Advancing the use of performance evaluation in health care

The purpose of this paper is to develop a framework for health care performance evaluation that enables decision makers to identify areas indicative of corrective actions. The framework should provide information on strategic pro-/regress in an operational context that justifies the need for organizational adjustments.

The study adopts qualitative methods for constructing the framework, subsequently implementing the framework in a Danish magnetic resonance imaging (MRI) unit. Workshops and interviews form the basis of the qualitative construction phase, and two internal and five external databases are used for a quantitative data collection.

By aggregating performance outcomes, collective measures of performance are achieved. This enables easy and intuitive identification of areas not strategically aligned. In general, the framework has proven helpful in an MRI unit, where operational decision makers have been struggling with extensive amounts of performance information.

The implementation of the framework in a single case in a public and highly political environment restricts the generalizing potential. The authors acknowledge that there may be more suitable approaches in organizations with different settings.

The strength of the framework lies in the identification of performance problems prior to decision making. The quality of decisions is directly related to the individual decision maker. The only function of the framework is to support these decisions.

The study demonstrates a more refined and transparent use of performance reporting by combining strategic weight assignment and performance aggregation in hierarchies. In this way, the framework accentuates performance as a function of strategic progress or regress, thus assisting decision makers in exerting operational effort in pursuit of strategic alignment.