Current Performance Measures Research Articles

A review of facilities management performance measurement

PurposeThe purpose of this paper is to present a comprehensive review of facilities management (FM) performance measurement (PM) research within the past two decades to understand existing gaps in FM PM literature.Design/methodology/approachThe paper employs a systematic approach to review papers in FM PM published from 1997 to 2017. The articles published in selected peer-reviewed international journals in the last 20 years were collected by conducting literature search in the Web of Science and Scopus databases. The content of the papers were scrutinized to understand the gap in literature.FindingsThe review depicts a slow pace of FM PM research characterized by diverse and fragmented performance measures, whereas the existing PM frameworks are at the nascent stage.Research limitations/implicationsThe judgments of the paper are based on the 54 papers selected for the critical review and analysis that should be treated as key issues in FM PM research agenda. The review also excludes energy management.Originality/valueThe paper identifies the gaps in the current PM literature in FM and set propositions for future research which is of utility and relevance to FM researchers more especially on the existing conceptual frameworks. To the best of the authors’ knowledge, this paper is the first attempt to conduct a review on FM PM in the extant literature.

Abstract 218: Challenges and Opportunities in Using Cardiovascular Health Metrics and Social Determinants of Health to Inform Population Health Management

Background: The collection of cardiovascular health (CVH) metrics and social determinants of health (SODH) can inform population health management activities such as care management and the development of CVH interventions. Therefore, this study sought to examine professionals’ knowledge of the term, CVH, and to gain their perspective on the collection and operationalization of CVH and SODH metrics. Methods and Results: The Population Health Conceptual framework guided the design of this mixed method study and inclusion criteria of participants. Specifically, the sample consisted of professionals that directly and indirectly influence the collection and use of CVH and SODH measures, including healthcare providers/practitioners, healthcare management/administration, physician organizations, and public health, health insurance, and health informatic professionals that provide services to Michigan residents. Data collection (2018-2019), consisted of participants completing a cross-sectional survey that determined their knowledge of the term, CVH, and identified CVH and SODH measures they currently collect and/or are interested in using. Quantitative questions were also utilized to obtain demographics (e.g., credentials and years of experience) of professionals. Following survey completion, individual semi-structured interviews were performed to gain insights on measure collection tools, and how CVH and SODH factors were operationalized in healthcare delivery and interventions. Descriptive statistics were conducted using STATA/MP14. Qualitative analysis, applying grounded theory to assess the data thematically to identify patterns was performed using NVivo12. Tableau Software illustrate study results. Findings indicated that professionals were knowledgeable of the term CVH, but were not familiar with the seven CVH metrics/goals. More than half of participants expressed interest in collecting populations’ sodium intake to inform programs and referrals. Neighborhood characteristics was one of the top SODH participants expressed interest in collecting. One of the most common barriers reported to collecting CVH metrics included lack of reliable collection methods for CVH measures. Additionally, participants articulated that CVH and SODH measures do not align with current performance measures (e.g., HEDIS) collected, thus, capturing CVH and SODH metrics would increase the number of measures they would be responsible for acquiring. Conclusions: Additional efforts are warranted to increase knowledge and awareness of CVH metrics across all professions that aid in the prevention and management cardiovascular disease. Further research is needed to develop reliable data collection tools. Additional advocacy should be performed to encourage the consolidation and alignment of performance measures to facilitate the collection of CVH and SDOH measures.

Mental health and addictions policy priorities and performance measurement frameworks.

To inform the future development of a pan-Canadian Mental Health and Addictions (MHA) performance measurement framework, we undertook a review and comparison of current provincial/territorial MHA policies and performance measurement frameworks. Most did not have performance measurement approaches that were explicitly linked to policy actions but eleven acknowledged the importance of performance measurement. Among the provinces with a framework, there were few performance domains in common. The common policy priorities and areas of convergence in current performance measurement practices may provide a useful starting point for the development of a pan-Canadian MHA performance measurement framework.

A prototype for the evolution of ATLAS EventIndex based on Apache Kudu storage

The ATLAS EventIndex has been in operation since the beginning of LHC Run 2 in 2015. Like all software projects, its components have been constantly evolving and improving in performance. The main data store in Hadoop, based on MapFiles and HBase, can work for the rest of Run 2 but new solutions are explored for the future. Kudu offers an interesting environment, with a mixture of BigData and relational database features, which look promising at the design level. This environment is used to build a prototype to measure the scaling capabilities as functions of data input rates, total data volumes and data query and retrieval rates. In this proceedings we report on the selected data schemas and on the current performance measurements with the Kudu prototype.

