Improvement culture in the public mental healthcare sector: evaluation of implementation efforts

Abstract

The Danish public healthcare system has been forced to improve performance in terms of better service and lower costs. One regional Danish public healthcare organization has systematically implemented an improvement culture in its psychiatry sector. This research paper contains an evaluation of the organization’s transformation journey towards continuous improvement in psychiatry. The study was based on twenty-five personal interviews, two group interviews and four focus group interviews with centre managers, doctors, psychologists, psychiatrists, nurses and medical personnel in two of the ten psychiatry centres in the region. The objectives of implementing an improvement culture were to create better service for patients and to improve efficiency. Findings indicate that a number of critical success factors and barriers exist in mental healthcare and that even though a number of resources was invested up front, adjustments of the implementation process were needed from centre to centre. Furthermore, the implementation of a lean culture had some positive effects on treatments. In particular, internally, efficiency improved in some areas, creating a common view of what creates value and how to make improvements. Involving different groups of specialists in the implementation of an improvement culture is important. However, the achievement of continuous improvement efforts could be challenging, as results can be difficult to quantify. The novelty of the paper lies in the fact that data is collected from different groups of employees (from both managers’ and employees’ perspectives) on the effects of a full-scale implementation of an improvement culture in public mental healthcare.     

From design to operations: a process management life-cycle performance measurement system for Public-Private Partnerships

Public–Private Partnerships (PPPs) have become a critical vehicle for delivering infrastructure worldwide. Yet, the use of such a procurement strategy has received considerable criticism, as they have been prone to experiencing time/cost overruns and during their operation poorly managed. A key issue contributing to the poor performance of PPPs is the paucity of an effective and comprehensive performance measurement system. There has been a tendency for the performance of PPPs to be measured based on their ex-post criteria of time, cost and quality. Such criteria do not accommodate the complexities and lifecycle of an asset. In addressing this problem, the methodology of sequential triangulation is used to develop and examine the effectiveness of a ‘Process Management Life Cycle Performance Measurement System’. The research provides public authorities and private-sector entities embarking on PPPs with a robust mechanism to effectively measure, control and manage their projects’ life cycle performances, ensuring the assets are ‘future proofed’.     

An exploratory study of the influence of the IS function and organizational context on business process reengineering project initiatives

To help evaluate the risk of process reengineering failure and enhance the prospect of its success, three potential sources of influence on BPR initiatives and success are examined in this study. These include the innovative capacity of the organization, IS maturity and strategy-IS interface. It was found that while factors related to IT maturity and influence such as experience in mainframe and client/server computing may facilitate the decision to reengineer, they are not critical in the later stages of the initiative. On the other hand, factors having significant relationships beyond the initial decision include variables pertaining to innovative capacity of the organization and strategy-IS interface. These findings suggest that technical IT competence as a critical enabler is necessary but not sufficient for reengineering success. Based on study findings regarding the innovative capacity of the organization, guidelines for reengineering risk assessment are proposed. In addition, implications of the findings, limitations of the study and opportunities for further research are also discussed.     

Identifying success factors for female entrepreneurs using the AMO framework: Empirical evidence from Japan

This study applies deep insights from the ability, motivation, and opportunity (AMO) framework as an overarching theoretical perspective to identify critical success factors for female entrepreneurs. In doing so, it investigates how entrepreneurial persistence (i.e., motivation or “M”), together with prior venture experience (i.e., ability or “A”) and competitive intensity (i.e., opportunity or “O”) influence the success of women's entrepreneurial activities. Using data from 308 Japanese female entrepreneurs, we show a positive association between entrepreneurial persistence and female entrepreneurs' venture growth, which becomes stronger when prior venture experience and competitive intensity are considered. Most importantly, the three-way interaction between these factors maximizes the business performance of female entrepreneurs. Thus, venture growth is the highest in the presence of high levels of entrepreneurial persistence, prior venture experience, and competitive intensity. Our findings suggest that policy makers should improve the competitiveness of women-led ventures and create supportive business environments for female entrepreneurs.     

Implementing the Balanced Scorecard in Greece: A Software Firm’s Experience

The Balanced Scorecard (BSC) is a relatively new approach to strategic management and performance measurement and control, which has generated substantial interest in the academic and industrial communities. This paper presents the experience from the implementation of a specific BSC model at a large software development company in Greece. The study illustrates and evaluates the main obstacles and shortcomings, as well as the critical success factors that characterise such BSC projects, while offering managerial insights and guidelines for similar implementations.     

