"It Depends on What They Experience in Each Health Facility. Some Are Satisfied, Others Are Not." A MixedMethods Exploration of Health Workers' Attitudes Towards Performance-Based Financing in Burkina Faso.

BACKGROUND: Evidence emerging from qualitative studies suggests the existence of substantial variation in how health workers experience performance-based financing (PBF) within the same setting. To date, however, no study has quantified or systematically explored this within-setting heterogeneity. Considering that differences in health workers' affective reactions to PBF likely constitute an important element mediating the effectiveness of PBF in improving health service delivery, systematic and tangible information will be highly valuable to policy-makers and program managers who aim to maximize positive impacts of PBF. Our study aimed at contributing to filling this gap in knowledge by quantifying health workers' knowledge of, satisfaction with, and perceptions of PBF in Burkina Faso, and exploring factors associated with heterogeneity therein. METHODS: The study employed a post-intervention cross-sectional explanatory mixed methods study design with a dominant quantitative component - a structured survey to a total of 1314 health workers from 396 intervention health facilities - and a small and focused qualitative component - key informant interviews with 5 program managers - to triangulate and further elucidate the quantitative findings. Quantitative data were analyzed descriptively as well as using 3-level mixed-effects models. Qualitative data were analyzed in a largely deductive process along the quantitative variables and results. RESULTS: Health workers were on average moderately satisfied with PBF overall, with a slight tendency towards the positive and large variation between individuals. Two-thirds of health workers did not have adequate basic knowledge of key PBF elements. Perceived fairness of the performance evaluation process, of the bonus distribution process, and satisfaction with the individual financial bonuses varied dramatically between respondents. Factors associated with heterogeneity in knowledge, satisfaction, and fairness perceptions included responsibility at the facility, general work attitudes, management factors, and training in and length of exposure to PBF. CONCLUSION: Findings imply that investments into staff training on PBF and manager training on organizational change processes might be beneficial to positive staff attitudes towards PBF, which in turn would likely contribute to improving the effectiveness of PBF

Evaluation of the Wellspring Model for Improving Nursing Home Quality

Examines how successfully the Wellspring model improved the quality of care for residents of eleven nonprofit nursing homes in Wisconsin. Looks at staff turnover, and evaluates the impact on facilities, employees, residents, and cost

INVESTIGATING THE LEVEL OF BURNOUT AND INFLUENCING FACTORS ON IT AMONG THE WORKERS: CASE STUDY THE PETROCHEMICAL INDUSTRIES NATIONAL COMPANY

This study is done with the purpose of investigation the level of burnout and influencing factors on it. The method used is measuring or filed-finding, descriptive studies type and the statistic society is made of the entire official and non-official workers in the petrochemical industries national company in the year (2009) including 6901people in the main office and 12 subsidiary companies who are working. The estimation of the sample volume is made using the cochran formula by the volume of 1742 people and the accidental class and the domesticated form of the Maslach Burn Out Inventory has been used for gathering the dependant variant data of the study. In this study the relevance or effect of 20 independent variables on the burnout and its constituents was investigated. In the two variable tests, the emotional commitment had a reverse relation with burnout. So that with the increase of the interest and bind of the workers to the organization, the level of burnout decreased. In analyzing the step by step regression of the burnout according to the expected variables, 41percent of the explained burnout (R 2 =41%), and ranking the amount of the standard coefficient, the main elements like the nature of the job, emotional commitment, work environment, job security, coworkers, education, job type, salary and the premium and job independence in the remaining regression equation and on the burnout variable have been influencing.burnout, emotional commitment, job satisfaction, job motivation, job content.

Using abm in managing territorial health services: the “home-care”.

