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In the quality management literature, measurements are attributed great importance in improving products and processes. Systems for performance measurement assessing financial and non-financial measurements were developed in the late 1980s and early 1990s. The research on performance measurement systems has mainly been focused on the design of different performance measurement systems. Many authors are occupied with the study of the constructs of measures and developing prescriptive models of performance measurement systems. There is a need in the research to shift focus from studying the construct of measurements to how they are used in real face-to-face situations in specific contexts. The purpose of this thesis is to analyse the development, i.e. the design, implementation and use, of performance measurement systems in Swedish health care services. The study aims to increase the understanding of the role of performance measurement system in Swedish health care and thereby support health care improvements in general. Three research questions have been derived from the purpose. (1) How and why are performance measurement systems being developed in Swedish health care services? (2) What problems can be identified in the development? (3) What enabling factors can be identified in the development? A qualitative research strategy was selected for the research. The research is based on a multiple case study design conducted within two research projects. Information has been gathered through interviews, documents and observations. The idea of performance measurement systems develops through several tracks when implemented in health care and the development follows a purposeful process of activities. The development was initiated when major changes occurred in the organisation or its environment. Performance measurement systems are primarily used to support a dialogue between management and employees regarding organisational improvement. Problems experienced are related to struggles to reach national consensus for measures, involving management, and the clarification of various end-users' needs. Enabling factors are the frequent interaction with people developing the system, management's involvement, the use of multi-skilled teams, and visual displays. The research contributes to several insights to the research area of performance measurement system and health care practitioners. The research shows that the development process is far from straight forward and is formed by the influence of factors in the organisational context, which cannot always be predicted. By seeing the development as an innovation process, the focus is broadened from being technological towards the organisation as whole, which contribute to the existing research on performance measurement systems.

According to U.S. government projections, employment in the health services industry is projected to increase 27 percent through 2014, adding about 3.6 million new jobs over the 2004-2014 period. While many of those opportunities will be for medical practitioners such as doctors and nurses, demand is also expected to increase for those who manage health care, such as hospital administrators. The expanding and increasingly complex health care system in the United States requires skilled, capable workers to develop and maintain the administrative framework within which doctors work

The theme of this volume is chronic care, health care systems and services integration. The volume is divided into three sections. The first section focuses on issues that relate to health care providers. The second section contains papers that deal with home and community based services for the elderly and those who need chronic care. The third section provides lessons from countries outside the United States related to the overall themes of chronic care, systems integration and services integration. These are themes of growing importance in the US health care system as well as in health care systems in most other developed nations. The aging of populations, already underway, and expected to increase in the coming decades will bring changes and challenges to the health care system. Many of these challenges relate to chronic care needs, since chronic care needs are more important in the elderly than in other population groups, although chronic care problems are not limited to the elderly. Once people reach their 40s and 50s, they begin to develop chronic problems. Chronic problems often require both more health care services and more complicated health care services, and thus place an emphasis on services integration.

Examining international health care management, this book consists of 12 papers, one of which serves as an introduction, with the other papers arranged into three sections. It focuses on issues such as how socio-cultural forces affect the health care experience; how global strategies affect providers and patients; and more

ABSTRACTHealth care has undergone a number of radical changes during the past five years. These include increased competition, fixed‐rate reimbursement systems, declining hospital occupancy rates, and growth in health maintenance organizations and preferred provider organizations. Given these changes in the manner in which health care is provided, contracted, and paid for, it is appropriate to review the past research on capacity management and to determine its relevance to the changing industry. This paper provides a review, classification, and analysis of the literature on this topic. In addition, future research needs are discussed and specific problem areas not dealt with in the previous literature are targeted.