Critical success factors of green supply chain management for achieving sustainability in Indian automobile industry

The aim of this study was to identify and analyse the key success factors behind successful achievement of environment sustainability in Indian automobile industry supply chains. Here, critical success factors (CSFs) and performance measures of green supply chain management (GSCM) have been identified through extensive literature review and discussions with experts from Indian automobile industry. Based on the literature review, a questionnaire was designed and 123 final responses were considered. Six CSFs to implement GSCM for achieving sustainability and four expected performance measures of GSCM practices implementation were extracted using factor analysis. interpretive ranking process (IRP) modelling approach is employed to examine the contextual relationships among CSFs and to rank them with respect to performance measures. The developed IRP model shows that the CSF ‘Competitiveness’ is the most important CSF for achieving sustainability in Indian automobile industry through GSCM practices. This study is one of the few that have considered the environmental sustainability practices in the automobile industry in India and their implications on sectoral economy. The results of this study may help the mangers/SC practitioners/Governments/Customers in making strategic and tactical decisions regarding successful implementation of GSCM practices in Indian automobile industry with a sustainability focus. The developed framework provides a comprehensive perspective for assessing the synergistic impact of CSFs on GSCM performances and can act as ready reckoner for the practitioners. As there is very limited work presented in literature using IRP, this piece of work would provide a better understanding of this relatively new ranking methodology.     

Performance measurement of supply chain management using the analytical hierarchy process

Performance measurement of supply chain management (SCM) is a rapidly growing multi-criteria decision-making problem owing to the large number of factors affecting decision-making. The right choice of performance metrics and measures is critical to the success and competitiveness of the firms in the era of globalisation. Recognising the multiple objective nature of the problem, this paper proposes the use of the analytical hierarchy process (AHP) methodology as aid in making SCM evaluation decisions. For pair-wise comparison in AHP, a survey methodology is used. The methodology presented can help firms to prioritise and formulate viable performance measurement strategies in the volatile and complex global decision environment from different balanced scorecard (BSC) perspectives. A demonstration of the application of this methodology in a real life problem is presented.     

An Examination of Public Private Academic Partnerships: Does Program Success Enhance University Performance Outcomes?

In response to a steady decline in State funding, universities have become heavily involved in a variety of public private academic partnerships (PPAPs) in such areas as medical research, business incubation, technological commercialization, continuing professional education, and intercollegiate athletics. Despite this trend, research which examines if such partnerships actually enhance university funding is rare within the public organization literature. Given this, we focus on university intercollegiate athletics programs, which represent one of the largest PPAPs ever undertaken by universities, to examine whether PPAP success can potentially enhance university performance outcomes leading to increased funding levels. Such programs represent a PPAP because public, private, and academic entities all come together to form an organization (division 1 football at the bowl subdivision level) which seeks to benefit all three entities through sharing resources and responsibilities. Study results showed that athletic success positively influenced a variety of university performance outcome variables such as enrollments and endowments. While results indicate that PPAP success can enhance university funding, we also suggest modifications that should enhance the chances that PPAPs will be successful.     

Coaching at the heart of managerial effectiveness: A cross-cultural study of managerial behaviours

This article considers the assessed performances of non-commissioned officers in aprogramme perceived as an important career enhancing activity for British military personnel. We introduce the idea of cognitive style as an important individual difference affecting performance on programmes of training and development and the implications for career progression. The research methodology adopted involved mixed methods as an alternative way of ‘seeing’, ‘researching’ and ‘theorising’ human resources development in this context. The research drew upon a mix of data from course participants and organizers, and it comprised cognitive style testing, within course assessment data and notes recorded during field observation. The results revealed relationships between the factors associated with ‘styles’, ‘assessed learning performance’ and ‘course experience’. Key perspectives on the experiences of training in terms of success and strategic direction were also identified. The study provides a deeper understanding of career-development processes in the military organization, considers the implications in which knowledge of an individual's style may have for the individual and course organizers and imports new theoretical frameworks into the study of human resource development.     

