Key Performance Areas Research Articles

Welfare schemes and social protection in India

Purpose – The purpose of this paper is to provide a broad overview of welfare schemes in India and their impact on social protection during a period of high economic growth. It summarizes India's performance with respect to select economic and social indicators relative to select low and middle-income countries in the Asia Pacific region. It further overviews trends in some key select economic and social indicators for India and discusses India's attainment in Social Protection relative to an index of such protection provided by the Asian Development Bank. Design/methodology/approach – This paper uses a comparative statistical approach and evaluates India's performance in key social welfare areas vis-à-vis that of countries with economic performance comparable to that of India. It also evaluates India's progress along these parameters over time. Findings – The basic messages of this paper are: first, compared to low and middle-income countries in the Asia Pacific India's economic performance has outstripped its performance in social and welfare indicators. Second, nevertheless India is spending less on social welfare programs and other welfare schemes than many countries in the Asia Pacific, including some of those whose economic performance has been less impressive than India's. Third, the efficiency and effectiveness of key welfare programs in India need to be substantially improved. Particular attention needs to be paid to female participation in and their access to social welfare programs. Originality/value – Informed analyses of social sector spending in India and their impact on welfare outcomes are relatively scarce although descriptive studies of social sector spending and welfare schemes abound. This paper attempts to fill this gap with a cross-country as well as intertemporal analysis of India's performance in these key areas.

Maintenance reengineering framework: a case study

PurposeThe purpose of this paper is to radically redesign the methodology of plant maintenance and develop a three phase framework. A framework for effective and continuous maintenance improvement is presented.Design/methodology/approachThe first phase determines the key performance area, the second phase makes decision about the appropriate policy selection and third phase aims to generate capability in an organization to compete at world level. A case is presented here, of the implementation of a “maintenance reengineering framework”, developed with the aid of certain maintenance components.FindingsThe maintenance reengineering framework, when implemented, proved successful with a more than 90 per cent rise in production rate.Research limitations/implicationsThe paper contributes some guidelines which can be helpful in making decision about the selection of maintenance policy and for the achievement of world‐class effectiveness.Practical implicationsMaintenance reengineering (MR) framework includes the core concepts of preventive maintenance practices, total maintenance management and system perspectives of maintenance. Its implementation goes through three phases from identification of key performance area, via suitable maintenance policy selection to generating the capability for world‐class effectiveness. The experience of this pilot implementation in a cement company in India suggested the feasibility of this framework in elevating the performance of maintenance management.Originality/valueThis article offers a framework that addresses research on maintenance reengineering. It attempts to establish a relationship among the components of maintenance, which can bring potential benefits to the corporations of similar operations and nature.

Intervening with practitioners to improve the quality of prevention: one-year findings from a randomized trial of assets-getting to outcomes.

There continues to be a gap in prevention outcomes achieved in research trials versus those achieved in "real-world" practice. This article reports interim findings from a randomized controlled trial evaluating Assets-Getting To Outcomes (AGTO), a two-year intervention designed to build prevention practitioners' capacity to implement positive youth development-oriented practices in 12 community coalitions in Maine. A survey of coalition members was used to assess change on individual practitioners' prevention capacity between baseline and one year later. Structured interviews with 32 program directors (16 in the intervention group and 16 in the control group) were used to assess changes in programs' prevention practices during the same time period. Change in prevention capacity over time did not differ significantly between the intervention and control groups. However, in secondary analyses of only those assigned to the AGTO intervention, users showed greater improvement in their self-efficacy to conduct Assets-based programming and increases in the frequency with which they engaged in AGTO behaviors, whereas among non-users, self-efficacy to conduct Assets-based programming declined. Interview ratings showed improvement in several key areas of performance among intervention programs. Improvement was associated with the number of technical assistance hours received. These results suggest that, after one year, AGTO is beginning to improve the capacity of community practitioners who make use of it.

