Search results

With rising health-care costs and the financial constraints in most developing countries, prioritization of needs have become an issue of strategic importance in public hospitals. As a result, there is the intense competition of scare resources between core health care and non-core facilities management (FM) services. Given that financial resources are needed to facilitate the smooth operation of the FM department, this paper aims to investigate the direct and indirect effects of finance on the relationship between service quality and performance of hospital FM services.

The paper adopts a quantitative approach following a general questionnaire survey which was conducted on the research population. Partial least squares structural equation modelling was used to investigate the relationships between service quality and performance of hospital FM services.

The study highlights the relevance of service quality to improving FM performance and demonstrate the direct and indirect influence of finance to ensure quality FM services delivery to improve core health care outcomes in hospitals.

The result of this study should motivate hospital management to prioritize attention on FM in scare resources management in public hospitals to create and maintain a decent health-care environment for better health outcomes. Further, managerial commitment to facilitate employee training, empowerment, incentives, awards and compensation should be strengthened in the quest of ensuring quality services delivery.

The paper extends knowledge by mediating the influence of finance on the relationship between service quality and FM performance. Proposes a parsimonious financial mediation framework which can easily be adaptable to several developing countries health-care FM management.

This paper aims to provide insights into how the New Zealand Office of the Auditor-General (NZOAG) legitimised the selection of topics for performance audit in the New Zealand public health sector over a 10-year period, 2003-2013, by fulfilling the key actors’ “taken for granted beliefs” of the dual roles of the NZOAG: its independence and accountability.

This paper uses evidence gathered from interviews with representatives of the District Health Boards, the Ministry of Health (including Health Advisory Committee members) and NZOAG staff, along with publically available documentary evidence over a 10-year period. The authors draw on Suchman’s (1995) authority on institutional legitimacy to inform the research findings.

The New Zealand Auditors-General (NZAGs) get inputs from various sources such as their own audit teams, parliamentary deliberations, the Ministry of Health, the District Health Boards, media and public concerns and complaints. These sources initiate ideas for performance audits. Subsequently, the NZAGs use the recurring themes and risk assessment criteria while simultaneously consulting with the auditees (the MOH and the DHBs) and other actors, such as health advisory groups, to select topics for such audits. This signals to the key actors, such as the MOH and the DHBs, that the NZOAG is addressing the topics and concerns relevant to the former while discharging its public accountability role. Furthermore, the consultative approach acts as a catalyst, ensuring that the actors involved with public sector health service delivery, specifically the auditees, accept the selected topic. This leads to a lack of resistance to and criticism of the topic; the selection process, therefore, is legitimatised, and credibility is added to the audits. Because of the consultative approach taken by the NZAGs, the actors, including the performance auditors, continue to believe that the Office acts independently from third party influence in selecting their audit topics, elevating the NZAGs’ moral legitimacy with respect to their public accountability role.

The study’s focus group does not include parliamentary representatives, only representatives from the DHBs, the MOH and the NZOAG; therefore, the conclusions on effective discharge of the NZOAG’s accountability role and Parliamentary acceptance is not conclusive – the NZOAG acts on behalf of the Parliament in discharging its accountability role and the latter is also the formal recipient of the reports.

The implications for practitioners and policymakers are that the use of a consultative approach to select topics for performance audit in the absence of performance auditing standards ensures auditee readiness and acceptance of such audits. This also promotes mutual benefits and “trust” between the AG and auditees. Such audits can be used to bring about efficacy in health service delivery.

The selected topics for audits will have an impact on citizens’ lifestyles, with improved health services delivery.

There is a dearth of research on who initiates the ideas for performance auditing and how the Office of the Auditor-General selects topics for such audits. This study adds a new dimension to the existing performance auditing literature. The authors reveal how the NZOAG seeks to legitimise the selection of topics for such audits by consulting with the auditees and other actors associated with public sector health service delivery, while upholding its independent status and making transparent how it discharges its accountability role within the context of performance auditing.

The purpose of this paper is to explore stakeholder expectations of performance within public healthcare services from a less-developed economic context – Zambia in this case. The study emerges from extant literature indicating potential variations in stakeholder conceptions and expectations of performance within public services.