Management leadership and productivity improvement programs

The intent of this empirical research is to identify the critical factors that are potentially fatal to productivity improvement programs and to analyze these factors relative to management leadership concepts. From this analysis we determine that these “fatal” factors can be prevented by the pre-existence of a leadership-based program that requires participative involvement of all members of an organization through good performance measurement and a sound reward system.     

Is there potential in assessing for high-potential? Evaluating the relationships between performance ratings,leadership assessment data,designated high-potential status and promotion outcomes in a global organization

While leadership is a critical component of organizational success, organizations need to be more effective at classifying talent based on future potential vs current performance. This need raises the question as to whether the assessment of leadership potential is truly adding value or enhancing the talent review and classification process. Data from 9,784 participants in PepsiCo’s Leadership Assessment and Development (LeAD) program—a multi-trait, multi-method (MTMM) assessment and development process—are used to examine relationships between individual performance, assessed potential, organizationally designated potential, and promotion rates post assessment. Results from the analyses indicate that assessed potential provides unique variance above performance alone in determining process outcomes (i.e., designated potential and promotions), and therefore can be useful for making more informed talent management decisions. The applications of these measures within the current organization as well as limitations of the study and areas for future research are discussed.     

Six things to manage--Designs

Transportation in reverse logistics (RL) plays a significant role and has impact on overall RL performance. Efficiency, effectiveness and impact are the distinct components of RL transportation. Balancing these components requires the implementation of an effective performance measurement (PM) system. The perspectives of balanced scorecard have been used where enterprises can link their performance to their transportation practices, which do not provide an understanding of the RL transportation operating objectives and the developing strategies through an analysis of stakeholders. This article proposes the comprehensive PM of transportation system, which is multi-angle perspective for RL enterprises. Recognising the multiple criteria nature of the problem, this article uses analytical hierarchy process methodology in order to find an overall comprehensive performance index, which is critical to the success of the RL transportation operations to assist logistics managers, researchers, transportation planners and decision-makers.     

Management Control Systems: One View of Components and Their Interdependence1

Professor Robert Anthony's statement that ‘control is the process of assuring that the organization does what management wants done’ implies that systems for management control must be broadly conceived. This paper takes the view that a comprehensive view of control systems should include at least five components: performance measurement, strategy, organization structure, direction and motivation. Each of these components reflects management choices, but those choices have implications for the other components. A strategy of dynamic new product development for example, requires a flexible structure, and should have performance measures that relate to the structure and the desired achievements for that strategy. As what is measured signals what is important, the measures provide direction and the basis for incentives and rewards. The interdependence of the components is seen as a key factor in control system design. When the components support each other, the interdependence is a source of strength; conflict or even absence of support among the components can be a source of weakness. This paper describes the components and illustrates ways in which the design of control systems needs to recognize their interdependence. The process of system implementation is also reviewed, as process choices can be independent of design choices. The framework is related to prior research and writing, showing that the components are themselves complex and have been the focus of extensive study. Finally, several teaching cases are decribed in order to show how the design issues may appear in practice and how the framework can be used to help teach management control systems.     

Interactions among the human and organizational factors within the public sector regarding epidemic prevention and control

The management of human and organizational factors (HOFs) within the public sector directly concerns the efficacy of epidemic prevention and control (EPC). Insufficient examination of such HOFs has led to defective countermeasures. This study attempts to comprehensively identify the HOFs within the public sector critical to EPC and investigate their interactions with the weighted network theory. A total of 55 HOFs were identified, and their interactions were assessed and visualized in the Chinese context. Then, the established weighted network was analyzed to investigate the interactions and diagnose critical factors and sectors. The analysis shows that there are strong interactions among HOFs, and that the human and organizational risks emerging from administrative departments of public health, centers for disease control and prevention, and medical institutions act as the key risk sources in the complex interconnected EPC system, exacerbating risk and causing a significant domino effect. It is recommended that the authorities devote more resources to the core sectors and endeavor to reinforce those critical HOFs by implementing closer risk communication, collaboration, and response. This study may deepen and broaden the authorities’ awareness and understanding of interactions among HOFs regarding epidemic mitigation, and strengthen their capacity to perceive, evaluate, and manage these factors in a proactive and effective way, thereby facilitating the success of EPC.     