Competency profile for librarians teaching information literacy

South African academic libraries are starting to pay attention to the role played by instruction librarians. There is an acknowledgement that librarians as 'educators' need to learn how to teach information literacy skills. Instruction librarians are either not trained educators or do not have a pedagogical background. Many instruction librarians were placed in, or found themselves, assuming a teaching role with regard to information literacy instruction, and subsequently refined their craft while on the job. The motivation for this research was that librarians as 'educators' are faced with challenges that impact on their teaching role. The research was carried out in two parts : a literature survey and an empirical investigation. The investigation was confined to academic libraries that have an instruction librarian who facilitates information literacy skills instruction. The findings of the research were supportive of the objective that there is a serious need to have understanding, knowledge and skills regarding the dynamics involved in the teaching of information literacy skills, in order to make the program a success. The authors propose a competency framework for implementation as a management tool for designing key performance areas for instruction librarians.

Environmental Performance Evaluation in Supply Chain

Environmental performance evaluation is an area of growing concern among the worldwide community. Consequently, measurements to evaluate environmental performance are of great importance. However, lack of a quantifiable model to study the environmental performance is a problem in this area. This study therefore attempts to quantify the environmental performance of supply chain of a manufacturing company, which requires evaluation of many criteria. Therefore, selection of environmental performance measures leads to a multi-criteria decision making problem. As a result, analytical hierarchy process is selected to develop the model and is solved with Expert Choice software. Finally the proposed model is applied to a case study company to identify the key areas of environmental performance of the company’s supply chain and to assess various product categories manufactured under those key areas.

An Application of the Capability Maturity Model for Evaluating Attraction Websites in Mainland China

ABSTRACTThis paper extends the applicability of the Capability Maturity Model to attraction website evaluation. Based on input by 120 respondents from four groups, including tourists, tourism academics, attraction managers, and IT professionals in Mainland China, an attraction website maturity model (AWMM) with six key performance areas and 48 key criteria was developed. To validate the applicability of the model, the AWMM was used to evaluate 357 websites of 4A‐level attractions in Mainland China. Empirical findings revealed that the development of the China's attraction websites was at an infancy stage, while eCommerce in China has been adopted rapidly. Major improvements are required in relation to the interaction and commerce functions of these websites. Implications of the results of such improvements, as well as future research, are discussed. Copyright © 2013 John Wiley & Sons, Ltd.

Improving Diabetes Care and Patient Outcomes in Skilled-Care Communities: Successes and Lessons From a Quality Improvement Initiative

To improve the quality of care for residents of long term care (LTC) facilities who have diabetes by (1) improving glycemic control, (2) increasing comprehensive diabetes management, (3) reducing fragmented care, and (4) empowering patient-care teams to educate patients and families regarding this disease. Based on the Plan-Do-Study-Act principles of effective change, a baseline evaluation of contemporary care for residents with diabetes was conducted through focus-group interviews, a confidence survey, and chart review. Three live educational workshops provided guideline-recommended information addressing educational desires and needs of clinical staff, a tool for improving performance in key areas of need, and an opportunity for care teams to engage in dialogue about advances in diabetes with a national diabetes expert. Reassessment was performed via chart review twice at 3 and 5months post education. Key lessons and tools for improvements were disseminated to other LTC communities through a CME-certified publication activity and follow-up teleconferences. Two skilled-nursing LTC communities. Physicians, administrators, nurses, certified nursing assistants, and nutrition staff. Three live continuing education/continuing medical education-certified workshops attended by 83 health care professionals. Twenty-five comprehensive clinical indicators of diabetes care and overall health were assessed for all residents with a diabetes diagnosis at baseline (n= 35), 3 months (n= 40), and 5 months (n= 27) post education. The primary objective of improving glycemic control we reached through a statistically significant 18% reduction in the percentage of residents experiencing hypoglycemia from baseline to 3 months post education (31% at baseline, 13% at 3 months, P= .046). Low levels of hypoglycemia (11%) were maintained at 5 months post education. Positive changes in an additional 3 measures of patient health include improved daily blood glucose levels, reduced ranges of HbA1c, and improved low-density lipoprotein cholesterol concentrations. Improvements in 4 measures of clinician performance were also observed, namely comprehensive foot evaluations, referrals to specialists for foot care and eye exams, and improved use of physical activity. Diabetes care, particularly in elder adults, is complex and requires a multidisciplinary approach. Focused quality improvement activities within LTC communities offer care providers the information and tools required to make effective changes that have the ability to promote improved patient care. These efforts must be multidisciplinary and effectively engage all stakeholders.

