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Design and Implementation of a Performance Measurement System in Swedish Health Care Services: A Multiple Cases Study of 6 Development Teams
Linköping University, Department of Management and Engineering, Quality Technology and Management . Linköping University, The Institute of Technology.
Linköping University, Department of Management and Engineering, Quality Technology and Management . Linköping University, The Institute of Technology.
Swedish Federation of County Councils, Stockholm, Sweden.
2005 (English)In: Quality Management in Health Care, ISSN 1063-8628, Vol. 14, no 2, 95-111 p.Article in journal (Refereed) Published
Abstract [en]

Performance measurement is considered to be an important part in improving and controlling contemporary organizations. Despite the increased interest in using and improving performance measurement systems, the number of researchers investigating the design and implementation process in more detail is still very small. The purpose of this article is to increase the understanding of how a performance measurement system, called the flow model, is designed and implemented by development teams in Swedish health care. The purpose of the flow model is to follow up the requirements in the National Care Guarantee through 8 measures. From a multiple case study of 6 local development teams, we conclude that the performance measurement system of the flow model is designed and implemented in Swedish County Councils through 3 development tracks, which are reflected in close interaction between the local development team and people in clinical departments. Enabling factors in the design and implementation are (1) the recognition of a need to change the current situation, (2) the teams' interaction with people in the clinical departments. (3) the national network meetings arranged by the financier. (4) the struggle to motivate and inform the top management, and (5) the establishment of contact with other development teams and ongoing projects.

Place, publisher, year, edition, pages
2005. Vol. 14, no 2, 95-111 p.
Keyword [en]
hospitals, medical care, county councils, public health, design and implementation, innovation management, performance measurement, quality assessment, waiting time measurement
National Category
Engineering and Technology
URN: urn:nbn:se:liu:diva-14567OAI: diva2:23846
Available from: 2007-06-18 Created: 2007-06-18 Last updated: 2009-05-22
In thesis
1. Performance Measurement Systems in Swedish Health Care Services
Open this publication in new window or tab >>Performance Measurement Systems in Swedish Health Care Services
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the quality management literature, measurements are attributed great importance in improving products and processes. Systems for performance measurement assessing financial and non-financial measurements were developed in the late 1980s and early 1990s. The research on performance measurement systems has mainly been focused on the design of different performance measurement systems. Many authors are occupied with the study of the constructs of measures and developing prescriptive models of performance measurement systems. There is a need in the research to shift focus from studying the construct of measurements to how they are used in real face-to-face situations in specific contexts.

The purpose of this thesis is to analyse the development, i.e. the design, implementation and use, of performance measurement systems in Swedish health care services. The study aims to increase the understanding of the role of performance measurement system in Swedish health care and thereby support health care improvements in general. Three research questions have been derived from the purpose. (1) How and why are performance measurement systems being developed in Swedish health care services? (2) What problems can be identified in the development? (3) What enabling factors can be identified in the development? A qualitative research strategy was selected for the research. The research is based on a multiple case study design conducted within two research projects. Information has been gathered through interviews, documents and observations.

The idea of performance measurement systems develops through several tracks when implemented in health care and the development follows a purposeful process of activities. The development was initiated when major changes occurred in the organisation or its environment. Performance measurement systems are primarily used to support a dialogue between management and employees regarding organisational improvement. Problems experienced are related to struggles to reach national consensus for measures, involving management, and the clarification of various end-users’ needs. Enabling factors are the frequent interaction with people developing the system, management’s involvement, the use of multi-skilled teams, and visual displays.

The research contributes to several insights to the research area of performance measurement system and health care practitioners. The research shows that the development process is far from straight forward and is formed by the influence of factors in the organisational context, which cannot always be predicted. By seeing the development as an innovation process, the focus is broadened from being technological towards the organisation as whole, which contribute to the existing research on performance measurement systems.

Place, publisher, year, edition, pages
Institutionen för ekonomisk och industriell utveckling, 2007. 98 p.
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 1092Dissertations from the International Graduate School of Management and Industrial Engineering, ISSN 1402-0793 ; 108
Quality management, Health care, Performance measurement, Innovation management, Qualitative research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
urn:nbn:se:liu:diva-9302 (URN)978-91-85715-19-0 (ISBN)
Public defence
2007-05-11, A2, Hus A, Campus Valla, Linköpings universitet, Linköping, 13:15 (English)
Available from: 2007-06-18 Created: 2007-06-18 Last updated: 2013-08-29

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