A new tool for measurement of process-based performance of multispecialty tertiary care hospitals

There is an increasing need of a model for the process-based performance measurement of multispecialty tertiary care hospitals for quality improvement. Analytic hierarchy process (AHP) is utilized in this study to evolve such a model. Each step in the model was derived by group-discussions and brainstorming sessions among experienced clinicians and managers. This tool was applied to two tertiary care teaching hospitals in Barbados and India. The model enabled identification of specific areas where neither hospital performed very well, and helped to suggest recommendations to improve those areas. AHP is recommended as a valuable tool to measure the process-based performance of multispecialty tertiary care hospitals. © Emerald Group Publishing Limited.

Measurement of hospital performance

The rationale for carrying out this research was to address the clear lack of knowledge surrounding the measurement of public hospital performance in Ireland. The objectives of this research were to develop a comprehensive model for measuring hospital performance and using this model to measure the performance of public acute hospitals in Ireland in 2007. Having assessed the advantages and disadvantages of various measurement models the Data Envelopment Analysis (DEA) model was chosen for this research. DEA was initiated by Charnes, Cooper and Rhodes in 1978 and further developed by Fare et al. (1983) and Banker et al. (1984). The method used to choose relevant inputs and outputs to be included in the model followed that adopted by Casu et al. (2005) which included the use of focus groups. The main conclusions of the research are threefold. Firstly, it is clear that each stakeholder group has differing opinions on what constitutes good performance. It is therefore imperative that any performance measurement model would be designed within parameters that are clearly understood by any intended audience. Secondly, there is a lack of publicly available qualitative information in Ireland that inhibits detailed analysis of hospital performance. Thirdly, based on available qualitative and quantitative data the results indicated a high level of efficiency among the public acute hospitals in Ireland in their staffing and non pay costs, averaging 98.5%. As DEA scores are sensitive to the number of input and output variables as well as the size of the sample it should be borne in mind that a high level of efficiency could be as a result of using DEA with too many variables compared to the number of hospitals. No hospital was deemed to be scale efficient in any of the models even though the average scale efficiency for all of the hospitals was relatively high at 90.3%. Arising from this research the main recommendations would be that information on medical outcomes, survival rates and patient satisfaction should be made publicly available in Ireland; that despite a high average efficiency level that many individual hospitals need to focus on improving their technical and scale efficiencies, and that performance measurement models should be developed that would include more qualitative data.

Linking comprehensive performance assessment to the balanced scorecard:evidence from Hertfordshire County Council

Over the course of the last twenty years there has been a growing academic interest in performance management, particularly in respect of the evolution of new techniques and their resulting impact. One important theoretical development has been the emergence of multidimensional performance measurement models that are potentially applicable within the public sector. Empirically, academic researchers are increasingly supporting the use of such models as a way of improving public sector management and the effectiveness of service provision (Mayston, 1985; Pollitt, 1986; Bates and Brignall, 1993; and Massey, 1999). This paper seeks to add to the literature by using both theoretical and empirical evidence to argue that CPA, the external inspection tool used by the Audit Commission to evaluate local authority performance management, is a version of the Balanced Scorecard which, when adapted for internal use, may have beneficial effects. After demonstrating the parallels between the CPA framework and Kaplan and Norton's public sector Balanced Scorecard (BSC), we use a case study of the BSC based performance management system in Hertfordshire County Council to demonstrate the empirical linkages between a local scorecard and CPA. We conclude that CPA is based upon the BSC and has the potential to serve as a springboard for the evolution of local authority performance management systems.

Handbook of research on strategic performance management and measurement using data envelopment analysis

Organizations can use the valuable tool of data envelopment analysis (DEA) to make informed decisions on developing successful strategies, setting specific goals, and identifying underperforming activities to improve the output or outcome of performance measurement. The Handbook of Research on Strategic Performance Management and Measurement Using Data Envelopment Analysis highlights the advantages of using DEA as a tool to improve business performance and identify sources of inefficiency in public and private organizations. These recently developed theories and applications of DEA will be useful for policymakers, managers, and practitioners in the areas of sustainable development of our society including environment, agriculture, finance, and higher education sectors. All rights reserved.

