Abstract
Combining insights from collaborative governance, performance management, and health technology assessment (HTA) literature, this study develops an integrated framework to systematically measure and monitor the performance of HTA network programmes. This framework is validated throughout an action research carried out in the Italian HTA network programme for medical devices. We found that when building up collaborative performance management systems, some elements such as the participation in the design and the use of context specific performance assessment framework, facilitate their acceptance by managers and policy makers especially in high professionalized and sector-specific organizations because it reflects their distinctive language and culture. The hybrid framework may help health authorities and policymakers to understand the HTA network, monitor its performance, and ensure network sustainability over time.
Highlights
Nowadays, public sector organizations are becoming more and more interdependent, moving toward various forms of horizontal governance [1] where cross-boundary collaborative actions are paramount to the solution of complex societal needs or “wicked problems” [2] like COVID-19 emergency
From the analysis of the three streams of literature (HTA, collaborative governance and performance management) we identified the dimensions reported in Figure 2 per each block
The framework measures the quality of collaborative governance regime actions, such as the quality of the technology assessment request in the health technology assessment (HTA) network programme, as well as participant satisfaction to be engaged in the cross-boundary collaboration
Summary
Public sector organizations are becoming more and more interdependent, moving toward various forms of horizontal governance [1] where cross-boundary collaborative actions are paramount to the solution of complex societal needs or “wicked problems” [2] like COVID-19 emergency. Multi-organizational arrangements are formed around problems or resources and commonly established to facilitate complex interactions, multilevel decision-making, service provision and delivery, transmission of knowledge and ideas, as well as other collaborative behaviors [3]. There is a growing need for public and private inter-organizational structures to address the increased complexity of such interactions and identify a set of values for assessing policy outcomes. Collaborative governance literature [4,5] provides a good ground for reflecting on the dynamics and actions of inter-organizational collaborations but still little evidence is available on how to assess such collaborations. Measuring the performance results of cross-boundary collaborations remains difficult and complex where little agreement exists on what constitute effective performance and how to successfully manage the collaboration [3,10,11,12]
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