Assessing Performance and Quality After Non-ST Segment Elevation Acute Coronary Syndromes.

This review summarizes and discusses the evidence base supporting current performance and quality measures used in assessing institutions in their care of patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS). Professional societies in the USA and Europe have developed performance and quality measures for NSTE-ACS. These measures are reviewed and updated periodically to reflect the most important evidence from the literature. In the USA, the ACC/AHA Task Force on Performance Measures published the updated 2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non-ST-Elevation Myocardial Infarction. In Europe, the ESC Acute Cardiac Care Association published the 2017 Quality Indicators for acute myocardial infarction. These documents build on guidelines previously developed and published by the two organizations. They include detailed reviews of current and past studies establishing that adherence with guidelines improves clinical outcomes. Both measure sets provide quantitative methodologies to assess program performance. Institutional programs that focus on these validated measures can increase guideline adherence, streamline and standardize care processes, and reduce morbidity and mortality. Performance and quality measures have become a critical part of healthcare today, allowing patients, providers, administrators, and payors to assess patient care objectively. They are also becoming an important component of value-based payment programs. To be fair, and useful, for internal institutional assessment, in comparing different institutions, and for value-based payments, only validated performance measures such as these should be employed.

Forecasting the development of explosive leg power in youth soccer players

ABSTRACTPurpose: Monitoring athletic development in youth soccer can help sporting professionals monitor athletic development and evaluate the effectiveness of training interventions. However, long-term follow up in talent development programmes in youth soccer is complicated. Therefore, the aim of this study was to forecast the developmental trajectories of explosive leg power in youth soccer players. Methods: Mixed effects regression models were used to forecast explosive leg power (countermovement (CMJ) and standing broad jump (SBJ)) in a longitudinal sample of 2201 youth soccer players from two high level Belgian acedemies and the Belgian National teams. Players were aged between 6 and 20 years (mean age = 13.04 ± 3.18 y) and were subdivided into three age cohorts (6–10, 11–15, and 16–20 y) for CMJ and two age cohorts (6–16, and 17–20 y) for SBJ. Results: This study was able to accurately forecast explosive leg power using different regression equations in each age cohort. Conclusions: Researchers, coaches, and sporting professionals can use these methods to either predict future explosive leg power from current performance measures, monitor the development of explosive leg power, or assess the effectiveness of training interactions aimed at altering predicted developmental trajectories.

Ranking statistically similar highway travel corridors using speed datasets within the USA

Commercially available probe vehicle speed data are becoming a reliable means to evaluate roadway performance within the United States of America (USA). These temporally defined data are used to identify roadway congestion along fixed-location, variable-length highway segments called traffic message channels (TMC). Current performance measures that define congestion as an increase in travel time are inherently skewed towards longer, arbitrarily defined segments. To overcome this limitation, this paper defined congestion as the relative travel time increase, a performance measure that directly accounts for the variation in TMC lengths. Next, concurrent TMC with statistically similar levels of congestion were grouped into corridors. The resulting corridors provide a more accurate assessment of regional congestion, simplify data collection and analysis and allow agencies to compare congestion across different highway segments. The proposed methodology was applied to 83 TMCs along Interstate 80 East in New Jersey, USA. The 83 TMCs had in excess of 30 million speed records in 2013 for the AM peak period that were grouped into over 300 000 15 min intervals. An analysis of variance of time intervals indicated that the 83 TMCs could be grouped into 34 corridors. The congestion along each corridor was then characterised and visualised.

ASSESSMENT OF CONTRACTORS’ PRACTICES TOWARDS RISKS OUT OF CONTRACTORS CONTROL IN CONSTRUCTION INDUSTRY

Research has shown that public construction projects in Saudi Arabia have exhibited poor performance for the past three decades. Recent studies have identified the ownership of parties who cause risks and lead to low performance in the Saudi construction industry. These studies identified that contractors are not the main party that cause risks as owners, consultants, and other parties have the major share of causing risks in the industry. The aim of this study is to assess the current risk management and performance measurement practices applied by contractors to minimize risk out of their control (caused by other parties) through conducting a questionnaire survey. The questionnaire survey was sent to contractors who work in public construction projects in Saudi Arabia. The assessment included the contractors’ practices in the identification of projects activities and risks, contractors’ practices in mitigating other parties’ activities and risks, and contractors’ practices in measuring the performance of all project parties. The study identified that contractors’ current risk management and performance measurement practices are not effective in minimizing projects risks caused by other parties and ineffective in measuring performance of all parties. The study recommends a proactive risk management approach that can help contractors to minimize risks caused by other parties and can measure the performance of all parties in projects.