An Implementation of ITIL Guidelines for IT Support Process in a Service Organization

Service level management (SLM) is a challenge in a distributed systems environment because all processes should provide a consistent, reliable, and predictable service delivery. Early 1990s, most organizations established few service-level agreements (SLA) as the key performance indicators (KPI) but it was difficult to measure or monitor them in a distributed systems environment. The strength of Information Technology Infrastructure Library (ITIL) is the approach of integrating the SLM with the support processes at strategic, tactical, and operational levels. This paper focuses on implementing ITIL guidelines at an operational level for service desk, incidents, problems, and change management. The ITIL framework only provides guidelines, so a service organization needs to explore a methodology for evaluating existing service support processes and implementing ITIL guidelines for improvements. To this end, we investigate upon how to apply the ITIL framework for reengineering of IT service support process in an organization. The approach is actually implemented at a dentalcare service provider with ten dental clinics connected in Wide Area Network (WAN) and the data is collected into a central server in the main dental center. We first started with the process mapping, and then moved towards reengineering following ITIL guidelines, while collecting the results in key performance areas before and after the process reengineering. This paper used questionnaires, document reviews, archival records and observation techniques for collecting the data. The results demonstrated improvements in differing magnitudes. Some statistical analysis such as mean and variance together with t-value distribution and null hypothesis were also developed to determine the quality of results. The paper is cautious about the limited scope of audience and the questionnaire which may compromise the results; however, the approach is useful in obtaining significant improvements when a company invests in integrating ITIL guidelines in to service support processes.

Evaluation of a new clinical performance assessment tool : A reliability study

Clinical practice is an essential requirement of any graduatephysiotherapy programme. For this purpose, valid and reliable assessment toolsare paramount for the measurement of key competencies in the real-worldsetting. This study aims to determine the internal consistency and inter-raterreliability of a newly developed and validated clinical performance assessmentform. A cross-sectional quantitative research design was used, which includedpaired evaluations of 32 (17 treatment and 15 assessment) student examinationsperformed by two independent clinical educators. Chronbachs alpha was computedto assess internal consistency and intraclass correlation coefficient (ICC’s) withconfidence intervals of 95% were computed to determine the percentage agreement between paired examiners. Thedegree of internal consistency was substantial for all key performance areas of both examinations, except for timeand organisational management (0.21) and professionalism (0.42) in the treatment and evaluation examinationsrespectively. The overall internal consistency was 0.89 and 0.73 for both treatment and assessment examinations,indicating substantial agreement. With regard to agreement between raters, the ICC’s for the overall marks were0.90 and 0.97 for both treatment and assessment examinations. Clinical educators demonstrated a high level ofreliability in the assessment of students’ competence using the newly developed clinical performance assessment form.These findings greatly underscore the reliability of results obtained through observation of student examinations, andadd another tool to the basket of ensuring quality assurance in physiotherapy clinical practice assessment.

Predicting block times: An application of Box-Jenkins models

Predictability is an important key performance area because it influences airlines’ on-time performance and passengers’ satisfaction. Predictability also plays a significant role in ensuring a successful transition from air traffic control to a managed air traffic system. Yet, predictable block times are all the more difficult to achieve as the on-time execution of a flight may be constrained by three types of delay which airlines cannot control: induced, propagated and random. This paper proposes a methodology based on the Box-Jenkins models to measure the predictability of block times as an alternative to variance or standard deviation of block delays. The padding of schedules and the timeliness of flight plans are likely to bias the variation in block delays as an indicator of predictability.

