Intelligent Evaluation and Performance Measurement in Public Health Policy and Public Service Systems

Abstract

Healthcare organisations are not immortal, far from it. The service science approach highlights the role of service users in the service process. Their success and failure are dependent on performance measurement and evaluation. This chapter analyses the role of performance measurement and evaluation in the domain of intelligent policy making in the field of health. Traditionally, the role of evaluation and performance measurement has been central in the management doctrines and practices of public policy and public organisations. Performance measurement and evaluation are important features in the public policy process since they provide feedback information on how public authorities have attained the goals set for them. In this chapter we discuss the role and definition of key evaluation concepts within the framework of intelligent public policy and link these key evaluation concepts into a time-wise three-dimensional model of intelligent evaluative inquiry (ex ante, ex nunc and ex post). We aim to make a strong case for more intelligent public policy evaluation by addressing the simple fact that even though the world is practically full of information today, only part of it converts to knowledge for decision-makers and public policy makers. This chapter builds upon the evaluation practice related to ‘classical’ evidence-based medicine, addressing the role of evidence (albeit always contested to a certain extent) in fostering and nurturing decision-making in public policy and public organisations, but goes further towards public policy and public organisations. To this end, we stress the importance of deploying the best ideas of evidence-based medicine to strengthen policy- and organisation-based performance judgement. This chapter also explores the implications of this transformation for evaluation, performance monitoring and accountability, underlining that horizontal accountability referencing a wide democratic footprint is likely to become more explicit. Consequently, this chapter develops the idea of transformation of public sector performance management from the viewpoint of organisational intelligence. This chapter concludes that ‘hard nose’ rationalistic models of performance and evaluation are no longer fit for purpose in the health sector.