The deployment of performance measurement system under the supply chain management environment: the case of Malaysian manufacturing companies

Performance measurement system in supply chain management (SCM) has been receiving increasing attention by business organizations as a way to evaluate efficiency in supply chain activities. Assessing the performance of supply chain uncovers the gap between planning and actual performance as to trace the potential problems thus ascertain necessary areas for improvement. This research aims to investigate the application of performance measurement system in SCM as well as exploring its relationship with organization’s performance among Malaysian manufacturing firms. By utilizing the questionnaire method, respondents involved were requested to indicate the extent to which they use a number of 24 selected performance measures that are related to SCM. The results show that the majority of the observed manufacturing firms utilize specific performance measurement tools in evaluating the supply chain performance. The current performance measurement techniques, the Balanced Score Card is adopted by around a quarter of the total responding firms followed by Supply Chain Operations References Model – SCOR, which attracts total users of only a fifth of the total respondents. In particular, performance measures under customer service category recorded the highest number of usage followed by cost-based performance measures and operations management. The results of this investigation also unveil few major points that are important to be highlighted. Firstly, the obtained outcomes of this study bring to light the significant relationships between the utilization of supply chain performance measures under customer service, operations management and organizational performance. In addition, this study discovered a significant correlation between the size of the organization and the extent of use of supply chain performance measures and how these two variables positively correlated. Lastly, the findings also suggested that the performance measures for SCM has been playing a crucial role in enhancing the performance of the organizations and is increasingly operated as the firms grow in size. Based on the brief highlighted points listed above, it is not an exaggeration to say that this research contributes new information to the body of knowledge in performance measurement system in SCM and its associations with organizational performance.

Measuring servitization progress and outcome: the case of ‘advanced services’

The purpose of this paper is to establish a framework for assessing the progress and outcome of a manufacturer’s transformation towards becoming a provider of ‘advanced services’ – a complex bundling of products and services, whereby manufacturers offer capabilities and outcomes instead of products alone. ‘Advanced services’ represent the most complex offering in the current servitization trend amongst manufacturers. However, current performance measures lack the breadth and focus to assess progress or outcomes, and so support research and practice of organisational transformation efforts required. To address this gap the paper investigates how a manufacturer’s efforts to become an ‘advanced services’ provider can be comprehensively measured, and develops a framework for assessing the transformation journey towards becoming an ‘advanced services’ provider. The research method is based on (1) a systematic literature review process to create a comprehensive set of service-related performance measures that are available to assess a manufacturer’s servitization efforts, followed by (2) an engagement with an expert panel to synthesise the identified measures and create a set of ‘advanced services’ performance measures. The proposed framework is presented as a scorecard that can be used in practice to assess the progress and outcome of a manufacturer’s transformation towards becoming a provider of ‘advanced services’.

Share if you care

Although the performance of Humanitarian Supply Chain (HSC) receives considerable attention in current literature, measuring HSC performance remains challenging. HSC performance depends largely on the ability to meet the needs of the sufferers which contradicts with current performance measures that focus on input metrics such as donations and expenditures rather than output metrics. In this paper, we address this gap in the literature by examining refugee service performance as perceived by refugees themselves. We examine the impact of information sharing and information quality on HSC service performance. We further draw on social capital theory to investigate how the dimensions of social capital influence information sharing and information quality. Data collected from 276 refugees in Zaatari camp in Jordan provide support for our proposed model. Our paper makes two contributions. First, we extend current literature on HSC performance by examining the impact of information sharing and the quality of the information shared on the beneficiaries’ perception of HSC performance. We therefore focus on output metrics rather than input metrics. Second, we apply a social capital theoretical lens to investigate how social ties and relations influence information sharing and information quality in HSC. We also offer theoretical and practical implications for academics and stakeholders in the field of HSC.