In recent years in Italy, as in other European countries, profound changes have been introduced in health care at both the central and the regional levels. Most of them were oriented towards a shift from “hospital-centred” healthcare to healthcare based more on territorial services. This transition pursues two objectives: giving more effective responses to citizens’ needs and reducing public health expenditure. Changes that involve organizational structure must also be carried out with the introduction of measurement tools that can help in planning and can control the changes. Starting from the experiences of the healthcare system of the Tuscan Region of Italy, the paper aims to provide an experience of the ABM approach to measure both output and efficiency of territorial health services. Activity Based Management provides an appropriate method to examine territorial activities and to meet the fact-finding needs of national and regional policy, by considering the issues indicated by the territorial managers of the Tuscan healthcare system and the regional and national experiences in recent years. ABM focuses on managing activities as the route to improving value for users and for the local healthcare unit; this is accomplished by the measurement of activities and resources that determine the costs and performance of territorial services. This approach requires organization and integration of sets of data belonging to different systems such as financial and operational systems. The ABM model is complex but it can be used by policy makers for strategic perspective and for continuous improvement. Moreover, ABM meets managers’ demands, as the Tuscan territorial managers have confirmed in interviews. On the basis of experience obtained in territorial long term homecare , the paper underscores the principal issues arising from the process of conducting an ABM project in territorial health services through strong involvement of healthcare workers. The paper also presents the main outputs achieved.Home care, performance measurement, ABM.

Measurement Error in Performance Studies of Health Information Technology: Lessons from the Management Literature

Just as researchers and clinicians struggle to pin down the benefits attendant to health information technology (IT), management scholars have long labored to identify the performance effects arising from new technologies and from other organizational innovations, namely the reorganization of work and the devolution of decision-making authority. This paper applies lessons from that literature to theorize the likely sources of measurement error that yield the weak statistical relationship between measures of health IT and various performance outcomes. In so doing, it complements the evaluation literature’s more conceptual examination of health IT’s limited performance impact. The paper focuses on seven issues, in particular, that likely bias downward the estimated performance effects of health IT. They are 1.) negative self-selection, 2.) omitted or unobserved variables, 3.) mis-measured contextual variables, 4.) mismeasured health IT variables, 5.) lack of attention to the specific stage of the adoption-to-use continuum being examined, 6.) too short of a time horizon, and 7.) inappropriate units-of-analysis. The authors offer ways to counter these challenges. Looking forward more broadly, they suggest that researchers take an organizationally-grounded approach that privileges internal validity over generalizability. This focus on statistical and empirical issues in health IT-performance studies should be complemented by a focus on theoretical issues, in particular, the ways that health IT creates value and apportions it to various stakeholders

Reforma del sector social en América Latina y el papel de los sindicatos

(Disponible en idioma inglés únicamente) En este trabajo se analiza la reacción de los sindicatos magisteriales y los gremios médicos a una serie de reformas del sector social en la región, incluidos la descentralización, mecanismos de pago a los prestadores de servicios y la introducción de mecanismos de evaluación del desempeño y de prestación privada de servicios. Combina la obra publicada sobre Economía y Politología para comprender las condiciones que moldean diversos patrones de comportamiento de los sindicatos y sus efectos en la aplicación de las políticas. El trabajo sugiere que las principales condiciones que influyen en el comportamiento de los sindicatos en el sector de la salud tienen que ver con la estructura del mercado (tamaño y nivel de competencia), debido a la participación combinada del sector privado y el público en el empleo. En la educación, donde el sector público es la principal fuente de empleo, los alineamientos políticos y las características organizacionales de las asociaciones magisteriales también desempeñan un papel importante para explicar el comportamiento de las organizaciones prestadoras de esos servicios. Se concluye, tomando en cuenta la naturaleza exógena de la mayoría de estas variables, presentando algunas sugerencias de políticas para alinear los objetivos de los sindicatos y los de los diseñadores de políticas mediante reformas de la normativa.

