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Article
Publication date: 10 April 2017

Adriana Pace and Sandra C. Buttigieg

The purpose of this paper is to analyse hospital dashboards’ visibility of information at different management levels to improve quality and performance in an acute…

Abstract

Purpose

The purpose of this paper is to analyse hospital dashboards’ visibility of information at different management levels to improve quality and performance in an acute general hospital.

Design/methodology/approach

Data were generated via 21 semi-structured interviews across different management levels.

Findings

All management levels had greater visibility of information, could make informed decisions, and registered performance improvement. Specifically, waiting time improved, however since introduction of hospital dashboards was work-in-progress at time of study, managers could not record improvement in terms of cost reductions, clinical effectiveness, patient safety and patient satisfaction. Different managerial levels had different visibility with top management having the greatest.

Research limitations/implications

In single case studies, where only one context is used, the findings cannot be reproduced in different contexts; even though most of the results could be matched with the current literature.

Practical implications

The need to have balanced key performance indicators that take into account other facets of improvements, apart from time, has been emphasised. Furthermore, if middle and departmental managers have greater visibility, this would allow them to work towards a strategic fit between the departments that they manage with the rest of the hospital.

Originality/value

There is scant literature regarding performance dashboards’ enhancement of visibility of information at different management levels. Furthermore, according to the authors’ knowledge, no other paper has tried to identify and discuss the different levels of information, which should be visible from bedside to board namely to management, clinicians and public.

Details

Journal of Health Organization and Management, vol. 31 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 15 May 2017

Sandra C. Buttigieg, Adriana Pace and Cheryl Rathert

The purpose of this paper is to give a comprehensive and updated analysis of the available literature on hospital dashboards.

Abstract

Purpose

The purpose of this paper is to give a comprehensive and updated analysis of the available literature on hospital dashboards.

Design/methodology/approach

A search of the current literature was performed by searching electronic databases, including Google Scholar, EBSCO and Medline, as well as books.

Findings

In all, 48 manuscripts consisting of peer reviewed articles, conference proceedings, case reports and text books were included in this review.

Practical implications

Despite the numerous advantages of performance dashboards, several authors have mentioned a number of challenges. It was evident from the literature that any setting requires significant effort, especially to ensure the quality of data being collected. In fact, significant investment, both in terms of financial and human resources, is required to achieve an effective dashboard. Furthermore, most of the studies available in the literature were individual case reports or anecdotal accounts rather than empirical studies. Thus, further research is required to ascertain the effectiveness of performance dashboards. In view of these findings, each organisation should make its own decisions whether or not to adopt performance dashboards.

Originality/value

Most of the literature is fragmented as it reports the use of different types of dashboards, namely strategic, tactical and operational, as separate tools. This literature review contributes to knowledge as it brings together the different types of dashboards and the cascading effect of one dashboard onto another in order to achieve and retain organisational alignment with the overall strategic goals.

Details

Journal of Health Organization and Management, vol. 31 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 3 August 2015

Ioana Bradea and Virginia Mărăcine

Performance indicates how well the activities, operations and business processes of an enterprise are performed. In health care, performance illustrates the quality of…

Abstract

Purpose

Performance indicates how well the activities, operations and business processes of an enterprise are performed. In health care, performance illustrates the quality of medical services and targets the strategic objectives, the efficiency and effectiveness and the obtaining of the desired financial results. In economic analysis, the key performance indicators (KPIs) offers real, relevant and accurate information regarding the performance, using analysis and diagnosis techniques. The purpose of this paper is to discuss grey systems theory in order to bridge the KPIs and the hospital’s performance.

Design/methodology/approach

Using the grey systems theory, the impact of seven selected KPIs (the beds utilization rate, the average length of hospitalization, the average cost of hospitalization/day, the proportion of physicians in total staff, the nosocomial infection rate, the death rate and the diagnostic concordance) on the hospital’s turnover is determined.

Findings

By analyzing the grey incidence between turnover and several KPIs, for a period of six years, it has been concluded that the greatest impact on performance has the diagnostic concordance and the percent of the physicians in the total staff, followed by the nosocomial infection rate, the average bed utilization rate and the death rate.

Research limitations/implications

The considered case study should be extended by including a greater number of hospitals into the analysis.

Originality/value

The usage of the grey systems theory in an uncertain and limited information field such as the medical one, is a premier in this field. According to the grey incidence analysis results, the performance of health care institutions depends mainly on the quality of medical staff (that influence the diagnostic concordance, the nosocomial infection rate and the death rate) and on the management ability to attract competent and well-trained physicians, which can conduct in a new approach that should be considered by the hospitals’ managerial staff.

Details

Grey Systems: Theory and Application, vol. 5 no. 2
Type: Research Article
ISSN: 2043-9377

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Book part
Publication date: 9 May 2014

Isabelle Flachère

We utilise the actor-network theory (ANT) – based especially on Latour (2005) – to examine how management accounting tools affect physicians’ representations and new…

Abstract

Purpose

We utilise the actor-network theory (ANT) – based especially on Latour (2005) – to examine how management accounting tools affect physicians’ representations and new managerial practices in French public hospitals currently undergoing reform.

