Key forces compelling the monitoring of hospital performance: An exploratory study

Abstract

Performance management in the public sector is both multifaceted and convoluted. This is particularly pertinent in hospitals, which are complex institutional organizations. Our paper explores the key drivers compelling Irish public acutecare hospitals to monitor their performance. The context of our study is located against the unique historical backdrop of the Irish health service, whose evolution over time reflects religious control, underfunding by the State and reliance on a decentralized structure up until the early 2000s. This study was conducted during 2009-2010, in the aftermath of the financial crisis of 2008-2009. Interviews were conducted with members of the hospital executive management team, comprising clinical and nonclinical senior managers, using the framework of Kelly et al. (2015) to explore and analyze respondent perspectives. We propose that a combination of key forces, emanating from new public management, the institutional environment, and its constituent elements spurs hospitals to monitor their performance. The confluence of these forces reveals a perceived change in the institutional logic underpinning hospital performance management. This change involved the substitution of autonomous clinical decision-making for a more team-based managerial logic whereby clinicians engaged as part of a This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

"Enhancing Hospital Performance: The Comprehensive Efficiency Index Approach"

“…This study proposes the Comprehensive Efficiency Index (CEI) as a novel tool for assessing and enhancing hospital performance across various domains. The CEI incorporates indicators informed by a comprehensive literature review [8][9][10] and intuitively chosen for their relevance to key aspects of hospital operations. The literature review encompassed academic publications, industry reports, and best practices guidelines to identify [11,12] • Commonly used Hospital Performance Indicators: We analyzed studies investigating hospital efficiency measurement, such as the ones related to the Italian National Health System [13][14][15][16][17][18] and identified frequently employed indicators across various domains.…”