An effectiveness analysis of healthcare systems using a systems theoretic approach

<p>Abstract</p> <p>Background</p> <p>The use of accreditation and quality measurement and reporting to improve healthcare quality and patient safety has been widespread across many countries. A review of the literature reveals no association between the accreditation system and the quality measurement and reporting systems, even when hospital compliance with these systems is satisfactory. Improvement of health care outcomes needs to be based on an appreciation of the whole system that contributes to those outcomes. The research literature currently lacks an appropriate analysis and is fragmented among activities. This paper aims to propose an integrated research model of these two systems and to demonstrate the usefulness of the resulting model for strategic research planning.</p> <p>Methods/design</p> <p>To achieve these aims, a systematic integration of the healthcare accreditation and quality measurement/reporting systems is structured hierarchically. A holistic systems relationship model of the administration segment is developed to act as an investigation framework. A literature-based empirical study is used to validate the proposed relationships derived from the model. Australian experiences are used as evidence for the system effectiveness analysis and design base for an adaptive-control study proposal to show the usefulness of the system model for guiding strategic research.</p> <p>Results</p> <p>Three basic relationships were revealed and validated from the research literature. The systemic weaknesses of the accreditation system and quality measurement/reporting system from a system flow perspective were examined. The approach provides a system thinking structure to assist the design of quality improvement strategies. The proposed model discovers a fourth implicit relationship, a feedback between quality performance reporting components and choice of accreditation components that is likely to play an important role in health care outcomes. An example involving accreditation surveyors is developed that provides a systematic search for improving the impact of accreditation on quality of care and hence on the accreditation/performance correlation.</p> <p>Conclusion</p> <p>There is clear value in developing a theoretical systems approach to achieving quality in health care. The introduction of the systematic surveyor-based search for improvements creates an adaptive-control system to optimize health care quality. It is hoped that these outcomes will stimulate further research in the development of strategic planning using systems theoretic approach for the improvement of quality in health care.</p

Reactivity to sustainability metrics: A configurational study of motivation and capacity

Previous research on reactivity – defined as changing organisational behaviour to better conform to the criteria of measurement in response to being measured – has found significant variation in company responses towards sustainability metrics. We propose that reactivity is driven by dialogue, motivation and capacity in a configurational way. Empirically, we use fuzzy set Qualitative Comparative Analysis (fsQCA) to analyse company responses to the sustainability index FTSE4Good. We find evidence of complimentary and substitute effects between motivation and capacity. Based on these effects we develop a typology of reactivity to sustainability metrics, which also theorises the use of metrics as tools for performance feedback and the building of calculative capacity. We show that when reactivity is studied configurationally, we can identify previously underacknowledged types of responses. We discuss the theoretical and practical implications for studying and using sustainability metrics as governance tools for responsible behaviour

Applying performance measures to support decision-making in supply chain operations: a case of beverage industry

Performance measurement systems (PMS) have commonly been applied to evaluate and reward performances at managerial levels, especially in the context of supply chain management. However, evidence suggests that the effective use of PMS can also positively influence the behaviour and improve performance at an operational level. The motivation is to accomplish organisational goals, namely to increase supply chain flexibility by responding to evermore-varying customer demands in a timely manner. The purpose of the study described in this paper was to develop a conceptual framework that adopts performance measures for ex-ante decision-making at an operational level within the supply chain. To guide the research, five questions were asked and subsequently key gaps have been identified. In an attempt to fill the gaps, a case study at a major global brand beverage company has been carried out, and as a result, a conceptual framework of the PMS has been developed. Overall, the research offers a foundation of the applicability and impact of PMS in the supply chain and provides a framework that attends to some of the potential uses of PMS that so far have not been practically applied. The outcomes from the testing indicate that the initial gaps identified in the literature have been addressed and that the framework is judicious with scope for practical applicability. The framework is deemed worthy of further testing in different operational contexts of the supply chain

Research and Applications of the Processes of Performance Appraisal: A Bibliography of Recent Literature, 1981-1989

[Excerpt] There have been several recent reviews of different subtopics within the general performance appraisal literature. The reader of these reviews will find, however, that the accompanying citations may be of limited utility for one or more reasons. For example, the reference sections of these reviews are usually composed of citations which support a specific theory or practical approach to the evaluation of human performance. Consequently, the citation lists for these reviews are, as they must be, highly selective and do not include works that may have only a peripheral relationship to a given reviewer\u27s target concerns. Another problem is that the citations are out of date. That is, review articles frequently contain many citations that are fifteen or more years old. The generation of new studies and knowledge in this field occurs very rapidly. This creates a need for additional reference information solely devoted to identifying the wealth of new research, ideas, and writing that is changing the field