The Roles of Supply Chain Performance Measurement on Manufacturing Firms

This paper is to investigate the current challenges, trends, relevance and the concept of supply chain performance measurements in developing nation basic metal industries. This paper gives an overview of different performance measurement tools that can be applied to measure and improve the supply chain systems of an organization. Since the study is focuses on supply chain performance measurements practices in the Ethiopian basic metal industries. The paper identifies and discusses the main motives and impact of supply chain performance measurement practice on the performance of basic metal manufacturing industries in Ethiopia and provided solutions to areas that needed improvement. While the study reviews the relevance of the main strategies, models and tools to measure the performance of supply chain in manufacturing industries is done though the research is conducted based on a qualitative methods. Structured questionnaires, field observation and oral interviews research techniques is use to get primary data from the sectors. Performance measure sets is identified through descriptive analysis. This study found that, large number of companies that now accomplish performance measurement systems at local and global level. Even though, most manufacturing firms use traditional performance measurement systems such as financial performance measurement systems. But this traditional performance measurement systems were not properly evaluates the performance and competitiveness of the whole supply chain systems of manufacturing sectors. Also according to this research proposes that the concept of supply chain performance measurement is not fully hold by the Ethiopian basic metal industries and highlights the difficulties associated with its implementation. Therefore, to tackle the challenges and attempt to the current performance measurement limitations, further studies need to involving other sectors and industries needs to be undertaken in order to gain an in-depth understanding of the key factors associated with the accomplishment of supply chain performance measurement practices in Ethiopia.

Assessing the value of rural community health services.

Rural health services are challenging to manage, a situation perhaps exacerbated by necessity to comply with one-size-fits-all performance frameworks designed for larger services. This raises the questions: do we know what rural health services are doing that is valuable and how should that be evaluated? Twenty-eight qualitative interviews with CEOs and staff of seven Victorian rural health services were conducted, exploring what they value about their 'best practice'. Themes emergent from analysis were compared with 19 government-produced health planning and performance documents. It was found that most dimensions of rural services value aligned with current performance frameworks, but a significant theme about 'community' was missing. Highlighting the relevance of this theme, achieving community-oriented goals accounted for one-third of best practice case studies identified by health services personnel. It is concluded that generating community outcomes is a significant area of value aimed for by rural health services that is missing from current performance measurement frameworks applied to Victorian health services. In this study, a new Evaluative Framework is outlined and further steps needed are suggested.

A composite rank measure based on principal component analysis for hotspot identification on highways

ABSTRACTIdentification of hotspots or high-crash locations on highways is important to ensure public safety and minimize loss of life, risk of injury and/or trauma; reduce crash cost to society; and any interruption to traffic flow. Many performance measures are available for use in identification of hotspots. Current performance measures, however, suffer from lack of accounting for traffic volume, crash injury severity, justification of weights used for ranking of sites, and issues with statistical distribution of crash data. This article proposes a composite rank measure based on principal component analysis to overcome limitations of existing measures for network screening. The results of a proposed measure called Composite Principal Rank Measure (CPRM) is demonstrated with interstate, U.S. and state highway data and compared against the commonly used sum-of-rank (SOR) measure. CPRM and SOR are evaluated based on several empirical and simulated data tests. CPRM was found to be robust and outperformed the SOR measure and is recommended for identification of hotspots. To ensure extensive evaluation of the measures, the entire highway routes are examined in this article.

Determinants of organizational performance of football clubs

Russian football currently finds itself in a challenging economic situation. In light of the upcoming FIFA World Cup in 2018 all members of the Russian football industry will be under immense pressure. Russian professional football clubs have been struggling to keep with European club management standards. This article aims to evaluate the industry-specific features of organizational performance within the context of professional football clubs. The current performance measurement system within Russian football is based on 5 straightforward licensing criteria, which do not conform with international requirements. During the course of the study the author was able to identify the main factors, which may be used to form a new performance measurement system for Russian professional football clubs.The findings of this paper allow to formulate the main directions of future research in the field of organizational performance of football clubs. The most acclaimed methodologies of foreign researchers attempted to combine both sporting and non-sporting (financial, marketing, etc.) indicators. The main theoretical findings may be used to modernize the current licensing system within Russian professional football. This article attempted to systemize the body of literature on organizational performance of sports organizations and football clubs by both Russian and foreign scholars. The conclusions of this study help broaden the understanding that in the current economic realities the ability to win competitions may not be regarded as the sole purpose of professional football clubs. Football clubs must strive to simultaneously achieve success on and off the pitch.