Professional performance evaluation within the Romanian administrative system

The current economic crisis, manifested in the entire world, highlights the need for sustained involvement of the local and regional authorities in each country, in conceiving and implementing Community policies (which already exist at European level) having an essential role in implementing the economic plans achievement. This view was shared by all European Union Member States, of which Romania is part, since 2007. Therefore, the economic crisis which is reflected in the Romanian society today, requires prompt and sustained intervention by the authorities in the execution of the economic recovery plan, implying the community strategies, due to sharply budgetary expenses cut, which is found in all European countries. In order to achieve this major objective, the Romanian authorities should have qualified and properly motivated personnel through an adequate remuneration, according to the training, skills, responsibilities and especially individual performance obtained at each position, as it happens in most developed countries of the European Union. In this context, this study approaches the issues related to the performance evaluation of the public sector’s employees. Considering the fact that strengthening and developing the human resources segment is a strategic goal of the Romanian administration for the period 2008 - 2013, which will lead to modernizing it and making it more efficient (at both central and local level), the personnel performance evaluation, at the organizational level represents a fundamental activity from the human resources’ management perspective.performance evaluation, performance indicators’ system, human resources management, Romanian administration.

Empirical study on intrinsic motivation factors of employees in transition economies

Purpose: This research study aims to unequivocally discuss and explore the intrinsic motivation factors of the employees in transition economies. The purpose of this study is to find which are the main internal factors that motivate employees? Taking in to consideration changes to the economic systems, different factors derived from theories, as well as other research analyzed. Design/Methodology/Approach: To describe the relationship between motivational factors that motivate workers today, we have developed a questionnaire which is distributed and filled by 510 respondents, not taking into account their hierarchy in the organization. Methodologies used in this research are Pearson correlation matrix to test the relationship with independent variables and dependent variable which in our case is intrinsic motivation and as a main econometric model binary logit is used Findings: The research shows that most of the data that we have used in this model are correlated, and have high level of significance, and there is no multicollinearity. Whereas, in Binary Logit model used Cox & Snell R Square is .696 meaning that our model is predicted by around 70 percent from the independent variables. From our research we found that most important intrinsic motivational factors are competence, job satisfaction, job recognition as well as financial rewards. There is no impact on intrinsic motivation that is dependent on finding the job interesting or not. Worthy of note is that the odds of employees to be intrinsically motivated are much higher in public institution than in private businesses. Practical Implications: This study raises awareness of motivational factors in economies that are still in transition. Results of this study can serve as a good guide especially for small businesses and business startups on importance of behaviorist approach for motivation factors as competence and job recognition. Originality/Value: this paper provides original insights of the compound relationship between different factors that have a direct affect in intrinsic motivation of employees’ therefore as an outcome better job performance.peer-reviewe

Minimization of tool path length of drilling process using particle swarm optimization (PSO)

In the era of challenging economic, the industry in our country has been forced to produce a good quality product and increase the productivity of machining process simultaneously in order to compete with other countries. Drrilling process is one of a very important cutting process in industry. In a drilling for machining by Computer Numerical Control (CNC) such as drilling machines, the parameter of the tool routing path for the machining operation plays a very important role to minimize the machining time (Tiwari 2013, Rao and Kalyankar 2012) . This machine can be used with procedures for drilling, spreading, weaning and threading with a lot of the holes precisely. In order to increase the efficiency and productivity of drilling process, optimization on parameters of process can lead to better performance. Optimization of holes drilling operations will lead to reduction in time order and better productivity of manufacturing systems. Optimizing the tool path has played an important role, especially in mass production because reducing the time to produce one piece eventually lead to a significant reduction in the cost of the entire series (Pezer, 2016). In various publications and articles, scientists and researchers adapted several methods of artificial intelligence (AI) or hybrid optimization method for tool path artificial immune system (AIS), genetic algorithms (GA), Artificial Neural networks (ANN) Ant Colony Optimization (ACO) and Particle Swarm Optimization (PSO) (Narooei and Ramli, 2014). These methods were been proven that can produce better performance and increase the productivity of drilling process. Therefore, in this study, the Particle Swarm Optimization (PSO) algorithm was develop in order to minimizing the tool path length in the drilling process which can produce the better results for the required machining time process. For this study, the main purpose is to apply the Particle Swarm Optimization (PSO) algorithm for use in searching for the optimal tool routing path for in simulation of drilling proces