This paper describes performance measurement and its indicators for mental health care services. Performance measurement can serve several goals such as accountability, quality improvement and performance management. For all three purposes structure, process and outcome indicators should be measured. Literature was retrieved from Medline and PsychInfo in order to see which performance indicators were used for the three purposes of performance measurement in mental health care. The indicators were classified in structure, process and outcome indicators. The results show no big differences in the indicators used among studies. Performance management is the performance measurement purpose most referred to, followed by accountability, and quality improvement. Outcome and process indicators are used most, structure indicators are in the minority. Several levels of measurement, that is national or service level, came forward in the literature review. To overcome misinterpretation of data and to be able to improve quality and manage performances, performance indicator sets should refer to structure, process and outcome. Indicators should be chosen carefully with the aim of the measurement taken into mind. Based on this review, a conceptual framework is presented to support managers in their decisions about which indictors can best be used for performance measurement. Additionally, a model that provides an understanding of the use of information gained by performance measurement is given.
More doctors would like to work parttime. Since research on fitting healthcare system design with the structure of parttime jobs is lacking, we studied how parttime work for medical doctors could be enabled from a system design perspective. A theoretical analysis was performed, illustrated by two case studies. We conclude that introducing parttime work can provide the opportunity for improving system design and, therewith, performance. From the case studies it seems that work redesign can enable parttime work, and at the same time improve system performance. Better managing variability in the system contributed to this. The case studies results also showed that systems characterized by different levels of variability fit with different work contracts.
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Demand for mental healthcare increases. Simultaneously, the need for more patient oriented processes increases and the market develops towards more competition among providers and organizations. As a result of these developments, mental healthcare organizations are becoming more aware of efficiency and effectiveness. Often, they choose to transform to more process oriented organizations, which require changes in planning and control systems and information technology (IT). However, little is known about the required planning and control systems and IT for mental healthcare.
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