Motion picture performance: A review and research agenda

This paper provides a comprehensive literature review of empirical studies of motion picture performance published from 1977 to 2006 inclusive in the following five disciplines of the social sciences: strategy, organization theory, marketing, cultural economics and sociology. It introduces a novel framework which organizes the various dimensions and explanatory factors of movie performance into five distinct categories and underscores their relationships. The paper, which uses this model as a roadmap for discussions of film success, serves two complementary purposes. First, it clarifies the current state of the literature, stresses core contributions and exposes limitations in existing research by emphasizing hitherto neglected independent explanatory factors, dependent dimensions and correlations between them. Second, it introduces five conceptual, methodological and empirical suggestions for further cinema performance research aimed at addressing these limitations and, accordingly, at providing better accounts of motion picture performance in view of the fast-changing conditions of cinema production, marketing and consumption.     

Performance measurement system for business processes

All companies need to know at what level and to what extent they are complying with their objectives. We present a system called PMS-BP (performance measurement system for business processes) which has been designed to define indicators and evaluate company performance. The system is used to measure performance through the integrated management of business processes and to define indicators or parameters at all levels of the company. It also detects the linkages that exist between parameters at different levels and associates them with the company's objectives and strategies through critical success factors. PMS-BP has been built around three components: a methodology, an architecture and a performance measurement structure. The interconnection between the different components makes it easy to constantly trace the relationships between the different performance measurement elements at different levels (enterprise, business entity, processes, etc.). Processes are analysed by means of different types of graphs which make it simple to read and interpret the entire context of the company. We describe a real-life case in which the PMS-BP was applied to an SME in the metal/mechanics sector.     

Success factors of management consulting

Management consulting as a service has become part of almost every medium to big company’s daily business. Despite management consulting’s high practical relevance the scientific discussion of this discipline is relatively young and needs to advance. Notably, there is little empirical research that focuses on the conceptualization and operationalization of management consulting’s success factors from a client perspective. Therefore, in this article we theoretically conceptualize and subsequently operationalize critical success factors of management consulting. Also, we examine those factors’ particular impact on management consulting success. Based on a survey of 255 companies and structural equation modeling, we show that six out of seven theoretically derived success factors have a significant positive effect on management consulting success. In particular, Consultant Expertise, Intensity of Collaboration and Common Vision have a strong impact on the performance of management consulting.     

Designing a Decision-Making Process for a Network Administrative Organization: A Case Study of the National Quality Forum’s Consensus Development Process

In 1999 the health care industry created the National Quality Forum—a network administrative organization—to address issues of health care quality in a new way by bringing together organizations from the public and private sectors and providing them with a forum to discuss and debate measures of quality, and ultimately, to effect change. Little, however, is known about the decision making processes of network administrative organizations despite the fact that their decisions may have far-reaching impacts on public policy. Using a grounded theory approach, this paper examines the creation and development of the NQF’s Consensus Development Process and identifies and discusses five key principles that underlie the process. This paper argues that in order to create a decision-making process for a network administrative organization that is balanced and inclusive of diverse interests a leader must consider and incorporate principles that are representative of the larger environment.     

Data Envelopment Analysis for Managerial Control and Diagnosis*

Data envelopment analysis (DEA) is a linear programming-based technique that converts multiple input and output measures into a single comprehensive measure of productive efficiency. This is accomplished via the construction of an empirically based production frontier and by the identification of peer groups. Each unit is evaluated by comparison against a composite unit that is constructed as a convex combination of other units in its peer group. DEA has now been applied in a variety of managerial contexts. In this paper we draw on theories of decision making, measurement and control, the mathematical properties of DEA, prior reported applications, and our own experience, to assess the potential of DEA as a general management tool. We first make the distinction between managerial diagnosis and control. We show how measurement requirements differ for these two managerial decision contexts, and argue that DEA has the potential to provide support in each context. Measurement and decision support criteria for each activity are then developed by reference to the literature on diagnosis and control. Based on its mathematical definition and properties, the relevant attributes of DEA are then derived. The technique is evaluated in each capacity by comparison to the appropriate set of criteria. This evaluation is supported with evidence from our experience with DEA in a large public-sector organization. We argue that the structural properties of DEA, critical managerial choices in its application, and situationally specific factors, interact to determine the strengths and limitations of DEA in each decision context. Implications for research and practice are discussed.