of Contribution Measurement also manifests in the fact that it appreciates the subjectivity of the value of the social outcomes. In figure 3, ‘family conflict’, ‘unsatisfying non-work life’ and ‘health problems’ are certainly negative contributions, while ‘stress reduction’ is a positive contribution. The rest of the outcomes, however, (i.e. state’s inability to accurately plan ahead, facilitated social movements, changing of the assumption about gender roles) cannot be easily labelled as positive or negative contributions. It may be the set values of the society that determine whether these are positive or negative contributions. This itself is very much subjective and can vary based on different stakeholders involved.
11 Read more
The term ‘performance’ is recognised as being indistinct and without simplified definition (Otley, 1999). Nevertheless, the idea of performance measurement and subsequent management, are essential components accepted by organisations worldwide (Hoque, 2010; Salem, 2003). The challenge facing today’s managers is maintaining optimum performance in an ever-changing workplace and global economy (Al-Khouri, 2010). In response, academics and theorists have assembled a plethora of tools to evaluate organisational performance (Martz, 2013). The 1990’s saw an upsurge in the topic; especially its linkages to embedding corporate strategy throughout an organisation (Neely, 1999; Kaplan & Norton, 1996; Labovitz & Rozansky, 1997; Bourne, et al., 2000; Adler, 2011). As per many private-sector firms, the NHS was also awakening to such ideologies - as analysing key metrics would provide evidence for decision-makers to enhance quality of care and public accountability (Gallani, et al., 2015; Strome, 2013). Similarly, Patel, et al. (2006), state PM systems assist under-pressure NHS managers to maintain effective levels of performance, whilst juggling limited staff and resources.
143 Read more
(Gummesson, 2000). Coghlan and Brannick (2005) further suggest that action research generates data from engagement with others. For this study I employed a number of data-gathering methods. These included face-to-face interviews, reviewing historical documents such as memos, plans, minutes of meetings that had been generated prior to me undertaking the study, and engaging in meetings and discussions about performance measurement. Other forms of data collection I used included informal conversations, phone calls, observations, unplanned questioning during meetings, facilitating meetings, generating business plans, carrying out Strength, Weakness, Opportunity and Threat (SWOT) analyses, discussions with third-party consultants, email communications, reviewing financial reports, and taking notes at regular monthly management team and board meetings. While engaging in these data-generating activities I found it useful to regularly remind myself of the objectives of the study and to ensure a link with performance measurement existed.
346 Read more
of these outcomes. However, the main customer in healthcare is the patient. Therefore, the second goal is to acquire the information needed for quality improvement within a healthcare institution. To this end, an alterna- tive EFA was performed. To include more content of the questionnaire in the domains, more questions were added. We think this information may help A&E man- agers and others to start evaluating quality improvement projects. Both goals represent a different way of con- structing domains in questionnaires. Following all cri- teria in the CQI guidelines, domains are constructed using the perspective of a reflective measurement model [22,23]. Only items with a 4-point Likert scale were included. Items that did not fit into any domain, and domains that did not fulfil the statistical criteria, were omitted . The qualitative phase was carried out in order to detect all aspects related to healthcare perform- ance in the A&E. Each aspect is a unique part of the provided care and together they form the construct ‘quality of care’. To end up with a few statistically related items neglects the broad range of the aspects. Therefore, a formative measurement model may be better suited to construct domains in experience questionnaires. The lat- ter theory concerns the construction of domains based on content and not solely on strict statistical criteria. In the second analysis, we did not try to construct domains solely from a formative perspective, but we tried to in- clude as many experience questions as possible, while still achieving internally consistent and interpretable domains. We included all domains that came up in the second EFA, thereby doubling the content of the
10 Read more
The obesity epidemic continues to provide challenges to healthcare professionals (HCPs). American and Euro- pean data suggest that the prevalence of obesity (body mass index [BMI] > 30 kg/m 2 ) has approximately dou- bled over the past fifteen years [1-5]. Over the same time period the prevalence of severe obesity (BMI > 40 kg/m 2 ) has increased three- to five-fold [6,7]. Obesity confers a 22% increase in overall mortality, a 48% increase in car- diovascular disease (CVD) mortality and a 7% increase in cancer mortality . Moderate intentional weight loss brings about multiple health benefits including a 24% reduction in mortality at 8 years . For people with se- vere obesity bariatric surgery brings about a 24% reduc- tion in mortality at 11 years and gastric bypass surgery effects a 40% reduction in mortality at 7 years [10,11].
• Provider perspective: From this point of view, the cloud is regarded as a complex distributed infrastructure, with many hardware and software ele- ments combined to provide a specific set of services. Measurements of this type give the CSP information about the internal performance of those ele- ments. This information serves as an internal status control in order to en- sure compliance with SLAs and other service requirements. It can be also used to optimize internal system management and use of resources. Exam- ples of measurements for the provider perspective are CPU utilization , net- work TX bytes and HD write errors , which can be mapped to the concepts of resource utilization, capacity and fault tolerance, respectively.
14 Read more
The word performance is widely used in all fields of management. Terms such as performance management, measurement, evaluation and appraisal are commonly discussed in management literature. Despite the frequency of use of the word performance, its precise meaning is rarely explicitly defined by authors. Often, performance is identified or equated with effectiveness and efficiency (Neely et al., 1995). The review of oxford dictionary depicts, “carrying out a task” as the meaning for the performance. Performance is referred to in most of the references as either an action (obtaining performance) or an event (a result) or both simultaneously. In view of this, according to Bourguignon (1995) performance refers simultaneously to the action, the result of the action and to the success of the result compared to some benchmark. All in all performance is doing today, what will lead to measured value outcome tomorrow. Thereby in view of better outcome for tomorrow, throughout the last two decades a number of industries, primarily manufacturing, have introduced new methods and techniques to shift traditional paradigms.
12 Read more
The Erasmus et al. (2010) systematic review focused on hand hygiene compliance in accordance to guidelines within hospital care. It cites an overall finding that compliance rates were lower amongst physicians (32%) than nurses (48%). This 32% vs. 48% comparison stems from the reviewers finding nine studies which reported hand hygiene rates of >50% in physicians, as opposed to the same compliance rates in nurses being reported in 17 studies. The 32% and 48% represent the median scores from these reported findings. Table 2 (pp. 288) in their paper provides a comprehensive analysis of compliance rates for nurses, physicians, other healthcare professionals, and remaining groups of healthcare professionals where no clear definition was made in the original publications. From this table it is clear to see a difference in compliance rates between nurses and physicians. Of the six studies found to show over 71% compliance in nurses (Pittet et al., 2000; van de Mortel et al., 2000; van de Mortel et al., 2001; O’Boyle et al., 2001; Cromer et al., 2008; Duggan et al., 2008), only one of these also shows the same over 71% compliance rate in physicians (van de Mortel et al., 2001). The others finding 61-70% (Cromer et al., 2008), 41-50% (van de Mortel et al., 2000) and <20% compliance (Pittet et al., 2000). The remaining study, O’Boyle et al. (2001), which found between 71-80% compliance in nurses did not involve physicians, so no direct comparison is possible.
467 Read more