Low Cost and Human-Centered Innovations in Healthcare Services: A Case of Excellence in Italy

2. Measuring And Managing Performance In A Healthcare Environment

The development of tools to better measure performance, improve efficiency, and increase accountability for results is on the agenda of many public sector organizations (Pollitt 2008; Van Dooren et al., 2010; Pollitt & Bouckaert, 2011). The goal of improving efficiency and effectiveness is not only a matter of managerial rationality but is also a political issue in many OECD countries. Indeed, more than two-thirds of OECD countries include non-financial performance data in the documentation available to managers and policy makers (internal use), and also provide reports on performance to the public (external use) (OECD, 2005).

From an external-use perspective, transparency has become a widespread symbol of “good governance” in many different contexts (O'Neill, 2008). It is a key element for public sector organizations that wish to become more accountable to their stakeholders, giving them the possibility to be involved in decision making (Pasquier & Villeneuve, 2012). Moreover, the collection of information through performance measurement can assist these organizations to move toward an improved allocation of resources through management control systems (Padovani & Young, 2012).

Internally, much of the recent focus has been on key performance indicators (KPIs). Designed properly, KPIs not only measure performance, but create incentives that help to align individual goals with the objectives of the organization, provide valuable feedback on the progress towards these objectives, and form the basis for internal and external accountability (Cavalluzzo & Ittner, 2004; Kravchuk & Schack, 1996).