The paper draws on institutional and structuration theories to investigate cross-sectional stakeholder expectations of performance together with power relations embedded within public healthcare performance expectations. Empirical data are drawn from semi-structured interviews with 33 stakeholders including legislators, policymakers, regulators of health services, healthcare professionals and health facility managers.

The findings not only reiterate the constructed and multi-dimensional nature of performance but also highlight the hierarchical configuration of stakeholder expectations linking macro-level health outcomes with micro facility-level service delivery processes.

The study points towards the need of harmonising the national performance measurement (PM) framework to ensure that macro-level goals are suitably cascaded and translated into micro-level service delivery processes through bottom-up structuration linkages.

In addition to filling the gap of explicating public healthcare PM practices in a less-developed economic context, the paper integrates insights from institutional and structuration theories to depict stakeholder expectations of performance through a multi-level and hierarchical framework.

The purpose of this paper is to study the efficacy of a district tuberculosis (TB) co-ordinating team on health service performance for suspected TB patients in a district hospital in northeastern Thailand.

A comparison study of pre- and post-evaluations of TB system improvement was conducted in a district hospital in northeastern Thailand between October 2016 and June 2017. Data collection reviewed the record of suspected TB cases reported in the district hospital in the past nine months as a base line for describing the health service performance in term of received investigation for TB diagnosis. Participants from a TB clinic, district health office and health center set up a TB co-ordinating team to explore situations and systematic gaps. The TB co-ordinating team gave recommendations of health service performance for suspected TB patients over a nine-month period. Records of suspected TB cases health service performance were collected nine months after intervention. Data analysis by descriptive statistics and to test the effect of intervention was performed.

The records from 324 and 379 suspected TB cases reported in the hospital from the 9 months preceding and 9 months, respectively, after intervention were reviewed. A TB co-ordinating team was set up to improve the system and health service performance in terms of investigation for TB diagnosis. The results revealed that health service performance in terms of complete microscopy and investigation in both chest radiography and microscopy increased after intervention. When comparing between pre- and post-intervention, suspected cases received both chest radiography and microscopy in 176 cases and 283 cases, respectively (p-value=0.001). There were 27 cases diagnosed for smear positive TB in pre-intervention and 51 cases diagnosed in post-intervention (p-value=0.011). There were 21 cases pre- and 36 cases post-intervention that had referral documents from health center with no statistically significant difference.

The TB co-ordinating team had the role to improve health service performance for suspected TB cases to enroll in investigation process for increase TB diagnosis in district hospital.

This paper proposes investigating a model of service recovery performance in a public health‐care setting.

Frontline hospital staff (administrative and nursing staff) representing a range of out‐patient departments/clinics in a New Zealand inner‐city public hospital completed a self‐administered questionnaire on organizational variables affecting their service recovery efforts, job satisfaction and intention to resign. Data obtained from the hospital were analyzed using the SEM‐based partial least squares (PLS) methodology.

The results show significant relationships between perceived managerial attitudes, work environment perceptions, service recovery performance and outcomes variables.

Limitations of the study are noted including the generalizability of the findings within a public health‐care environment. Suggestions for future research include an examination of other variables potentially important in service recovery efforts. A patient perspective would also be valuable.

The research advances understanding of frontline service recovery performance in a health‐care setting and the findings indicate that health‐care managers can take actions on a number of fronts to assist progress toward the achievement of frontline service recovery excellence.

Very little attention has been given to understanding the antecedents and outcomes of service recovery performance in the health‐care literature. By expanding earlier research in private sector industries, the study investigates a model of service recovery performance in a public health‐care setting.

The purpose of this paper is to estimate the performance of Brazilian hospitals’ services and to examine contextual variables in the socioeconomic, demographic and institutional domains as predictors of the performance levels attained.

The paper applied a two-stage approach of the technique for order preference by similarity to the ideal solution (TOPSIS) in public hospitals in 92 Rio de Janeiro municipalities, covering the 2008–2013 period. First, TOPSIS is used to estimate the relative performance of hospitals in each municipality. Next, TOPSIS results are combined with neural networks in an effort to originate a performance model with predictive ability. Data refer to hospitals’ outpatient and inpatient services, based on frequent indicators adopted by the healthcare literature.