Measuring and managing performance in extended enterprises

Purpose - The purpose of this research paper is to demonstrate how existing performance measurement may be adopted to measure and manage performance in extended enterprises. Design/methodology/approach - The paper reviews the literature in performance measurement and extended enterprises. It explains the collaborative architecture of an extended enterprise and demonstrates this architecture through a case study. A model for measuring and managing performance in extended enterprises is developed using the case study. Findings - The research found that due to structural differences between traditional and extended enterprises, the systems required to measure and manage the performance of extended enterprises, whilst being based upon existing performance measurement frameworks, would be structurally and operationally different. Based on this, a model for measuring and managing performance in extended enterprises is proposed which includes intrinsic and extrinsic inter-enterprise coordinating measures. Research limitations/implications - There are two limitations this research. First, the evidence is based on a single case, thus further cases should be studied to establish the generalisibility of the presented results. Second, the practical limitations of the EE performance measurement model should be established through longitudinal action research. Practical implications - In practice the model proposed requires collaborating organisations to be more open and share critical performance information with one another. This will require change in practices and attitudes. Originality/value - The main contribution this paper makes is that it highlights the structural differences between traditional and collaborative enterprises and specifies performance measurement and management requirements of these collaborative organisations. © Emerald Group Publishing Limited.

Managing healthcare performance in analytical framework

Purpose – The purpose of the paper is to develop an integrated framework for performance management of healthcare services. Design/methodology/approach – This study develops a performance management framework for healthcare services using a combined analytic hierarchy process (AHP) and logical framework (LOGFRAME). The framework is then applied to the intensive care units of three different hospitals in developing nations. Numerous focus group discussions were undertaken, involving experts from the specific area under investigation. Findings – The study reveals that a combination of outcome, structure and process-based critical success factors and a combined AHP and LOGFRAME-based performance management framework helps manage performance of healthcare services. Practical implications – The proposed framework could be practiced in hospital-based healthcare services. Originality/value – The conventional approaches to healthcare performance management are either outcome-based or process-based, which cannot reveal improvement measures appropriately in order to assure superior performance. Additionally, they lack planning, implementing and evaluating improvement projects that are identified from performance measurement. This study presents an integrated approach to performance measurement and implementing framework of improvement projects.

Application of analytic hierarchy process for measuring and comparing the global performance of intensive care units

Purpose: To develop a model for the global performance measurement of intensive care units (ICUs) and to apply that model to compare the services for quality improvement. Materials and Methods: Analytic hierarchy process, a multiple-attribute decision-making technique, is used in this study to evolve such a model. The steps consisted of identifying the critical success factors for the best performance of an ICU, identifying subfactors that influence the critical factors, comparing them pairwise, deriving their relative importance and ratings, and calculating the cumulative performance according to the attributes of a given ICU. Every step in the model was derived by group discussions, brainstorming, and consensus among intensivists. Results: The model was applied to 3 ICUs, 1 each in Barbados, Trinidad, and India in tertiary care teaching hospitals of similar setting. The cumulative performance rating of the Barbados ICU was 1.17 when compared with that of Trinidad and Indian ICU, which were 0.82 and 0.75, respectively, showing that the Trinidad and Indian ICUs performed 70% and 64% with respect to Barbados ICU. The model also enabled identifying specific areas where the ICUs did not perform well, which helped to improvise those areas. Conclusions: Analytic hierarchy process is a very useful model to measure the global performance of an ICU. © 2005 Elsevier Inc. All rights reserved.

Shareholder value application in UK listed companies

This paper is based upon the initial findings of a CIMA research project into the way in which corporate performance measurement systems are influenced by the use of shareholder value management techniques. It compares and contrasts the techniques in use in a sample of 10 companies that either explicitly use shareholder value techniques also known as Value-Based Management (VBM), or explicitly do not use such techniques. The analysis undertaken is based upon the finding of semi-structured interviews with company representatives which formed the first part of the data collection process of the project. The analysis traces the interactions between corporate objectives, decision making criteria, performance measurement systems and executive incentive schemes in order to develop an understanding of the effects of such shareholder value techniques upon corporate behaviour. The literature reviewed suggests that the other aspects of the planning and control system should be aligned with the corporate objectives whether a company has adopted VBM or not. Therefore this research contributes new evidence on the use of VBM techniques in the UK and also more generally on whether VBM and non-VBM companies internal planning and control systems are aligned.

Measuring the operational performance of intensive care units using the analytic hierarchy process approach

Purpose - The purpose of this study is to develop a performance measurement model for service operations using the analytic hierarchy process approach. Design/methodology/approach - The study reviews current relevant literature on performance measurement and develops a model for performance measurement. The model is then applied to the intensive care units (ICUs) of three different hospitals in developing nations. Six focus group discussions were undertaken, involving experts from the specific area under investigation, in order to develop an understandable performance measurement model that was both quantitative and hierarchical. Findings - A combination of outcome, structure and process-based factors were used as a foundation for the model. The analyses of the links between them were used to reveal the relative importance of each and their associated sub factors. It was considered to be an effective quantitative tool by the stakeholders. Research limitations/implications - This research only applies the model to ICUs in healthcare services. Practical implications - Performance measurement is an important area within the operations management field. Although numerous models are routinely being deployed both in practice and research, there is always room for improvement. The present study proposes a hierarchical quantitative approach, which considers both subjective and objective performance criteria. Originality/value - This paper develops a hierarchical quantitative model for service performance measurement. It considers success factors with respect to outcomes, structure and processes with the involvement of the concerned stakeholders based upon the analytic hierarchy process approach. The unique model is applied to the ICUs of hospitals in order to demonstrate its effectiveness. The unique application provides a comparative international study of service performance measurement in ICUs of hospitals in three different countries. © Emerald Group Publishing Limited.

