Peter M. Jackson

An innovative framework for health care performance measurement

Today, hospitals not only have to contend with the dynamics of regulation and market forces but most importantly “service quality”. Service quality is a measure of how well the total service package meets customers’ expectations. The abilities to identify and prioritize customers’ expectations and to perform existing process assessment are important elements of a successful quality improvement strategy. The inherent characteristics of services complicate the efforts for quality improvement. Quality function deployment (QFD) is a systematic technique for designing services or products that are based on customers’ expectations. Given the proven success of QFD in manufacturing, this paper explores the applicability of QFD in health care. It describes the QFD technique and how it leads to a better understanding of customers’ expectations. It presents recommendations and a generic framework that is supported by empirical findings as a reference model for hospitals.

The management of performance in the public sector

Having no ‘bottom line’ is no excuse for failing to manage performance. In the private sector, where profits are not known until after the event, managers use measures and indicators of performance. In spite of the technical difficulties, measuring performance must become embedded in the management culture of the public sector if the quality of services is to improve.

Public Sector Added Value: Can Bureaucracy Deliver?

This paper takes stock of our understanding of the ‘architecture’ of public sector resource allocation mechanisms. It is a speculative venture and provides a framework for thinking about issues rather than a completed theoretical model. The concept of architecture is borrowed from the design sciences and is used to explore the conditions of performativity within networks of relational contracts. The age-old question of markets versus hierarchy is too simplistic. Instead, the search is for optimal complex network relationships that are based upon co-operation and participation rather than competition and control. Within these networks the public sector, it is argued, has a new role of acting as a broker in the creation of value. Judging the public sector’s relative effectiveness in the creation of value also requires closer attention to be given to the context within which public sector managers take decisions. In particular it is necessary to acknowledge that they confront the ‘wicked’ problems of society that the electorate demand to be solved. This gives renewed interest in the notion of market failure.

Public service performance evaluation: A strategic perspective

Performance evaluation of government activities is essential in any democracy. Government, no matter the level (central/federal, state, or local), should be accountable and responsible to the electorate and a host of other stakeholders. Accountability involves, among other things, an assessment of policy outcomes, along with the means and processes used to deliver the policies. Were the policies suitable for the problems that the electorate wanted to be solved? Were the policies implemented efficiently and effectively? Did the electorate, taxpayers, and users of public services (often these aw distinct groups) obtain value‐for‐money?

Governance by numbers: what have we learned over the past 30 years?

The performance of public sector organizations, even when they are doing well, is the subject of critical commentary. No matter what they do, some group will argue that they could do better and do things differently. Criticism of public service organizations is a very public affair. That is the nature of the public sector. The management of private sector organizations are seldom placed in the public gaze unless they are involved in some major environmental catastrophe or a governance scandal.

Managing public sector networked organizations

The authors argue that we are in the age of the networked society. Lying between the governance structures of markets and hierarchies, networks have emerged as an organizational form which seeks to confront many of the ‘wicked problems’ faced by public and private organizations. While the precise architecture of networks remains vague, much is claimed for them in terms of their potential contribution to adding value and enhancing performance. This article explores the use of networks in the delivery of public services and the problems and issues that arise for their management. Public service managers need to be aware of the costs and benefits of alternative network architectures and how these might be actively managed. The treatment of public sector networks here is also intended to contribute to the current debate on ‘joined-up’ government.

High Impact/ Low Frequency extreme events: Enabling Reflection and Resilience in a Hyper-connected World

Abstract Helbing (2013:51) poignantly argues that ‘Globalization and technological revolutions are changing our planet’. Along with the benefits and opportunities associated with worldwide collaboration networks comes ‘pathways along which dangerous and damaging events can spread rapidly and globally’. With our hyper-connected world underpinned by hyper or hybrid-risks, the impact of unexpected events such as floods, earthquakes, financial crisis, and cyber-attacks has revealed the fragility and vulnerabilities that lie within the social/technological/economic/political/ecological interdependent systems. In particular, events that affect critical infrastructure such as damage to electric power, telecommunications, transportation, health care systems, financial markets and water-supply systems can have local, regional and global impact. Taleb (2007) calls these extreme events ‘Black swans’ to describe their inherent quality of surprise. Many of the systemic risks that characterize Natural Hazard triggered Technological disasters (NATECH) often arise from unanticipated consequences of interactions within and between different types of systems. Johnson and Tivnan (2012:65) argue that, ‘…understanding, controlling and predicting extreme behavior [of NATECH] is an important strategic goal to support resilience planning’. In this light, a new paradigm is required to support disaster risk reduction (DRR) embedded in hyper-risks; one that will develop not only anticipatory measures for risk management but also prepare for the unpredictable and the ‘unknown’ by building organisational resilience for hyper-risks in general and NATECH disasters in particular. In this paper we explore the emergency management domain associated with the Fukushima Daiichi nuclear accident to show the hyper-connectivity and hyper-risks that permeated the problem space and thereby show how ‘reflective responses’ underpinned by ‘critical reflective practices’ can be used to support resilience in such a complex disaster.

Productivity and performance of public sector organisations

Public sector activity accounts for about 40% of a developed economys total production. Whilst attention has been focused upon manufacturing productivity and performance, until recently virtually nothing was known about the public sectors productivity. The article reviews a number of the conceptual issues, which lie at the heart of public sector productivity and performance measurement. It then critically considers those measures that have been provided and looks to how developments in this area might progress.

Public choice and public sector management

Public sector economics and public sector management should complement one another more than they do. Public sector economists have not fully appreciated the issues of concern to public sector management, whilst those in public sector management have not had sufficient access to public sector economics. This article seeks to explore the relevance of public sector economics for public sector management. It emphasizes the importance of a strong theoretical foundation for management practice and the importance of the public choice perspective for an understanding of public policy and public sector decision‐making.

Debate: Fraud risk management in the public sector

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