Design/methodology/approach

We conducted a longitudinal case study – based on interviews and observations – in a large French public hospital in which dashboards are diffused to physicians and nurses dealing with both medical and managerial activities.

Findings

The case shows that head physicians and nurses are implicated in their new managerial tasks and spend time analysing dashboards. Management accounting tools thus play a role, as mediators, in organising new managerial practices, and dashboards are a means of materialising and giving structure to new managerial practices and enabling discussions and exchanges to take place between actors who were previously separated.

Research implications

The case shows that management accounting tools are not necessarily useful because they help in decision-making or control – as in the dominant paradigm; rather, they are beneficial because they may help in changing representations and building a new collective organisation. Future research should therefore expand on the organisational and social roles of management accounting tools, especially in the healthcare field.

Originality/value

Most ANT-inspired studies in management accounting focus on explaining changes in accounting practices, which are perceived as a consequence of an ANT process. This chapter, however, analyses the practices by which management accounting tools act as a vehicle to organisational change.

Details

Performance Measurement and Management Control: Behavioral Implications and Human Actions
Type: Book
ISBN: 978-1-78350-378-0

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Article
Publication date: 19 July 2013

S. Guha, W.P. Hoo and C. Bottomley

Risk management is an essential cornerstone of any effective unit. The maternity dashboard has been found to be an efficient governance tool, but there is no such…

Abstract

Purpose

Risk management is an essential cornerstone of any effective unit. The maternity dashboard has been found to be an efficient governance tool, but there is no such scorecard in gynaecology. The paper aims to conceptualise and implement an acute gynaecology dashboard in a teaching hospital over a period of two years and review the changes brought in practice as a result of the dashboard.

Design/methodology/approach

This acute gynaecology dashboard was designed in line with the existing maternity dashboard. Goals and benchmarks were determined on the basis of available national guidelines, expert opinions and local policies. The dashboard was prospectively implemented, updated monthly and presented in the relevant forums. A retrospective overview of the changes brought in the practice is presented in this paper.

Findings

Through the use of the dashboard significant problems related to workforce, training and clinical activity were identified. A number of changes were subsequently executed to improve patient management, service provision and training. This paper provides empirical insights about how positive changes in clinical practice could be brought in by the implementation of the acute gynaecology dashboard. The acute gynaecology dashboard was found to be a valuable governance tool to monitor performance and improve training and patient care.

Practical implications

The acute gynaecology dashboard can be used as an effective clinical governance tool to monitor performance and leads to improvement in clinical practice in other acute gynaecology units.

Originality/value

Though the maternity dashboard is widely in use, there has been no previous description of an acute gynaecology dashboard and this is the first paper in this area. With the increasing demand of acute gynaecology services, the dashboard becomes an essential tool for clinical governance.

Details

Clinical Governance: An International Journal, vol. 18 no. 3
Type: Research Article
ISSN: 1477-7274

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Book part
Publication date: 24 October 2019

Courtney Hebert and Elisabeth Dowling Root

This chapter discusses the potential role of geographic information systems (GIS) for infection control within the hospital system. The chapter provides a brief overview…

Abstract

This chapter discusses the potential role of geographic information systems (GIS) for infection control within the hospital system. The chapter provides a brief overview of the role of GIS in public health and reviews current work applying these methods to the hospital setting. Finally, it outlines the potential opportunities and challenges for adapting GIS for use in the hospital setting for infection prevention. A targeted literature review is used to illustrate current use of GIS in the hospital setting. The discussion of complexity was compiled using the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework. Challenges and opportunities were then extracted from this exercise by the authors. There are multiple challenges to implementation of a Hospital GIS for infection prevention, mainly involving the domains of technology, organization, and adaptation. Use of a transdisciplinary approach can address many of these challenges. More research, specifically prospective, reproducible clinical trials, needs to be done to better assess the potential impact and effectiveness of a Hospital GIS in real-world settings. This chapter highlights a powerful but rarely used tool for infection prevention within the hospital. Given the importance of reducing hospital-acquired infection rates, it is vital to identify relevant methods from other fields that could be translated into the field of hospital epidemiology.

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Article
Publication date: 30 September 2013

Jeremy Henri Maurice Veillard, Michaela Louise Schiøtz, Ann-Lise Guisset, Adalsteinn Davidson Brown and Niek S. Klazinga

This paper's aim is to evaluate the perceived impact and the enabling factors and barriers experienced by hospital staff participating in an international hospital

Abstract

Purpose

This paper's aim is to evaluate the perceived impact and the enabling factors and barriers experienced by hospital staff participating in an international hospital performance measurement project focused on internal quality improvement.

