Performance Improvement in Health Care Organizations
By Hummy Song, University of Pennsylvania, USA, hummy@wharton.upenn.edu | Anita Tucker, Boston University, USA, altucker@bu.edu
Abstract
Performance improvement is an important organizational capability that is essential for health care organizations to achieve excellence on the three components of the Triple Aim: patient experience, health, and cost. In this monograph, we present a framework for performance improvement in health care organizations: the Model of Transformational Performance Improvement. This model takes a system-level approach to performance improvement and comprises six key components: (1) determining and communicating a system-level goal; (2) developing and using system-level performance measures; (3) understanding and managing interdependencies; (4) selecting a portfolio of projects aligned with system-level goals; (5) creating an organizational engine for improvement; and (6) implementing, spreading, and sustaining improvements. In addition to presenting this model, we review the operations management literature on performance improvement with a special focus on operations management tools and principles that may help with successful implementation of these six components. Though work has already been done in these areas, much remains unknown and many opportunities for future research exist. This monograph seeks to inform the research of operations management scholars and to equip clinicians and health care leaders with techniques that may be leveraged to improve performance in health care organizations.
Performance Improvement in Health Care Organizations
Performance Improvement in Health Care Organizations reviews the literature on this important topic and presents a framework that synthesizes the factors associated with successful transformational performance improvement. The model – the Model of Transformational Performance Improvement (TPI) – comprises six key components: (1) determining and communicating a system-level goal, (2) developing and using system-level measures of performance, (3) understanding and managing interdependencies, (4) selecting a portfolio of projects aligned with system-level goals, (5) creating an engine for improvement, and (6) implementing, spreading, and sustaining improvements.
Performance Improvement in Health Care Organizations is intended for two audiences: operations management scholars who conduct research on or teach about improvement in health care organizations and clinicians and health care leaders with knowledge about operations management techniques that can be leveraged to improve performance. Section 1 provides an overview of the U.S. health care system, discusses the need for a health care specific framework for improvement, and introduces key operations management concepts relevant for performance improvement. Section 2 presents the Model of Transformational Performance Improvement. The authors also review other models for improvement and compare them to the TPI model. Sections 3 through 8 presents each of the six key components of the model and draws on case studies and empirical research to explain the components in more depth and provide examples of their implementation. Each component is also linked to relevant operations management literature streams. Section 9 examines common barriers to performance improvement that can be avoided by applying the framework and the operations management principles outlined in this monograph. Finally, Sections 10 and 11 provide ideas for future research and offer a conclusion.