Science and Medicine Applied to Soccer Refereeing

Soccer referees are required to keep up with play at all times to ensure optimal positioning in making key decisions. While the physiological aspects of soccer refereeing have been extensively reviewed, other key areas of preparation and performance have yet to be considered in detail. We present a contemporary examination of methodological considerations for the interpretation of referees' match activities, the validation of fitness testing and training protocols, match and training injury profiles, and the understanding and development of perceptual-cognitive expertise. A referee covers approximately 11 km during a match, with ∼900 m of high-speed running and, consequently, the demands of match play represent a significant physical challenge. The analyses of within-match activity profiles have attempted to assess the possible occurrence of referee fatigue, with equivocal findings. However, researchers have demonstrated that referees' physical performances are interrelated with those of the players during the same match. Therefore, the evaluation of referees' match activity profiles should be made in the context of the players' performances. High match-to-match variability in key variables, namely, high-speed running and sprinting, along with age-related reductions in match running are other factors that require due consideration when interpreting physical performances. Fitness testing is used by national and international referee governing bodies as part of their match selection criteria. Therefore, the tests need to reflect the physical task of refereeing, yet for the recent fitness tests introduced by the Fédération Internationale de Football Association--a 20 × 150 m high-intensity and 6 × 40 m repeated-sprint test - only the repeated-sprint test possesses the appropriate construct validity for assessment of match-related running capacity. Also, the performance standards of the tests have not been validated. Consequently, the scientific rationale behind the tests and their associated standards is not clear. Soccer referees dedicate a large proportion of their overall training to the development of physical capacity and researchers have demonstrated that high-intensity (>85% maximal heart rate) training protocols are effective for improving fitness and match running performance. These high training loads combined with increasing age could, in part, explain an incidence of non-contact match injuries (18 injuries per 1000 match hours) similar to players, with lower leg muscle strains being the most common type of non-contact injuries in referees. The implementation of injury prevention programmes along with the careful monitoring of training and match loads may help minimize referee's injury incidence. The perceptual-cognitive demands of soccer refereeing are significant, yet there remains limited research examining the perceptual and cognitive processes informing referees' decisions. As such, a three-step approach for the study of expertise in soccer referees is proposed. First, objective and reliable markers of decision making should be established, with due consideration to the development of naturalistic test situations while maintaining experimental control. Second, process-tracing measures can be used to identify the perceptual and cognitive mechanisms involved in accurate decision making. Finally, research is required to help understand the acquisition of superior decision making and whether such expertise can be developed via training programmes.

The balanced scorecard in health care: a multilevel latent variable approach

PurposeThe purpose of this paper is to propose a practical conceptualization of the balanced scorecard (BSC) to describe the mechanism producing creation of monetary value for hospitals in the territorial context of Lombardy region (Italy).Design/methodology/approachThe authors propose a model‐building strategy that assigns key indicators to key performance areas, and identifies causal relationships between key performance areas. Second, the authors utilize a suitable statistical approach to estimate causal relationships among involved latent variables, taking into account the hierarchical structure of data. Utilizing a suitable data decomposition, the causal model is applied separately to the within data (hospitals) and to the between data (local health agencies).FindingsIn the measurement model a new latent construct (medical human capital) was found that resumes the amount of formal training and the performance of surgical staff in hospitals. The estimated causal models reflect the usual directional assumptions, supposed in a typical BSC causal scheme, with some differences. For local health agencies, fruits (financial measures) are strongly related to clinical processes (leaves) for which the medical human capital constitutes its unique trunk. However, for hospitals, fruits (financial measures) are directly linked to clinical processes and Patient Satisfaction.Research limitations/implicationsThe main limitations of this study are the lack of new independent data to validate the obtained causal structures and the limited number of indicators that reflect the deficiency of available information in regional administrative archives.Originality/valueThe present study may be useful to guide further efforts which attempt to conceptualize BSC in the health sector. As more information can be made available, other performance indicators can prove to be linked with this structure using the same methodology.

