Abstract

Institutional and organizational theory supports the argument that current features of performance measurement systems (PMS) in public organizations are generally unsuitable for the actual nature of these professional organizations. Longitudinal and cross-sectional studies in the health care and higher education sectors in the Netherlands have shown that, despite external pressures, the implementation of such systems is slower than intended and seems to occur outside the primary process of the organization. Two rounds of interviews with quality coordinators in 2003 and 2006 showed that the gap between performance measurement systems and the operational process continued to exist, although its nature had changed. In general, quality coordinators responded pragmatically to the changes imposed upon them, as peer review and collegial trust played a vital part. The empirical findings illustrate that institutional and professional theories supplement each other in a fruitful way. Points for practitioners Policy-makers in the public sector involved with quality care and assurance should be aware that a well-structured performance measurement system (PMS) is no guarantee of smooth implementation. On the contrary, the implementation deserves attention in its own right. The more sophisticated and demanding the design of PMS, the more likely it is that employees find ways to work round such a system and only use it in a superficial or compliant manner. If implementation is not taken seriously into account, this will only lead to a greater gap between reality and rhetoric.

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