Performance management in primary healthcare services: evidence from a field study

Abstract

Abstract:Purpose -There is a growing interest in research focusing on performance management practices in the public sector, but research is still limited with regards to public primary healthcare services (PHSs), which play an important role in national healthcare systems. These organisations are frequently criticised for alleged poor performance management practices and misuse of resources, though such claims are not always substantiated. The purpose of this study is to examine performance management practices in public PHSs.Design/methodology/approach -Three case studies of PHSs organisations were conducted resulting in interview material and archival data. Otley's performance management framework was used to examine the data.Findings -It is found that the performance management systems of the studied PHSs were disjoint and lacked consistency and coherence. Lack of direction and motivational were key issues in PHSs. Furthermore, the observations indicate that vertical controls between PHSs and parent organisation were weak and accountability poor.Research limitations/implications -Generalisability of findings and social desirability bias are the important limitations. A key research implication is that the conceptual framework adopted can be meaningfully used to generate insights into performance management issues in public sector healthcare organisations.Practical implications -The study highlights the implications of the poor design and use of performance management systems and highlights areas for improvement in the organisations studied, and potentially across the sector.Originality/value -This study is the first to draw upon Otley's performance management framework to examine performance management practices in PHSs and to demonstrate its usefulness in this context.

Public Sector Performance Management: Insights from Selected Literature

“…Nevertheless, a number of studies have studied the interconnections between performance elements in greater detail (Esposito et al, 2013;Johnston & Pongatichat, 2008;Silva & Ferreira, 2010). Johnston and Pongatichat (2008) describe the alignment of performance measures with strategic implementation.…”

“…They found that diagnostic monitoring and corrective mechanisms were adopted widely and closely connected to explicit types of knowledge. Finally, the study by Silva and Ferreira (2010) was the most comprehensive study, incorporating the major elements of performance management. Their use of an integrative framework resulted in better understanding of how the elements were connected to each other.…”

“…A majority of the reviewed studies have examined the elements of objectives and plans, with varying depth (Auber et al, 2014;Deakins, Dillon, Al Namani, & Zhang, 2010;Dormer & Gill, 2010;Esposito, De Nito, Pezzillo Iacono, & Silvestri, 2013;Ferry & Ahrens, 2017;Halkjaer & Lueg, 2017;Johnston & Pongatichat, 2008;Silva & Ferreira, 2010;Trondal, 2015). A number of authors have examined the linkage between objectives and plans.…”

Researcher perceptions and choices of interview media: the case of accounting research

“…In particular, any potential concerns about social desirability and self‐selection bias warrant a response . The effect of social desirability bias—where respondents either deliberately or unconsciously provide a biased representation of the facts (Silva and Ferreira, )—is a potential consideration. Given that those academics participating in this study were known to the authors, their favourable evaluation of the importance of the study may be attributable to their familiarity with us as researchers.…”

Issues and Challenges of Performance Measurement Practice

“…There is rich literature on performance measurement and management in for-profit organisations (Collier, 2005;Hyvonen, 2007;Tuomela, 2005) and public sector organisations (Brignall & Modell, 2000;Kloot & Martin, 2000;Cavalluzzo & Ittner, 2004;Silva & Ferreira, 2010;Spekle & Verbeeten, 2014;Sutheewasinnon, Hoque & Nyamori, 2016). Among the propagated performance management tools is the balanced scorecard, which seeks to cascade key performance measures and targets from the top level down to the individuals (Kaplan & Norton, 1996;2001).…”