Measuring Performance in Rail Freight Transportation Companies

Performance Measurement Systems - PMSs has become relevant for Organizations in the last years taking into consideration the broad approach and the strategic link which the current performance measurement is focused on. Brazilian railroad transportation has poor performance when compared with other similar countries. The rail transportation production has 25% of participation within total transportation matrix. Besides infrastructure aspects, management is the key for the improvement of this performance. A Performance Measurement System - PMS framework using Balanced Scorecard – BSC structure is proposed aiming to allow a more comprehensive and strategic performance measurement in railroad companies. A systematic approach was used for the literature review. Due to the lack in the literature related to the purpose of this paper a long period was considered for the search of references linked to performance measurement for railroads. Aiming to elaborate a PMS framework for railroad companies a case study method was applied in a large Brazilian railroad company. Semi-structured interviews and documental data collection were used in order to get evidences related to the processes, environment, customers and strategic objectives as perspectives needed to elaborate a PMS based on Balanced Scorecard. This case study applied in a large freight railroad company in Brazil allowed to understand typical strategic objectives as well as processes, customer’s requirements and environment related to this kind of business. Balanced Scorecard was suitable to the performance measurement needs of the railroad company operation. It can measure operations performance comprehensively and strategically in an effective way. This study brings up important contribution in terms of PMS literature and it can be used as a reference guide for future researches focused on this field. Also it can be worth for practitioners who desire implement PMS in Organizations, not limited for railroad companies, but also for other kind of operations. This framework proposed is unique taking into consideration that there is no comprehensive PMS for a railroad companies using Balanced Scorecard structure. This same structure can be applied in more field researches seeking better understandings about performance measurement in freight railroad companies. Some research questions in order to solve future issues related to this study are proposed at the end of this paper.

Mobile Phone-Based Measures of Activity, Step Count, and Gait Speed: Results From a Study of Older Ambulatory Adults in a Naturalistic Setting.

BackgroundCellular mobile telephone technology shows much promise for delivering and evaluating healthcare interventions in cost-effective manners with minimal barriers to access. There is little data demonstrating that these devices can accurately measure clinically important aspects of individual functional status in naturalistic environments outside of the laboratory.ObjectiveThe objective of this study was to demonstrate that data derived from ubiquitous mobile phone technology, using algorithms developed and previously validated by our lab in a controlled setting, can be employed to continuously and noninvasively measure aspects of participant (subject) health status including step counts, gait speed, and activity level, in a naturalistic community setting. A second objective was to compare our mobile phone-based data against current standard survey-based gait instruments and clinical physical performance measures in order to determine whether they measured similar or independent constructs.MethodsA total of 43 ambulatory, independently dwelling older adults were recruited from Nebraska Medicine, including 25 (58%, 25/43) healthy control individuals from our Engage Wellness Center and 18 (42%, 18/43) functionally impaired, cognitively intact individuals (who met at least 3 of 5 criteria for frailty) from our ambulatory Geriatrics Clinic. The following previously-validated surveys were obtained on study day 1: (1) Late Life Function and Disability Instrument (LLFDI); (2) Survey of Activities and Fear of Falling in the Elderly (SAFFE); (3) Patient Reported Outcomes Measurement Information System (PROMIS), short form version 1.0 Physical Function 10a (PROMIS-PF); and (4) PROMIS Global Health, short form version 1.1 (PROMIS-GH). In addition, clinical physical performance measurements of frailty (10 foot Get up and Go, 4 Meter walk, and Figure-of-8 Walk [F8W]) were also obtained. These metrics were compared to our mobile phone-based metrics collected from the participants in the community over a 24-hour period occurring within 1 week of the initial assessment.ResultsWe identified statistically significant differences between functionally intact and frail participants in mobile phone-derived measures of percent activity (P=.002, t test), active versus inactive status (P=.02, t test), average step counts (P<.001, repeated measures analysis of variance [ANOVA]) and gait speed (P<.001, t test). In functionally intact individuals, the above mobile phone metrics assessed aspects of functional status independent (Bland-Altman and correlation analysis) of both survey- and/or performance battery-based functional measures. In contrast, in frail individuals, the above mobile phone metrics correlated with submeasures of both SAFFE and PROMIS-GH.ConclusionsContinuous mobile phone-based measures of participant community activity and mobility strongly differentiate between persons with intact functional status and persons with a frailty phenotype. These measures assess dimensions of functional status independent of those measured using current validated questionnaires and physical performance assessments to identify functional compromise. Mobile phone-based gait measures may provide a more readily accessible and less-time consuming measure of gait, while further providing clinicians with longitudinal gait measures that are currently difficult to obtain.

