Assessing the Effectiveness of a Performance Evaluation System in the Public Health Care Sector: Some Novel Evidence from the Tuscany Region Experience

Since 80's the introduction of New Public Management principles has promoted the use of performance measurement to drive a more efficient, effective and accountable public sector. The adoption of a sophisticated and comprehensive multidimensional performance measurement system, which looks beyond traditional financial measures, based on organization strategies, such as the balanced scorecard, has thus been suggested. This revolution in the public management came together with the devolution processes that involved most European public health systems. Set within this context, in the last decade, each of the twenty Italian regions developed its own management tools. Among others, the Tuscan performance evaluation system (PES) has been valued as a particularly innovative and comprehensive system. This paper reports the novel experience of the Tuscan PES; in particular, it measures PES effectiveness and discusses the critical factors that could have led to the PES success. Five are the critical success factors identified by researchers: the visual reporting system, the linkage between PES and CEO's reward system, the public disclosure of data, the high level of employees and managers involvement into the entire process and the strong political commitment. All those factors run together to achieve better results; however, the process of development of the system plays a pivotal role. Scholars suggest the use of a constructive approach in order to gain effective changes in human organization. According to this stream of literature, this paper contributes by the novel experience of the Tuscan PES in addressing as a further fruitful application of the constructivist approach in healthcare

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Individual placement and support in Europe

Topic: Individual Placement and Support (IPS) is a psychosocial intervention with a considerable body of evidence for its effectiveness in helping people with severe psychiatric disorders to obtain and maintain competitive jobs. In the last decades several European studies have replicated earlier American outcomes, generating widespread interest about its implementation in Europe. Purpose: This article describes and compares details about achievements and challenges of IPS in 4 European countries: the United Kingdom, Italy, The Netherlands, and Spain. Sources Used: This description draws from published and nonpublished material about policy, development of services, and services evaluation. Results: In the United Kingdom and in The Netherlands, empirical studies exploring the consistency of results over time and the effectiveness of IPS adaptations to local needs and special population are in course. In the United Kingdom, IPS has become national policy, as well as in some regions of Italy and Spain. Training is quite extensive in the United Kingdom and in The Netherlands, developing well in Italy and Spain. Implementation seems to be less straightforward, mostly because of deeply rooted cultural values regarding both work and mental health care. Strong local leadership is still required. In all countries contingencies related to the current economic crisis seems to have increased interest in IPS. Conclusions and Implications for Practice: With the converging forces of strong local leadership, rapid economic changes, and slow cultural shifts, IPS may soon become a priority intervention in Europe for ensuring that people living with serious mental illnesses are able to obtain competitive employment. © 2014 American Psychological Association

Individual placement and support in Europe

Topic: Individual Placement and Support (IPS) is a psychosocial intervention with a considerable body of evidence for its effectiveness in helping people with severe psychiatric disorders to obtain and maintain competitive jobs. In the last decades several European studies have replicated earlier American outcomes, generating widespread interest about its implementation in Europe. Purpose: This article describes and compares details about achievements and challenges of IPS in 4 European countries: the United Kingdom, Italy, The Netherlands, and Spain. Sources used: This description draws from published and nonpublished material about policy, development of services, and services evaluation. Results: In the United Kingdom and in The Netherlands, empirical studies exploring the consistency of results over time and the effectiveness of IPS adaptations to local needs and special population are in course. In the United Kingdom, IPS has become national policy, as well as in some regions of Italy and Spain. Training is quite extensive in the United Kingdom and in The Netherlands, developing well in Italy and Spain. Implementation seems to be less straightforward, mostly because of deeply rooted cultural values regarding both work and mental health care. Strong local leadership is still required. In all countries contingencies related to the current economic crisis seems to have increased interest in IPS. Conclusions and implications for practice: With the converging forces of strong local leadership, rapid economic changes, and slow cultural shifts, IPS may soon become a priority intervention in Europe for ensuring that people living with serious mental illnesses are able to obtain competitive employment