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The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries.

One hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries.

The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system.

Hospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems.

The first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.

Previous studies on hospital supply chain performance have attempted to measure the performance of the hospital supply chain either by the measurement of performance indicators or the performance of specific activities. This paper attempts to measure the internal hospital supply chain's performance indicators to find their interdependencies to understand the relationship among them and identify the key performance indicators for each of those aspects of the logistics process toward improvement.

In this research, a systematic assessment and analysis method under vagueness is proposed to assess, analyze and measure the internal health care performance aspects (HCPA). The proposed method combines the group Decision-Making and Trial Evaluation Laboratory (DEMATEL) method and rough set theory.

The study results indicate that the most critical aspects of hospital supply chain performance are completeness of treatment, clinical care process time and no delay in treatment.

The causal relationship from rough-DEMATEL can advise management officials that to improve the completeness of treatment toward patient safety, clinical care process time should be addressed initially and with it, patient safety aspects such as free from error, clinical care productivity, etc. should be improved as well. Improvement of these aspects will improve the other aspects they are related to.

The purpose of this paper is to capture factors behind professional views of indicator usefulness as a common structure for assessing healthcare performance and their important characteristics to design limited key performance indicators (PIs) for holistic hospital management.

Two surveys were conducted using self-administered questionnaires, in which hospital manager/staff respondents were asked to rate the 52 PIs’ usefulness. In total, 228 manager and 894 staff responses were collected.

Eight factors were elicited from manager and staff responses as performance measures with 72 percent cumulative variance accounted for. Hospital managers and staff showed similar performance measure perceptions: high-utility acknowledgment on safety, operational efficiency and patient/employee satisfaction but relatively low-employee development concerns. Manager indicator usefulness perceptions were rather homogeneous and significantly higher than staff for almost all performance measures.

Homogeneous manager views mean that a single key PI set for hospital management may be established regardless of hospital attributes. The following aspects may be measures that should be managed in a healthcare organization based on their key PIs: patient/employee safety, operational efficiency, financial effectiveness and patient/employee satisfaction.

This is a pilot study on hospital management PIs in Japan. The eight-dimensional factor structure and findings about healthcare provider perceptions may be useful for healthcare management.

This paper aims to report on a study that aims to establish a list of systematically classified key performance indicators (KPIs) that are useful for hospital facilities management (FM).

A review of literature was conducted to identify indicators that are applicable to hospital FM. Each indicator was classified using a phase–hierarchy (P-H) model, which is a two-dimensional matrix comprising three phases (input, process and output) of facilities services delivery and three hierarchical FM levels (operational, tactical and strategic). The classified indicators were further shortlisted via a focus group study.

From the literature review, 61 indicators were identified as applicable to hospital FM. Most of the indicators, according to the P-H model, are for evaluating the FM input or output phase, at the strategic or tactical level. Further refinement and shortlisting of the indicators by the focus group experts resulted in 18 KPIs, which fall into 4 aspects: “physical”, “safety”, “environmental” and “financial”.

The study illustrates that the P-H model is useful for classifying the performance indicators systematically along the two fundamental FM dimensions – phase and hierarchy. Further research may use this model to classify performance indicators in other contexts.

The method of this study can be adapted for use in identifying, classifying and shortlisting FM performance indicators for other types of buildings. The shortlisted KPIs can be used for assessing the FM performance of hospitals.

To the best of the authors’ knowledge, this study is the first of its kind that used the P-H model to classify hospital FM performance indicators.

Key performance indicators (KPIs) help to monitor performance, thereby revealing the gap between planned and executed results relative to organizational objectives. The purpose of this paper is to develop KPIs for performance measurement of facilities management (FM) services in public hospitals.

Following a comprehensive literature review of KPIs in FM, a set of KPIs were first selected. This was then subjected to content validation by experts. Thereafter a questionnaire survey was conducted to identify participants perception on the level of importance of the proposed KPIs. The main analytical tool used was SPSS factor analysis/principal component extraction.

Adapting an expanded balanced scorecard typology, the paper identifies 17 KPIs, which are useful for performance improvement of FM. The study also introduces new financial dimensions beyond the traditional cost and profit-centered metrics.

The study was limited to three FM services. Although the results of the Kruskal–Wallis test shows no significant difference in the level of importance on more than 80% of the indicators, larger sample is required in future studies to examine indicator preference for the respective services. An empirical study to test the proposed indicators to measure FM performance could also be a next step.

The paper presents the first step to develop performance indicators, which are of relevance to FM performance measurement and could be utilized to improve performance. The indicators are largely generic and can easily be adapted by other FM service sectors for performance measurement.

Overall equipment effectiveness (OEE) is a performance indicator that is been used to measure manufacturing productivity. The purpose of this paper is to propose the operating room effectiveness for hospital operating rooms (ORs), adapted from the OEE, to measure performance and identify losses based on lean health-care principles.

The present study is an exploratory, descriptive and applied research work. Literature review, documents of the hospital, observation and interviews with employees of a large university hospital in southern Brazil were analyzed to organize the proposed effectiveness indicator. After that, historical data of the ORs was collected and the usefulness of the indicator was analyzed. The indicator was applied for 10 months and validated with an expert committee from the hospital.

The present study describes an adaptation of a performance indicator to ORs of hospitals, allowing to classify its types of operational losses in a lean health-care context. The application of this indicator and the development of improvement actions to a university hospital, resulted in operational efficiency gains of 12 per cent and estimated annual savings of US$400,000.