Wanting More, Getting Less: Gaming Performance Measurement as a Form of Deviant Workplace Behavior

Investigating the causes of unethical behaviors in academia, such as scientific misconduct, has become a highly important research subject. The current performance measurement practices (e.g., equating research performance with the number of publications in top-tier journals) are frequently referred to as being responsible for scientists’ unethical behaviors. We conducted qualitative semi-structured interviews with different stakeholders of the higher education system (e.g., professors and policy makers; N = 43) to analyze the influence of performance measurement on scientists’ behavior. We followed a three-step coding procedure and found (1) that the participants described a variety of positive behavioral consequences (e.g., higher productivity) but mainly negative behavioral consequences (e.g., questionable publishing practices) of current performance measurement practices in academia; (2) that scientists’ behavior can be described as gaming performance measurement (i.e., achieving performance goals by reducing performance quality and focusing on those tasks that are measured); and (3) that gaming performance measurement shares the same characteristics as deviant workplace behavior (i.e., a voluntary violation of organizational norms that harms the university). We discuss that gaming performance measurement has not been considered as a type of deviant workplace behavior in the previous literature. Furthermore, we draw from research on deviant workplace behavior and goal setting to discuss psychological processes that may underlie gaming performance measurement. Our results indicate the importance of connecting literature on deviant workplace behavior and goal setting to advance our understanding of gaming performance measurement.

Assessing redundancies in environmental performance measures for supply chains

Incorporating environmental sustainability into production systems and supply chain management perspectives is a growing issue; this requires thorough efforts in measuring the environmental performance of such systems and benchmarking these against industry standards, through the usage of appropriate indicators.The usage of environmental indicators in order to monitor and manage sustainability issues is an ongoing topic of debate and deliberation in the scientific community, which has generated the development of several methodological and conceptual approaches, often incorporated into Life Cycle Assessment frameworks, enabling the evaluation and monitoring of cumulative polluting impacts resulting across the whole product supply chain. In this field, the main challenge is to identify indicators to be employed in environmental assessments, in such a way that a precise account of sustainability issues is given without overloading end-users with overly complex and redundant information.By utilising well-established environmental indicators measuring the sustainability performance of supply chains, this paper aims at critically assessing the amount of redundancy embedded in current performance measurement systems, also identifying the subset of environmental indicators that, if employed, could cover a wide amount of environmental impact categories without redundancies and providing decision-makers with a clear perspective.

Differences in Hospital Risk-standardized Mortality Rates for Acute Myocardial Infarction When Assessed Using Transferred and Nontransferred Patients.

One in 5 patients with acute myocardial infarction (AMI) are transferred between hospitals. However, current hospital performance measures based on AMI mortality exclude these patients from the evaluation of referral hospitals. To determine the relationship between risk-standardized mortality for transferred and nontransferred patients at referral hospitals. This is a retrospective cohort study. Fee-for-service Medicare claims from 2011 for patients hospitalized with a primary diagnosis of AMI, at hospitals admitting at least 15 patients in transfer. Hospital-specific risk-standardized 30-day mortality rates (RSMRs) for 2 groups of patients: those admitted through transfer from another hospital, and those natively admitted without a preceding or subsequent interhospital transfer. There were 304 hospitals admitting at least 15 patients in transfer. These hospitals cared for 77,711 natively admitted patients (median, 254; interquartile range, 162-321), and 11,829 patients admitted in transfer (median, 26; interquartile range, 19-46). Risk-standardized mortality rates were higher for natively admitted patients than for those admitted in transfer (mean, 11.5%±1.2% vs. 7.2%±1.1%). There was weak correlation between hospital performance as assessed by RSMR for patients natively admitted versus those admitted in transfer (Pearson r=0.24, P<0.001); when performance was arrayed by quartile, 102 hospitals (33.6%) differed at least 2 quartiles of performance across the 2 patient groups. For Medicare patients with AMI, hospital-specific RSMRs for natively admitted patients are only weakly associated with RSMRs for patients transferred in from another hospital. Current AMI performance metrics may fail to provide guidance about hospital quality for transferred patients.