Exploring the Issues: An Evaluation Literature Review

Finding ways to make evaluation more meaningful and more useful has been a key theme in the evaluation literature since the discipline began, and there is no shortage of discussion around improving evaluation among nonprofit practitioners. The topic has been a highlight at ONN's annual conference in recent years.However, much of the discussion around improving evaluation focuses on methodology, tools, and indicators.There has been less attention paid to who is asking and determining the questions of evaluation, such as who evaluation is for and what is its purpose. Consequently, the purpose of this background paper is to review the literature on evaluation use with a particular focus on systemic factors. In other words, we are interested in looking at the relationship between evaluation practice and the overall structure and function of the nonprofit sector in Ontario.We're interested in the policies and regulations that guide us, the roles played by various actors, theassumptions we make, the language we use, and the ways in which resources move through the sector. We're examining the purposes that evaluation serves, both overt and implicit. We want to learn more about the factors that make evaluations really useful, the issues that can get in the way of evaluations being useful, and ideas for improvement. Ultimately, our goal in this paper is to generate a broad vision to inform our project's final outcomes

Student-Centered Learning: Functional Requirements for Integrated Systems to Optimize Learning

The realities of the 21st-century learner require that schools and educators fundamentally change their practice. "Educators must produce college- and career-ready graduates that reflect the future these students will face. And, they must facilitate learning through means that align with the defining attributes of this generation of learners."Today, we know more than ever about how students learn, acknowledging that the process isn't the same for every student and doesn't remain the same for each individual, depending upon maturation and the content being learned. We know that students want to progress at a pace that allows them to master new concepts and skills, to access a variety of resources, to receive timely feedback on their progress, to demonstrate their knowledge in multiple ways and to get direction, support and feedback from—as well as collaborate with—experts, teachers, tutors and other students.The result is a growing demand for student-centered, transformative digital learning using competency education as an underpinning.iNACOL released this paper to illustrate the technical requirements and functionalities that learning management systems need to shift toward student-centered instructional models. This comprehensive framework will help districts and schools determine what systems to use and integrate as they being their journey toward student-centered learning, as well as how systems integration aligns with their organizational vision, educational goals and strategic plans.Educators can use this report to optimize student learning and promote innovation in their own student-centered learning environments. The report will help school leaders understand the complex technologies needed to optimize personalized learning and how to use data and analytics to improve practices, and can assist technology leaders in re-engineering systems to support the key nuances of student-centered learning

Team Learning: A Theoretical Integration and Review

With the increasing emphasis on work teams as the primary architecture of organizational structure, scholars have begun to focus attention on team learning, the processes that support it, and the important outcomes that depend on it. Although the literature addressing learning in teams is broad, it is also messy and fraught with conceptual confusion. This chapter presents a theoretical integration and review. The goal is to organize theory and research on team learning, identify actionable frameworks and findings, and emphasize promising targets for future research. We emphasize three theoretical foci in our examination of team learning, treating it as multilevel (individual and team, not individual or team), dynamic (iterative and progressive; a process not an outcome), and emergent (outcomes of team learning can manifest in different ways over time). The integrative theoretical heuristic distinguishes team learning process theories, supporting emergent states, team knowledge representations, and respective influences on team performance and effectiveness. Promising directions for theory development and research are discussed

Low carbon housing: lessons from Elm Tree Mews

This report sets out the findings from a low carbon housing trial at Elm Tree Mews, York, and discusses the technical and policy issues that arise from it. The Government has set an ambitious target for all new housing to be zero carbon by 2016. With the application of good insulation, improved efficiencies and renewable energy, this is theoretically possible. However, there is growing concern that, in practice, even existing carbon standards are not being achieved and that this performance gap has the potential to undermine zero carbon housing policy. The report seeks to address these concerns through the detailed evaluation of a low carbon development at Elm Tree Mews. The report: * evaluates the energy/carbon performance of the dwellings prior to occupation and in use; * analyses the procurement, design and construction processes that give rise to the performance achieved; * explores the resident experience; * draws out lessons for the development of zero carbon housing and the implications for government policy; and * proposes a programme for change, designed to close the performance gap

The Role-Based Performance Scale: Validity Analysis of a Theory-Based Measure

This study introduces a theory-based measure of employee performance (Role Based Performance Scale, RBPS) that is supported with results from a validation study using 10 data sets from six companies. In contrast to traditional, job-related measures of employee performance, we propose an alternative measure of performance based on role theory and identity theory. Because our results support the validity of the scale, we think that the instrument can be used for future research that requires a generalizable measure of performance. The scale demonstrates diagnostic properties that make it useful for practitioners as well as researchers

Psychometrics in Practice at RCEC

A broad range of topics is dealt with in this volume: from combining the psychometric generalizability and item response theories to the ideas for an integrated formative use of data-driven decision making, assessment for learning and diagnostic testing. A number of chapters pay attention to computerized (adaptive) and classification testing. Other chapters treat the quality of testing in a general sense, but for topics like maintaining standards or the testing of writing ability, the quality of testing is dealt with more specifically.\ud All authors are connected to RCEC as researchers. They present one of their current research topics and provide some insight into the focus of RCEC. The selection of the topics and the editing intends that the book should be of special interest to educational researchers, psychometricians and practitioners in educational assessment