Despite a slight performance increase over the period, substantial room for improvement is observed. The most important performance predictors were related to the demographic and socioeconomic status (area in square feet and GDP per capita) and to the juridical nature and type of ownership of the healthcare facilities (number of federal and private hospitals).

The results provide managerial insights regarding the performance of public hospitals and opportunities for better resource allocation in the healthcare sector. The paper also considers the impact of external socioeconomic, demographic and institutional factors on hospitals’ performance, indicating the importance of integrative public health policies.

This study displays an innovative context for applying the two-stage TOPSIS technique, with similar efforts not having been identified in the healthcare literature.

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.

A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.

Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.

Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.

Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.

For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.

This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.

The purpose of this study is to develop a customised model to measure the performance of housekeeping (HK) services in Sri Lankan health-care facilities.

An exploratory sequential mixed approach was adopted in the study to collect and analyse data. A case study strategy was adopted in the initial phase to explore the current HK practices, and to determine the applicable key performance indicators (KPIs) found through literature. Semi-structured interviews were used as the data collection method in the selected case studies. A questionnaire survey was conducted in the next phase to verify the validity of case study findings. Quantitative data were analysed using descriptive statistics. One sample t-test was used to identify significant KPIs and to formulate the customised performance measurement (PM) model.

The study identified and ranked 46 KPIs, which can be used to measure the performance of HK divisions of health-care facilities, in balanced scorecard perspectives. The findings also revealed that the KPIs determined using the model have a significant impact on implementing effective health-care HK services and could be used to measure both real and subjective cleanliness.

The developed model can be used for numerous PM requirements in health-care setups in both developing and developed countries. The KPIs determined using this model can be presented in quality audits and government inspections as proof of effective HK management. The HK managers of the health-care sector can effectively monitor the performance of their divisions using the proposed PM model and this model can be customised to match the other facilities management service divisions.

Many studies focus on overall health-care PM. This study expands the knowledge on HK PM in the health-care sector by presenting a collection of performance indicators centred on HK function.

This paper seeks to describe the New Zealand Ministry of Health District Health Board (DHB) Mental Health Service Profile, which for the first time compares performance on a number of quality indicators for the populations of 21 DHBs.

The background, theory and development of the Ministry of Health Mental Health Directorate DHB Mental Health Service Profile (Profile) is discussed and example pages from the Profile are included

The DHB Profile overcomes the problem of setting arbitrary benchmarks by using the range of current practice across the sector. The profile demonstrates that certain levels of performance can be achieved and, given a better understanding of the long‐term client group, is potentially a very powerful tool for encouraging improved service delivery. Improved data quality is also likely to be a spin‐off from the use of the Profile in the sector.

Having key DHB mental health quality information in one place and being able to compare individual DHB performance with minimum, medium and maximum values for all DHBs are a significant step to improving information use and understanding DHB service and quality issues.

Improving the performance of health care organizations is now perceived as essential in order to better address the needs of the populations and respect their ability to pay for the services. There is no consensus on what is performance. It is increasingly considered as the optimal execution of four functions that every organization must achieve in order to survive and develop: reach goals; adapt to its environment; produce goods or services and maintain values; and a satisfying organizational climate. There is also no consensus on strategies to improve this performance. The paper aims to discuss these issues.

This paper intends to analyze the performance of primary health care organizations from the perspective of Kauffman’s model. It mainly aims to understand the often contradictory, paradoxical and unexpected results that emerge from studies on this topic.

To do so, the first section briefly presents Kauffman’s model and lays forward its principal components. The second section presents three studies on the performance of primary organizations and brings out the contradictory, paradoxical and unexpected results they obtained. The third section explains these results in the light of Kauffman’s model.

Kauffman’s model helps give meaning to the results of researches on performance of primary health care organizations that were qualified as paradoxical or unexpected. The performance of primary health care organizations then cannot be understood by only taking into account the characteristics of these organizations. The complexity of the environments in which they operate must simultaneously be taken into account. This paper brings original development of an integrated view of the performance of organizations, their own characteristics and those of the local environment in which they operated.