Inter-examiner agreement in clinical evaluation

The reliability of assessment is an important issue in the evaluation of competence in medical and allied health practice, particularly when assessments are conducted by multiple examiners. The purpose of this study was to examine the agreement between multiple examiners in the assessment of a postgraduate physiotherapy student using a specifically designed performance evaluation system. Seven examiners simultaneously watched a recording of a postgraduate student's examination and treatment of one patient. The Postgraduate Physiotherapy Performance Assessment (PPPA) form was used to guide the assessment of performance in key areas of patient examination and management. Each examiner independently recorded a grade for each of five performance categories, and these scores were used to guide the global performance grade and mark. Five examiners agreed on the global performance grade and four of the performance categories. The level of pass grade awarded was more variable, with scores in the performance categories spanning two grades, and in one case, three grades. The two examiners who were not in agreement with the majority consistently awarded higher grades across most performance categories. This preliminary study has demonstrated majority agreement in global performance between multiple examiners when physiotherapy clinical practice is assessed against specific performance standards. Not all examiners awarded global grades consistent with the majority, and there was greater variability between examiners when grading performance in specific aspects of practice. These findings highlight the importance of examiner training and review sessions to improve inter-examiner agreement in assessments of clinical performance that require multiple examiners.

Augmented input reveals word deafness in a man with frontotemporal dementia.

We describe a 57 year old, right handed, English speaking man initially diagnosed with progressive aphasia. Language assessment revealed inconsistent performance in key areas. Expressive language was reduced to a few short, perseverative phrases. Speech was severely apraxic. Primary modes of communication included gesture, pointing, gaze, physical touch and leading. Responses were 100% accurate when he was provided with written words, with random or inaccurate responses for strictly auditory/verbal input. When instructions to subsequent neuropsychological tests were written instead of spoken, performance improved markedly. A comprehensive audiology assessment revealed no hearing impairment. Neuroimaging was unremarkable. Neurobehavioral evaluation utilizing written input led to diagnoses of word deafness and frontotemporal dementia, resulting in very different management. We highlight the need for alternative modes of language input for assessment and treatment of patients with language comprehension symptoms.

Augmented Input Reveals Word Deafness in a Man with Frontotemporal Dementia

We describe a 57 year old, right handed, English speaking man initially diagnosed with progressive aphasia. Language assessment revealed inconsistent performance in key areas. Expressive language was reduced to a few short, perseverative phrases. Speech was severely apraxic. Primary modes of communication included gesture, pointing, gaze, physical touch and leading. Responses were 100% accurate when he was provided with written words, with random or inaccurate responses for strictly auditory/verbal input. When instructions to subsequent neuropsychological tests were written instead of spoken, performance improved markedly. A comprehensive audiology assessment revealed no hearing impairment. Neuroimaging was unremarkable. Neurobehavioral evaluation utilizing written input led to diagnoses of word deafness and frontotemporal dementia, resulting in very different management. We highlight the need for alternative modes of language input for assessment and treatment of patients with language comprehension symptoms.

A Case Study on Change Dimensions, Factors and Models in a Private Services Sector, India

Change management has received considerable attention in human resource management. A strong and effective organization must be able to both pro act and react with flexibility to changing environmental demands.Change management can be viewed from two perspectives - from those implementing the change and from the recipients of change. GKNM Hospital wants to explore the models of Change management and assist the process of Change management and it wanted to improve its Business and Service performance. The three dimensions which were considered for the research are structure, technology and people.GKNM Hospitals made a conscious effort to identify the priority area of Change Management practices.The researcher used dependent and independent variable and various statistical tools and applied change models based on the inferences.Change management in GKNM involves formulation of Change models, Key performance areas and strategies to ensure that it is an integral part of HR strategy.

