Framework to Analyze Senior Management Performance

Goals

To identify a framework or best practices for analyzing the performance of senior management in large healthcare organizations and to identify topics and interview questions. This is for the board of a large healthcare organization to evaluate if the management team has what it takes to implement transformative change.

Early Findings

  • "A well-implemented performance management system in the healthcare industry can allow managers to quickly assess how effectively their strategies are carried out, and can react and fine-tune as and when required."
  • "Middle-level managers, individual contributors, executives and managers can more easily work together and ensure they are properly aligned."
  • "Policy-makers should consider what makes performance indicators effective in improving system performance and accountability."
  • "Organizations deploying healthcare scorecards and strategy maps are good examples of the power of performance management."

Performance Management Approaches and Critical Success Factors

  • More attention has been given to "innovations in organizational performance management systems that balance financial and non-financial dimensions."
  • The most influential has been the Balanced Scorecard (BSC), where recent research has shown that various forms of BSC have been increasingly implemented in practice and that influences a managers’ thinking about performance management.
  • These "multidimensional performance measurement systems (PMS) are linked to organizational strategy and should support decision-making. Developments in PMS thinking should impact on strategic investment decision-making (SIDM), where the aim is to evaluate how future investment projects will affect organizational performance and the achievement of strategic goals."

Balanced Score Card Framework (BSC)

  • The BSC suggests that an organization is examined from "four different perspectives to help develop objectives, measures (KPIs), targets, and initiatives relative to those views."
  • "Financial (or Stewardship): views an organization’s financial performance and the use of financial resources."
  • "Customer/Stakeholder: views organizational performance from the perspective of the customer or key stakeholders the organization is designed to serve."
  • "Internal Process: views the quality and efficiency of an organization’s performance related to the product, services, or other key business processes."
  • "Organizational Capacity (or Learning & Growth): views human capital, infrastructure, technology, culture, and other capacities that are key to breakthrough performance"
  • The BSC framework can be used as a guide to analyze the performance of senior management in large healthcare organizations. Interview questions can be constructed based on the given themes to evaluate their performance to see if they have what it takes to move the organization forward.

Complementary Approaches

  • Other approaches on investigating the impact of management on health care performance can include: "(a) the impact of management practices on performance, (b) the impact of managers’ characteristics on healthcare performance, (c) the impact of the engagement of professionals in performance management, and (d) the impact of organizational features and management styles on performance."
  • The first approach can look into evaluating managerial practices (i.e., their ability to plan, organize, coordinate, and control), as these have been significantly related to better clinical and financial performance.
  • The second approach can look into the clinical background of top management, as this has been a predictor of high performance.
  • The third approach can evaluate the association between physician engagement in management practices, as this has been an indicator of improved organizational performance.
  • The fourth approach can evaluate management styles and its relationship with performance and organizational features.
  • Research has found that high-performing organizations have "transactional leadership (rather than the charismatic one), a multidimensional performance management system, clarity of goals, and the use of managerial operating systems (e.g., strategic planning, budgeting, and business planning)."

Interview Question Options:

  • "What are the top three critical success factors in the organizations and explain how these were translated into key performance indicators."
  • "Explain the rationale and decision-making process for at least one major project and to share views on how the project proposal was constructed and approved and what the key decision criteria were."
  • "Have you considered the effects a project is likely to have on internal business processes? "
  • "Do you explicitly consider the links between the non-financial and financial aspects of strategic investment decision projects?"
  • "Do you follow up on both the financial and non-financial aspects of performance?"

Proposed next steps:

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