Performance monitoring in the Victorian health care system: an exploratory study

Abstract

This paper reports on an exploratory study which aims to improve our understanding of how the Chief Executive Officers of Victorian health services monitor strategic and operational performance in their organisations. As a component of a large scale human resource management study, we surveyed 130 Chief Executive Officers (CEOs) of Victorian health sector agencies. Our findings suggest that performance monitoring was more advanced among the larger Victorian health sector organisations, and that there were areas for improvement throughout the system. Overall, the CEOs reported limited use of performance indicators related to service and clinical perspectives, with financial and volume indicators most widely used. There was little evidence that these organisations had processes in place (such as benchmarking and linking required outcomes to staff performance management) to understand the implications of the performance information and translate them into management action. The findings suggest that the sector requires technical expertise and support in data reporting, benchmarking and quality improvement in order to improve performance monitoring and ensure its relevance to strategic control, but further study is STRATEGIC DIRECTION, sound operations and effective performance monitoring are required to ensure high quality, safe and financially sustainable health care. Yet, in all industries we have seen the difficulty decision makers have in detecting poor performance early enough to respond effectively. 1 In the health sector there are many examples of health services that appear to be operating effectively, but which experience financial, quality or other crises in a relatively short time frame. In the absence of agreed national or statewide performance monitoring frameworks, many health services collect a vast amount of information, but appear to be unable to detect looming issues. This lack of strategic understanding and response may result because the organisation has not defined and does not collect the What is known about the topic? There is strong evidence that effective performance monitoring is a necessary prerequisite to improving organisational performance. What does this study add? Victorian health care organisations rely largely on traditional financial and service volume data in monitoring performance. Although there is strong research evidence of the importance of benchmarking, and of linking organisational performance requirements with staff performance management, the participants in this study had few processes in place to understand the implications of the performance information or translate them into management action. What are the implications?It is unlikely that health care managers currently have the information they require to successfully monitor organisational performance. Managers and policymakers need to focus on improving performance monitoring, including improving access to data and indicators that provide a more balanced view of performance and processes for effective linka...

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