Moneycorp benefits from innovative approach to customer‐service training

PurposeThis paper aims to describe a 12‐week training program for cashiers and branch managers that helped to improve customer service at Moneycorp, which operates retail currency and foreign exchange outlets at a number of UK airports.Design/methodology/approachThe paper explains the reasons for the training, the form it took and the results it has achieved.FindingsThe paper details how interaction was the key to making the experience engaging for trainees, so the company used group games and media, personal presentations, guest speakers, video mystery shoppers and role‐play as well as on‐site individual coaching and personal‐development time.Practical implicationsThe paper reveals that the pilot group produced a 10 percent increase in sales turnover, making the program an excellent return on investment.Social implicationsThe paper explains that, although the recession had not hit at the point that the Moneycorp training academy idea was conceived, it was becoming apparent that external factors such as airline bankruptcies and lower passenger numbers were going to bring some significant challenges. The training would put the company in a much stronger competitive position.Originality/valueThe paper highlights how the introduction of a personal‐development plan provided data on key performance areas. This furnished the transparency and ownership to motivate staff to go above and beyond what they had achieved before – even the top performers.

RW1-2.1 Reducing infant mortality through improved supportive supervision under IM(N)CI: Experiences from India

IMNCI has been implemented in India with a view to reduce neonatal and infant mortality by strengthening community based management of neonates, infants and children. First 10 days of neonatal...

Modeling social services performance: a four-stage DEA approach to evaluate fundraising efficiency, capacity building, service quality, and effectiveness in the nonprofit sector

Managers in nonprofit human and social service organizations are increasingly tasked with the design of performance measurement systems in an attempt to monitor aspects of their day-to-day operations. Monitoring key performance areas is said to improve the chances of sustainability and to provide early warnings of managerial and operational problems in tough fundraising environments. The data envelopment analysis (DEA) modeling framework described by this research was created for social service organizations that operate a network of field offices and are spatially distributed but provide similar services under the same managerial format. We define and assess multiple performance dimensions and more specifically, fundraising efficiency, capacity building, service quality and effectiveness (outcome achievement). The performance with respect to each of the four dimensions is represented as a separate stage where a DEA formulation is provided at each stage. Central to each formulation is the need to account for the influence of key environmental socio-economic factors and for the incorporation of the customer’s voice that is obtained through service quality and effectiveness questionnaires. Results from the implementation of the proposed framework in hundreds of field offices of one of the largest nonprofit organizations in the United States, suggest that social service nonprofits have a harder time being efficient in the fundraising area than in any of the other three areas of activity but that efficient fundraising is not a guarantee for efficient and high quality service delivery, nor it is guarantee of client outcome achievement (effectiveness).

Multidimensional evaluation of performance with experimental application of balanced scorecard: a two year experience

BackgroundIn today's dynamic health-care system, organizations such as hospitals are required to improve their performance for multiple stakeholders and deliver an integrated care that means to work effectively, be innovative and organize efficiently. Achieved goals and levels of quality can be successfully measured by a multidimensional approach like Balanced Scorecard (BSC). The aim of the study was to verify the opportunity to introduce BSC framework to measure performance in St. Anna University Hospital of Ferrara, applying it to the Clinical Laboratory Operative Unit in order to compare over time performance results and achievements of assigned targets.MethodsIn the first experience with BSC we distinguished four perspectives, according to Kaplan and Norton, identified Key Performance Areas and Key Performance Indicators, set standards and weights for each objective, collected data for all indicators, recognized cause-and-effect relationships in a strategic map. One year later we proceeded with the next data collection and analysed the preservation of framework aptitude to measure Operative Unit performance. In addition, we verified the ability to underline links between strategic actions belonging to different perspectives in producing outcomes changes.ResultsThe BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the specific perspective contribution to overall performance enhancement. After time results comparison was possible depending on the selection of feasible and appropriate key performance indicators, which was occasionally limited by data collection problems.ConclusionsThe first use of BSC to compare performance at Operative Unit level, in course of time, suggested this framework can be successfully adopted for results measuring and revealing effective health factors, allowing health-care quality improvements.