Practice Of Performance Improvement Research Articles

Shadowboxing with data: A framework for informing the critical analysis of performance and performance measures

The practice of performance improvement requires measuring before and after conditions to determine if changes have occurred as a result of an intervention. Understanding how to take, make, interpret, and use measurements can go a long way toward improving performance improvement work and improving conditions for clients. The risk of not adequately analyzing measures leads to shadowboxing with data, where performance measures may not be equated with authentic performance issues.

Social Systems Science and the Practice of Performance Improvement

Performance Improvement QuarterlyVolume 10, Issue 3 p. 3-6 Social Systems Science and the Practice of Performance Improvement Peter J. Dean, Peter J. Dean EditorSearch for more papers by this author Peter J. Dean, Peter J. Dean EditorSearch for more papers by this author First published: 22 October 2008 https://doi.org/10.1111/j.1937-8327.1997.tb00055.xCitations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume10, Issue3September 1997Pages 3-6 RelatedInformation

Interventions (Solutions) Usage and Expertise in Performance Technology Practice: An Empirical Investigation

Performance technology (PT) is complex, drawing theory from instructional design, organizational development, communications, industrial psychology, and industrial engineering to name a few. The Standards of Performance Technology developed for the certified performance technology designation codified the processes used in the practice of performance improvement. The Human Performance Technology (HPT) Model of the International Society for Performance Improvement illustrates the Standards for the Performance Technology process, including the selection, design, and implementation of appropriate performance interventions. Research exists on specific PT interventions, such as problem solving, feedback, or job analysis. This foundational study considers intervention usage within organizations and the expertise of performance technologists. Findings indicate that years of experience in the field or related field is positively correlated to expertise. Some alignment was found between higher ranked PT expertise and higher ranked intervention usage within those organizations.

An Integrated Model of Performance Domains: Bounding the Theory and Practice

Performance is a multi-dimensional but poorly defined construct. An extensive review of performance models in other fields revealed the need for a performance model that is parsimonious, sitxiationally adaptable, embraces multiple organizational types, embraces multiple organizational measures, and fits any performance system. An integrated taxonomy of performance domains is developed which incorporates performance outcomes and performance drivers to define more clearly appropriate performance domains for human resource development and performance improvement practice. An extensive research agenda is proposed based on the new model.

Five faults and a submission: The case for the local government improvement programme

Despite the increasing body of evidence that questions the efficacy of central government performance instruments, there has been a reluctance to learn from mistakes made in the UK and elsewhere. This article examines some key dimensions of performance in the local government sector and suggests that there are at least five faultlines that undermine the Labour government's approach to date. In the context of the above the paper draws on longitudinal research with six local authorities to argue that the Local Government Improvement Programme is a performance management initiative that is best calibrated to both theories of change management and the practice of performance improvement. The paper concludes by identifying a range of determinants that have underpinned improvement in the sample.

The practices of effective managerial coaches

Coaching is a frequently cited, but less often effectively implemented, developmental tool for enhancing managerial performance at all levels. The purpose of this paper is to identify and explore the practices junior managers consider to be most critical for senior managers to employ when implementing coaching as a performance improvement practice. In this research, we engaged 45 focus groups consisting of 225 middle managers from over twenty different US organizations to explore the issue of managerial coaching and its implications for organizations and individual managers.

A collaborative perspective on nursing leadership in quality improvement. The foundation for outcomes management and patient/staff safety in health care environments.

By 2004, only organizations whose institutional operating strategies are built on a continual state of readiness and include performance improvement practices throughout the organization are going to successfully meet Joint Commission on Accreditation of Healthcare Organizations standards. As stewards of patient care, nurses maintain a unique role in identifying and guiding the intervention processes central to quality care, which prepares them to become key players/designers of a paradigm that demonstrates commitment to establishing and maintaining quality care. However, without recognition and support from organization leadership and physicians, the opportunity to effectively use the capabilities of nursing may be lost. The collaborative perspectives offered here attest to the fact that mutual belief and vision, coupled with creativity, strategic planning, and implementation, can effectively mobilize resources to establish priority measures and achieve quality patient/safety outcomes within the organization. Shifting the paradigm from just meeting the standards to continual readiness and performance improvement throughout the organization then becomes mission and mantra.

Measurement and evaluation in performance improvement in international reproductive health

Measurement and evaluation are being applied to strengthen performance improvement practices and appraise their effectiveness in the field of international reproductive health. However some challenges to this task exist. Collection and analysis of data describing vital events such as birth and death or frequency and distribution of diseases have been a central activity in health for more than a century. Measurement and evaluation have also been applied methodically to assess clinical interventions and public health programs. Measurement and evaluation in health are not simple undertakings due to the inherent complexities of health care. In less-developed countries a wide diversity of geographical settings cultures and health systems coupled with a scarcity of resources often creates further difficulties in measurement. (excerpt)

Risk factors and clinical impact of central line infections in the surgical intensive care unit.

To determine the risk factors and clinical impact of central line infections in critically ill surgical patients. Retrospective study. The surgical intensive care unit of a large tertiary care university hospital. A total of 232 consecutive central line catheters sent for culture from patients in a surgical intensive care unit during 1996 and 1997. Catheters were sent for microbiologic analysis when the patient was clinically infected and the central line was a possible source. None. Risk factors associated and clinical impact of a positive catheter culture. Of 232 consecutive catheters from 93 patients sent for microbiologic analysis, 114 catheters (49%) had no growth, 40 (17%) were colonized (<15 colonies), and 78 (34%) were considered infected (> or =15 colonies). Univariate analysis showed that site (internal jugular vs subclavian, P<.001), catheter use (monitoring > dialysis > fluid > nutrition, P=.006), placement in the operating room vs the intensive care unit (P=.02), and placement of a new catheter (> guide wire, > new site, P=.003) were all significant factors. Surprisingly, neither the number of lunmens nor the duration of the catheter in situ were predictors when a catheter was suspected and not proved infected compared with a suspected and proved catheter infection. In the multiple regression model, the placement of the catheter in the internal jugular position was the single most important predictor of a catheter infection (P<.001; odds ratio, 1.83; 95% confidence interval [CI], 1.41-2.37). The presence or absence of a specific clinical sign of infection was not predictive of a proved catheter infection. Eighty-six percent of patients had gram-positive bacteria identified on the culture, while the remaining patients had gram-negative bacteria or Candida identified. Of the catheter infections, 68% were monomicrobial, whereas 32% were polymicrobial. Of the catheters sent for microbiologic analysis, 209 (90%) had concurrent peripheral blood cultures for analysis. Nineteen (32%) with no growth from the catheter, and 14 (23%) of colonized catheters had concurrent bacteremia; all had another identifiable cause of infection. Twenty-seven (45%) of infected catheters had a concurrent bacteremia, and 9 of 27 had a second site positive for the same organism. Death related to the infection occurred in 15 patients, 2 in the first 72 hours and 13 in the following 14 days. Central line infections remain an important cause of morbidity and mortality. Comprehensive review of hospital practices may show a directed focus for performance improvement practices. At our institution, internal jugular catheters have the highest rate of infection. This may suggest breaks in technique during catheter insertion or during catheter maintenance and care.