The application of a performance management system in hospitals: A hypothetical example

Abstract

The central theme of this article is performance management, defined as activities of organizations aimed at an effective and efficient use of their human resources. The organization focused on in particular is the hospital. Three principles taken from motivation theory are dealt with which are basic to performance management: goal setting, feedback and reinforcement. Next, a recently developed procedure (Pritchard 1990, Pritchard et al. 1988, 1989) for the design of performance management systems is described. This procedure, ProMES: Productivity Measurement and Enhancement Systems, is explained using a team of ward nurses as a hypothetical example. In addition to the nursing wards example, other potential applications of the ProMES technique to several hospitals areas are mentioned. Finally, some conditions that should be fulfilled in order to successfully start a ProMES project are discussed.     

The breakdown and influence properties of outlier rejection-plus-mean procedures

In a recent paper, Hampel (1985) studied the properties of rejection-plus-mean procedures as estimators of a location parameter. He reported that these procedures have low breakdown and high variance. In this article it is pointed out that these results are due to the outliers being rejected in a forwards-stepping manner, and when a more appropriate backwards-stepping approach is used, rejection-plus-mean procedures lead to estimators with high breakdown and high variance. In this article it is pointed out that these results are due to the outliers being rejected in a forwards-stepping manner, and when a more appropriate backwards-stepping approach is used, rejection-plus-mean procedures lead to estimator with high breakdown and redescending theoretical influence function.     

Asymptotocally nonparametric tests with censored paired data

A class of asymptotically nonparametric test with contains a test proposed by Wei(1980), is considered for testing the equality of two continuous distribution funcitons when paired observations are subject to arbitrary right censorship. It is shown that under the null hypothesis each test statistic converges in distribution to the standard normal random variable. Furthermore. the Monte Carlo simulation results indicate that some tests in this class are more powerful than Wei's test. A generalization to incomplete censored paired data is also included.     

Adaptable Careers: Maximizing Less and Exploring More

Today, young adults are expected to decide between educational, vocational, and job options and to make the best choice possible. Career literatures emphasize the importance of young adults' career decision making but also acknowledge the problems related to making these decisions. The authors argue that career counselors could support clients' intuitive processing of career information and help their clients to develop a positive and flexible view of the self and the environment while diminishing concerns about accountability for and irreversibility of career decisions. The authors argue that career adaptability rather than decision making should become the focal concept of career theory and practice.     

Bootstrap method in ranking and slippage problems

In this paper, the bootstrap method of Efron (1979) is given for a ranking and a slippage problem, where the ranking (or slippage) is with respect to the mean of the distributions. The method is also applied to obtain a confidence interval for the largest mean.     

A note on cost-return calculations and decisions to migrate

In the notions of the aggregative cost-benefit migration models, this paper questions the assumption that prospective migrants behave as if they are not only concerned with, but are able to calculate expected pecuniary and non-pecuniary returns to re-location. Results of a survey which evaluates the role of cost-return calculations in decisions to migrate suggest that there may be population sub-groups who either do not care to make cost-returns calculations to migration, or who are unable to do so.     

Minimax property of stein's estimator

Stein's estimator and some other estimators of the mean of a K-variate normal distribution are known to dominate the maximum likelihood estimator under quadratic loss for K > 3, and are therefore minimax. In this paper it is shown that the minimax property of Stein's rule is preserved with respect to a generalized loss function.     

Efficacy of Statistical Outlier Analysis for Monitoring Quality of Care

Researchers have proposed that hospitals with excessive statistically unexplained mortality rates are more likely to have quality-of-care problems. The U.S. Health Care Financing Administration currently uses this statistical “outlier” approach to screen for poor quality in hospitals. Little is known, however, about the validity of this technique, since direct measures of quality are difficult to obtain. We use Monte Carlo methods to evaluate the performance of the outlier technique as parameters of the true mortality process are varied. Results indicate that the screening ability of the technique may be very sensitive to how widespread quality-related mortality is among hospitals but insensitive to other factors generally thought to be important.     

Contraceptive Responsibility among Male University Students

Abstract

This paper assesses the male contribution to contraceptive mismanagement and unwanted pregnancy. The subjects were 109 students at the University of Melbourne. A high incidence of risk-taking was reported, and almost one-fifth of the sexually experienced men stated that they had been involved in an unwanted pregnancy. A small group of these reported more than one such incident. The underlying reasons for poor contraceptive technique seemed to be related to two beliefs: that contraception is a female responsibility, and that sexual intercourse should be entirely spontaneous and unplanned.