Consumer-based brand equity conceptualization and measurement:a literature review

Although there is a large body of research on brand equity, little in terms of a literature review has been published on this since Feldwick’s (1996) paper. To address this gap, this paper brings together the scattered literature on consumer based brand equity’s conceptualisation and measurement. Measures of consumer based brand equity are classified as either direct or indirect. Indirect measures assess consumer-based brand equity through its demonstrable dimensions and are superior from a diagnostic level. The paper concludes with directions for future research and managerial pointers for setting up a brand equity measurement system.

Strategic sourcing:a combined QFD and AHP approach in manufacturing

Purpose – This paper aims to develop an integrated analytical approach, combining quality function deployment (QFD) and analytic hierarchy process (AHP) approach, to enhance the effectiveness of sourcing decisions. Design/methodology/approach – In the approach, QFD is used to translate the company stakeholder requirements into multiple evaluating factors for supplier selection, which are used to benchmark the suppliers. AHP is used to determine the importance of evaluating factors and preference of each supplier with respect to each selection criterion. Findings – The effectiveness of the proposed approach is demonstrated by applying it to a UK-based automobile manufacturing company. With QFD, the evaluating factors are related to the strategic intent of the company through the involvement of concerned stakeholders. This ensures successful strategic sourcing. The application of AHP ensures consistent supplier performance measurement using benchmarking approach. Research limitations/implications – The proposed integrated approach can be principally adopted in other decision-making scenarios for effective management of the supply chain. Practical implications – The proposed integrated approach can be used as a group-based decision support system for supplier selection, in which all relevant stakeholders are involved to identify various quantitative and qualitative evaluating criteria, and their importance. Originality/value – Various approaches that can deal with multiple and conflicting criteria have been adopted for the supplier selection. However, they fail to consider the impact of business objectives and the requirements of company stakeholders in the identification of evaluating criteria for strategic supplier selection. The proposed integrated approach outranks the conventional approaches to supplier selection and supplier performance measurement because the sourcing strategy and supplier selection are derived from the corporate/business strategy.

High stability multiplexed fiber interferometer and its application on absolute displacement measurement and on-line surface metrology

We propose a self-reference multiplexed fibre interferometer (MFI) by using a tunable laser and fibre Bragg grating (FBG). The optical measurement system multiplexes two Michelson fibre interferometers with shared optical path in the main part of optical system. One fibre optic interferometer is used as a reference interferometer to monitor and control the high accuracy of the measurement system under environmental perturbations. The other is used as a measurement interferometer to obtain information from the target. An active phase tracking homodyne (APTH) technique is applied for signal processing to achieve high resolution. MFI can be utilised for high precision absolute displacement measurement with different combination of wavelengths from the tuneable laser. By means of Wavelength-Division-Multiplexing (WDM) technique, MFI is also capable of realising on-line surface measurement, in which traditional stylus scanning is replaced by spatial light-wave scanning so as to greatly improve the measurement speed and robustness.

General and multiplicative non-parametric corporate performance models with interval ratio data

The increasing intensity of global competition has led organizations to utilize various types of performance measurement tools for improving the quality of their products and services. Data envelopment analysis (DEA) is a methodology for evaluating and measuring the relative efficiencies of a set of decision making units (DMUs) that use multiple inputs to produce multiple outputs. All the data in the conventional DEA with input and/or output ratios assumes the form of crisp numbers. However, the observed values of data in real-world problems are sometimes expressed as interval ratios. In this paper, we propose two new models: general and multiplicative non-parametric ratio models for DEA problems with interval data. The contributions of this paper are fourfold: (1) we consider input and output data expressed as interval ratios in DEA; (2) we address the gap in DEA literature for problems not suitable or difficult to model with crisp values; (3) we propose two new DEA models for evaluating the relative efficiencies of DMUs with interval ratios, and (4) we present a case study involving 20 banks with three interval ratios to demonstrate the applicability and efficacy of the proposed models where the traditional indicators are mostly financial ratios. © 2011 Elsevier Inc.