Search results
1 – 10 of 826Adriana 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 general…
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
Keywords
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
Keywords
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 medical…
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
Keywords
We utilise the actor-network theory (ANT) – based especially on Latour (2005) – to examine how management accounting tools affect physicians’ representations and new managerial…
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
Keywords
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 scorecard in…
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
Keywords
Adelaide Ippolito, Marco Sorrentino, Francesco Capalbo and Adelina Di Pietro
The aim of this paper is to analyse how technological innovations in performance measurement systems make it possible to overcome some of the challenges that public healthcare…
Abstract
Purpose
The aim of this paper is to analyse how technological innovations in performance measurement systems make it possible to overcome some of the challenges that public healthcare organizations face where management and control are concerned. The changes that could be applied to the performance measurement system of healthcare organisations were analysed together with an evaluation of the responses developed in order to achieve these changes.
Design/methodology/approach
The paper contains an in-depth case-study of a public university hospital which utilises an innovative information system.
Findings
The case-study highlights how technological innovations in performance measurement systems impact the management and monitoring information system in a public university hospital, through the implementation of a multidimensional management dashboard.
Research limitations/implications
The limitation of this paper is that only one case-study is analysed, albeit in depth, while it would be interesting to consider more public university hospitals.
Practical implications
The paper highlights the fundamental role of middle management in change processes in the healthcare sector.
Originality/value
The case-study highlights how critical the active involvement of middle management is in performance measurement and management, and how this is achieved thanks to the adoption of a simple, clear method which ensures comprehensible communication of the objectives, as well as the measurement of performance by means of radar plots.
Details
Keywords
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 of the…
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.
Details
Keywords
Facilities management (FM) plays a vital role toward creating the hospitable environment that supports the core clinical business of rendering quality health care. To ensure…
Abstract
Purpose
Facilities management (FM) plays a vital role toward creating the hospitable environment that supports the core clinical business of rendering quality health care. To ensure optimal performance of FM, public hospitals require a performance measurement (PM) framework that could guide and assist facilities managers in their operations. This paper aims to respond to this need by developing a performance measurement framework useful to improve FM performance within the context of developing countries hospital FM services delivery.
Design/methodology/approach
The paper synthesizes knowledge from a comprehensive review of FM performance measurement literature and the results of an earlier PhD research on FM performance measurement in Ghana’s public hospitals.
Findings
The paper presents a simplified performance measurement framework which demonstrates four key performance measurement tasks: establishing performance goals; measuring the FM service delivery; evaluating FM outcomes; and performance review and reporting. The study suggests the establishment of a central coordination point to enhance performance measurement activities of public hospitals’ FM practices.
Research limitations/implications
Although reference is made to research on key performance indicators (KPIs), future study is recommended to develop appropriate methodology for selecting relevant KPIs. The author also intends to pilot the framework to a health facility in Ghana to leverage its usefulness, given the fact that it has not been tested empirically.
Practical implications
The application of the framework is expected to lead to the identification of performance gaps and weakness which when acted upon could lead to operational effectiveness and efficiency of the FM process, ultimately leading to improved FM performance.
Originality/value
The paper develops a novel performance measurement framework useful within the context of the nascent FM industry in the developing world.
Details
Keywords
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 performance…
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
Keywords
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 inconclusive…
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