Changing the U.S. health care system: the patient protection and affordable care act -- Improving access to care in America -- Ethnic disparities in health status -- Racial and ethnic disparities in health care -- Multilevel social determinants of health -- Public policies to extend health care coverage -- Private health insurance -- Measuring health care costs and trends -- Containing health care costs -- Promoting pharmaceutical access while controlling prices and expenditures -- Measuring health-related quality of life and other outcomes -- Evaluating the quality of care -- Public release of information on quality -- Health care information systems -- Performance measurement of nursing care -- Long-term services and supports for the elderly population -- Hiv and aids in the twenty-first century -- Health reform for children and families -- Homeless persons -- Changing the US health care delivery system -- Medicare reform -- Public health and clinical care -- Strengthening the safety net -- Ethical issues in public health and health services

Background By tradition, the Swedish health care system is based on a representative and parliamentary form of government. Recently, new management forms, inspired by market principles, have developed. The steering system is both national and regional, in that self-governing county councils are responsible for the financing and provision of health care in different regions. National and local documents regulating Swedish health care mention several ethical values, such as equity in health for the whole population and respect for autonomy and human dignity. It is therefore of interest to investigate the status of such ethical statements in Swedish health care management. Method The aim of the present study was to investigate perceptions of the status of ethics in the daily work of politicians, chief civil servants and Chief Executive Officers (CEOs) from care-giver organizations in the county council of Stockholm. A qualitative method was used, based on inductive content analysis of individual interviews with 13 health care managers. Results The content analysis resulted in four categories: Low status of ethics; Cost-effectiveness over ethics; Separation of ethics from management; and Lack of opportunities for ethical competence building. The informants described how they prioritized economic concerns over ethics and separated ethics from their daily work. They also expressed that they experienced that this development had been enforced by the marketization of the health care system. Further, they described how they lacked opportunities for ethical discussions, which could have helped develop their ethical competence. Conclusions In order to improve the status of ethics in health care management, ethical considerations and analyses must be integrated in the regular work tasks of politicians, chief civil servants and CEOs; such as decision-making, budgeting and reform work. Further, opportunities for ethical dialogues on a regular basis should be organized, in order to improve ethical competence on the management level. New steering forms, less focused upon market principles, might also be needed, in order to improve the status of ethics in the health care management organization.

Cover -- CONTENTS -- Editorial advisory board -- Editorial overview -- Health status assessment using reverse supply chain data -- Integration of supply and marketing for a blood service -- Employer brand image in a health care organization -- Managing competitive bidding in the Finnish healthcare sector -- The impact of extrinsic and package design attributes on preferences for non-prescription drugs -- The effect of competence-based trust between physicians and administrative executives in healthcare on decision outcomes.

Patient safety : state-of-the-art in health care management and future directions / Eric W. Ford, Grant T. Savage -- Quality and patient safety from the top : a case study of St. Francis medical center governing board's call to action / Louis Rubino, Marsha Chan -- The trustee and patient safety : redefining boundaries / Richard A. Culbertson, Julia A. Hughes -- Protecting the patient : collaborating to achieve the ideal hospital work environment / Donde Batten, Gerald Goodman, Susan M. Distefano -- Privacy, security and the national health information network : a mixed methods case study of state-level stakeholder awareness / Kimberly A. Galt, Karen A. Paschal, Amy Abbott, Andjela Drincic, Mark V. Siracuse, James D. Bramble, Ann M. Rule -- Evidence-based medicine and patient safety : limitations and implications / Grant T. Savage, Eric S. Williams -- Examining barriers to health information technology adoption / James D. Bramble, Mark V. Siracuse, Kimberly A. Galt, Ann M. Rule, Bartholomew E. Clark, Karen A. Paschal -- Improving patient safety through organizational development : considering the opportunities / Ann Scheck McAlearney -- S*t*a*r*t : a great handoff : an approach to effective medical communication in a high-risk environment / Ellen S. Deutsch, Brian Binck, Gina Moore, Ben-Tzion Karsh -- Changing a pediatric sub-acute facility to increase safety and reliability / Daved W. van Stralen, Racquel M. Calderon, Jeff F. Lewis, Karlene H. Roberts -- The anatomy and physiology of error in adverse health care events / Patrick A. Palmieri, Patricia R. DeLucia, Lori T. Peterson, Tammy E. Ott, Alexia Green -- Promoting patient safety by monitoring errors : a view from the middle / Michal Tamuz, Cynthia K. Russell, Eric J. Thomas

Volume 16 of AHCM presents papers that explore population health management and organizational change across various levels of the healthcare system. Aspects of health care organizations discussed in the volume include the PCMH, ACOs, integration with the public health and mental health systems, hospital-physician alignment, and resource planning