ORs are a critical service for hospitals. This paper presents a new way to measure the performance of ORs and identify their main types of wastes. It also shows how to implement it and the potential gains of its application. The main research limitations are related to technical analysis of care data from doctors and nurses involved.

This paper fulfills the need to study how ORs performance can be measured and its operational wastes can be identified. In addition, this paper classifies the planning, performance and quality related losses, which can be used by researchers and practitioners to improve the performance of operation rooms.

Performance metrics have become widely used and much lamented – about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use of performance metrics in healthcare regulation and clinical practice. Studying multi-actor settings of performance measurement systems in healthcare in Sweden and the Netherlands, the authors show how regulatory agencies (i.e., the inspectorate and national registries), patients, hospitals, and practitioners engage in the constitution of healthcare practices through developing performance indicators that form the input for ranking, ensuing intensive dialogues on what should be measured and accounted for, and to what effects. The authors analyze this process as caring for numbers. The authors discern two practices of caring for numbers: validating and contexting. Validating refers to the practices of making numbers reflect those practices they intend to depict; contexting is about how with the use of numbers specific contexts of healthcare are built. These processes together emphasize the performative character of numbers as well as the reflexive uses of performativity. The paper shows how collaborative and rather pragmatic practices of caring for numbers co-construct specific practices of healthcare. Though this reflexive entanglement of production and use of numbers actors not only constitute specific performance metrics and ranking practices but also perform healthcare.

Clinical governance should be based on cultural elements that value lifelong learning, skill development and research. The purpose of this paper is to introduce a set of indicators to improve educational governance in hospitals.

Key indicators were identified from the international and national literatures. Later, the indicators were rated and prioritized by a multidisciplinary panel of medical professionals using two rounds of Delphi technique. Subsequently at two consensus meetings, the panel evaluated the indicators.

A set of 51 draft indicators were identified. The expert panel members rated 28 indicators as high priority indicators for measuring educational performance of the hospitals.

This set of indicators can be used to measure the educational performance of the hospitals in identifying the gaps and take steps to resolve them.

Education and training is the basic component of clinical governance. Hospital staff education and training is a fundamental step towards organizational and individual development. To improve the educational performance at hospital level it is necessary to reliably measure such performance. This can be done through developing and using relevant indicators. There are limited systematic studies, especially in middle and low income countries, to introduce appropriate indicators. This study has investigated developing a set of indicators to measure and improve the educational performance in hospitals.

The purpose of the study is to measure the performance of Indian hospitals, both operationally and financially, by using hospital KPI's. The assessment is predominantly done by linking it to the existing Lean practices in Indian hospitals.

An empirical study based on cross-sectional survey of hospital managers and specialists in various private healthcare facilities across India was conducted to validate the proposed Lean framework. From an extensive literature survey, the authors identified quality, delivery, efficiency, accessibility and patient centeredness to be the main operational performance (OP) indicators for hospitals. Business or financial performance was measured based on parameters which are average revenue per occupied bed (ARPOB), earnings before interest, tax, depreciation and amortization (EBITDA) and operating revenue. Confirmatory Factor Analysis (CFA) was carried out using a specialized technique, called Structural Equation Modelling(SEM) and an explicit factor structure was hypothesized.

Management commitment towards Lean in hospitals is statistically proven to have impacted operational and financial performance. However, leanness in technology and business processes showed no statistical significance on either operational or financial performance parameters. Hospital stakeholders showed statistical significance on though it had no impact on the financial performance. Results obtained from the statistical analysis indicate a positive impact of hospital Lean practices on timely delivery of services and improved service quality. Efficiency, accessibility of services and patient centered behavior in hospital operations could not be statistically proven to have impacted the financial performance.

Effectiveness of Lean management (LM) principles in improving hospital operations is largely dependent on patient centered behavior. Empowered employees who are trained to add value from a customer view point, make hospital operations safe and improved. Properly trained and communicated employees who are committed to quality improvements can make a positive impact on patients' quality of life and thus positively impact the society. The study lists ways to attain the required outcomes.

This paper is among the very few that has attempted to suggest ways to link implementation of Lean practices more effectively in Indian hospitals to improve hospital performance at operational and financial levels.

This study aims to establish a rigorous model that can pragmatically evaluate the facilities management (FM) performance of hospitals.

Among the applicable performance indicators that were identified from extant literature, a focus group study shortlisted ten key performance indicators (KPIs) in four categories (safety, physical, financial and environmental) and verified their practicality. Using the analytic network process (ANP) method to process the focus group’s responses yielded importance weightings for the KPIs and developed the intended evaluation model. This model was then validated by a case study.

From the empirical data collected, two types of FM performance data and two scenarios of KPI scores were identified. To process these data and scores, a robust calculation method was devised and then proved useful in obtaining an overall score for holistic hospital FM performance. The case study confirmed the appropriateness and validity of the model developed.

Through illustrating how the ANP method could be applied to develop an FM performance evaluation model, the study contributes knowledge to the multi-criteria decision-making domain. Despite the geographical limitation of the model established (i.e. centered around a group of hospitals investigated in Hong Kong), the study can serve as a reference for developing performance evaluation models for other buildings or infrastructures globally.

The model constitutes a practical tool for evaluating the FM performance of hospitals. Using this model on a regular basis will enable performance benchmarking and hence, continuous improvement of FM services.

The ANP model established is the first of its kind tailored for evaluation of hospital FM performance.