Performance management in healthcare: The illusory appeal of shiny new tools
Kavisha Shah1, Digital Health Cooperative Research Centre Sydney 1Digital Health Cooperative Research Centre, Sydney, NSW, Australia
Abstract
Recent health care reforms have deployed a number of approaches to performance management designed to improve the safety and quality of care – many of which have been adopted from other industries and contexts. These include the use of clinical indicators, registries, performance reviews and audits as well as mandates for continuous professional development. While such approaches have often been enthusiastically endorsed because they are proactive, standardise management of ‘critical incidents’ and promote accountability and change across health systems, these new technologies and strategies may not work, may not be adopted or supported by health practitioners, may mask systemic problems that in the health care system that create and perpetuate unsafe care and may actually inhibit genuine self-reflection and practice change.
This presentation will address the impact of established and emergent approaches to performance management in healthcare and question whether the regulation of such activities might make meaningful improvements to clinical practice and practice care. Literature on root cause analysis will be used as a case study to demonstrate how acceptance of any approach relies on proper alignment with established policies and processes. This will be contrasted with findings from recent stakeholder interviews on practice analytics – the use of data for practice reflection and performance management. This data will be used to explore the degree to which organisational change relies on minimising tensions, perceived or otherwise, between public legitimacy and transparency and professional learning, and how this may be achieved in ways that are effective, sustainable and ethico-legally robust.
Biography
Kavisha is a PhD Candidate with the Digital Health Cooperative Research Centre, and a Research Assistant at the University of Sydney. Her work explores secondary uses of data, and implementing, evaluating and sustaining virtual models of care.