Sustaining healthcare excellence through performance measurement

The healthcare sector is one of the fastest growing areas of the economy of most developed countries. Governments (and taxpayers) invest in it increasingly larger amounts of money, either directly or indirectly, and expect in return high quality services. The reality, however, is often different: long waiting times, inefficiency, low productivity, stressed medical staff and less than satisfied patients. Over the last decade, total quality management (TQM) has emerged as one potential solution to improve the efficiency and effectiveness of healthcare provision and, ultimately, to lead to healthy communities. Despite the enthusiasm raised by the potential benefits of TQM implementation, the fact is that many initiatives have not delivered the promised results. Reasons for failure are to be essentially found in the insufficient support of health professionals, the lack of leadership commitment and the tendency to look at TQM in isolation rather than putting it at the core of the institution's strategy. The system of performance measurement we present in this paper is expected to overcome some of these deficiencies, contributing to sustaining the TQM efforts and, thus, to achieving organizational excellence. The main potential of the system comes from the explicit and active involvement of all stakeholders and from the holistic and integrated approach it forces.