Design/methodology/approach

Semi-structured interviews involving international hospital performance measurement project coordinators, including 140 hospitals from eight European countries (Belgium, Estonia, France, Germany, Hungary, Poland, Slovakia and Slovenia). Inductively analyzing the interview transcripts was carried out using the grounded theory approach.

Findings

Even when public reporting is absent, the project was perceived as having stimulated performance measurement and quality improvement initiatives in participating hospitals. Attention should be paid to leadership/ownership, context, content (project intrinsic features) and processes supporting elements.

Research limitations/implications

Generalizing the findings is limited by the study's small sample size. Possible implications for the WHO European Regional Office and for participating hospitals would be to assess hospital preparedness to participate in the PATH project, depending on context, process and structural elements; and enhance performance and practice benchmarking through suggested approaches.

Originality/value

This research gathered rich and unique material related to an international performance measurement project. It derived actionable findings.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

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Article
Publication date: 19 March 2021

Jean-Sebastien Marchand, Mylaine Breton, Olivier Saulpic and Élizabeth Côté-Boileau

Lean-inspired approaches and performance management systems are being implemented in public healthcare organisations internationally. However, the literature is…

Abstract

Purpose

Lean-inspired approaches and performance management systems are being implemented in public healthcare organisations internationally. However, the literature is inconclusive regarding the benefits of these management tools and there is a lack of knowledge regarding processes for large-scale implementation of these tools. This article aims to describe the implementation process and to better understand how this process influences the mandated performance management system.

Design/methodology/approach

This research is based on a comparative case study of three healthcare organisations in Canada. Data consist documents, non-participant observation and semi-structured interviews with key actors (n = 30). Analysis is based on a sociotechnical approach to management tools that considers organisational context, and the tool's technical substrate, theory of action and managerial philosophy.

Findings

Results show that despite a standardised national mandate, the tool as implemented varied between organisations in terms of technical substrate and managerial philosophy. These variations are explained by the flexibility of the technical substrate, the lack of clarity of the managerial philosophy, and some contextual elements. Successful implementation may rest upon high hybridization of the tool on these different dimensions. A precise and prescribed technical substrate is not sufficient to guarantee implementation of a managerial philosophy.

Practical implications

Mandated implementation of management tools may be more successful if it is explicit on the managerial philosophy, the technical substrate and the link between the two, and if it provides some leeway to adapt both to the organisational context.

Originality/value

This is one of the few studies to describe and analyse the process involved in mandated large-scale implementation of performance management systems in public healthcare organisations.

Details

Journal of Health Organization and Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 9 July 2018

Scott A. Hutton, Kelly Vance, Jesse Burgard, Susan Grace and Lynn Van Male

The purpose of this paper is to describe the process used to standardize a Workplace Violence Prevention Program (WVPP) within a five-hospital healthcare system in…

Abstract

Purpose

The purpose of this paper is to describe the process used to standardize a Workplace Violence Prevention Program (WVPP) within a five-hospital healthcare system in Veterans Health Administration (VHA).

Design/methodology/approach

A description of the lean process improvement principles, used to bring the WVPP into compliance with Occupational Safety and Health Administration (OSHA) and other agencies through streamlining/standardizing processes.

Findings

There was significant standardization in both the threat assessment and education arms of the WVPP. Compliance with all major US Department of Labor OSHA requirements, as well as substantial time savings, were realized as part of this process improvement.

Originality/value

VHA is leading the way in inter/multidisciplinary assessment and mitigation of workplace violence, however, there are significant competing demands on staff time. This first ever use of lean principles to streamline processes around workplace violence prevention freed up clinician time for care while improving internal and external customer satisfaction, representing a major step forward in workplace violence risk mitigation.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 11 December 2017

Desiree Chachula, Cathy Grant, Prado Antolino, Jenna Davis, Desiree Hanson, Lesley Harris, Venessa Rivera-Colon and B. Lee Green

The purpose of this paper is to provide a case study of a multifaceted institutional approach to minimizing cancer health disparities, presenting a novel organizational…

Abstract

Purpose

The purpose of this paper is to provide a case study of a multifaceted institutional approach to minimizing cancer health disparities, presenting a novel organizational framework entitled, “A.C.C.E.S.S.” to guide those efforts.

Design/methodology/approach

This paper presents a case study of an organization that operates under the theory that cancer health disparities are a result of the cumulative incongruence of differences that exist between people in various contexts and interactions over time. Consequently, the A.C.C.E.S.S. framework is used to demonstrate the range of opportunities within an organization to intervene and mitigate gaps that result in inequality.

Findings

Addressing A.C.C.E.S.S. in various interactions and contexts over a sustained period of time results in a continuous improvement cycle that attenuates cancer health disparity.

Originality/value

The antecedents and impacts of cancer health disparities are well documented. However, there is a dearth of directionality for institutions and organizations in achieving equality in cancer treatment and care. This paper provides a framework to consider in organizing such endeavors.

Details

International Journal of Human Rights in Healthcare, vol. 10 no. 5
Type: Research Article
ISSN: 2056-4902

Keywords

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