Abstract
Healthcare organisations are not immortal, far from it. The service science approach highlights the role of service users in the service process. Their success and failure are dependent on performance measurement and evaluation. This chapter analyses the role of performance measurement and evaluation in the domain of intelligent policy making in the field of health. Traditionally, the role of evaluation and performance measurement has been central in the management doctrines and practices of public policy and public organisations. Performance measurement and evaluation are important features in the public policy process since they provide feedback information on how public authorities have attained the goals set for them. In this chapter we discuss the role and definition of key evaluation concepts within the framework of intelligent public policy and link these key evaluation concepts into a time-wise three-dimensional model of intelligent evaluative inquiry (ex ante, ex nunc and ex post). We aim to make a strong case for more intelligent public policy evaluation by addressing the simple fact that even though the world is practically full of information today, only part of it converts to knowledge for decision-makers and public policy makers. This chapter builds upon the evaluation practice related to ‘classical’ evidence-based medicine, addressing the role of evidence (albeit always contested to a certain extent) in fostering and nurturing decision-making in public policy and public organisations, but goes further towards public policy and public organisations. To this end, we stress the importance of deploying the best ideas of evidence-based medicine to strengthen policy- and organisation-based performance judgement. This chapter also explores the implications of this transformation for evaluation, performance monitoring and accountability, underlining that horizontal accountability referencing a wide democratic footprint is likely to become more explicit. Consequently, this chapter develops the idea of transformation of public sector performance management from the viewpoint of organisational intelligence. This chapter concludes that ‘hard nose’ rationalistic models of performance and evaluation are no longer fit for purpose in the health sector.
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References
Aarons GA, Hurlburt M, McCue Horwitz S (2011) Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health 38(1):4–23
Anderson RA, McDaniel RR Jr (2000) Managing healthcare organizations: where professionalism meets complexity science. Healthc Manag Rev 25(1):83–92
Argyris C (2005) Double-loop learning in organizations. A theory of action perspective. In: Smith KG, Hitt MA (eds) Great minds in management. The process of theory development. Oxford University Press, Oxford, pp 261–279
Argyris C (2010) Organizational traps. Leadership, culture, organizational design. Oxford University Press, Oxford
Bauman AE, King L, Nutbeam D (2014) Rethinking the evaluation and measurement of health in all policies. Health Promot Int 29(1):143–151
Bendor J (2015) Incrementalism: dead yet flourishing. Public Adm Rev 75(2):194–205
Bianchi C (2015) Enhancing joined-up government and outcome-based performance management through system dynamics modelling to deal with wicked problems: the case of societal ageing. Syst Res Behav Sci 32:502–505. https://doi.org/10.1002/sres.2341
Birkland TA (2016) An introduction to the policy process. Theories, concepts and models of public policy making. Routledge, New York
Bort E, McAlpine R, Morgan G (2012) The silent crisis: failure and revival in local democracy in Scotland. The Jimmy Reid Foundation, Glasgow
Bouckaert G, Halligan J (2008) Managing performance: international comparisons. Routledge, London
Bouckaert G, Van Dooren W (2009) Performance measurement and management in public sector organizations. In: Bovaird T, Löffler E (eds) Public management and governance. Routledge, London, pp 151–164
Bovens M (2005) Public accountability. In: Ferlie E et al (eds) The Oxford handbook of public management. Oxford University Press, Oxford, pp 182–209
Bovens M (2010) Two concepts of accountability: accountability as a virtue and as a mechanism. West Eur Polit 33(5):946–967
Bovens M, Goodin RE, Schillemans T (eds) (2014) The Oxford handbook of public accountability. Oxford University Press, Oxford
Cadilhac DA, Amatya B, Lalor E, Rudd A, Lindsay P, Asplund K (2012) Is there evidence that performance measurement in stroke has influenced health policy and changes to health systems? Stroke 43(12):3413–3420
Campbell DT, Russo MJ (1999) Social experimentation. Sage, Newbury Park
Clarke A (2006) Evidence-based evaluation in different professional domains: similarities, differences and challenges. In: Shaw IF et al (eds) The SAGE handbook of evaluation: policies, programs and practices. Sage, London, pp 559–581
Dahler-Larsen P (2006) Evaluation after disenchantment? Five issues shaping the role of evaluation in society. In: Shaw IF et al (eds) The SAGE handbook of evaluation. Sage, Thousand Oaks, CA, pp 141–160
Dahlgren D, Whitehead M (2007) European strategies for tackling social inequalities in health: levelling up part 2 [Online]. http://www.thehealthwell.info/node/91930. Accessed 23 Dec 2016
De Jong GJ, Tesch Römer C (2012) Loneliness in old age in Eastern and Western European societies: theoretical perspectives. Eur J Ageing 9(4):285–295
Dunleavy P, Carrera L (2013) Growing the productivity of government services. Edward Elgar, Cheltenham
Ferlie EL, Fitzgerald G, McGivern DS, Bennett C (2011) Public policy networks and ‘wicked problems’: a nascent solution? Public Adm 89(2):307–324
Flynn N (2007) Public sector management. Sage, London
Geuijen K, Moore M, Cederqvist A, Ronning R, van Twist M (2016) Creating public value in global wicked problems. Public Manag Rev, published online 25.8.2016. https://doi.org/10.1080/14719037.2016.1192163. Accessed 27 Dec 2016
Ghaffarzadegan D, Lyneisb J, Richardson GP (2011) How small system dynamics models can help the public policy process. Syst Dyn Rev 27(1):22–44
Glennerster H (2002) United States poverty studies and poverty measurement: the past twenty-five years. Soc Serv Rev 76(1):83–107
Greene JC (2006) Evaluation, democracy and social change. In: Shaw IF et al (eds) The SAGE handbook of evaluation. Policies, programs and practices. Sage, London, pp 118–140
Greenhalgh T, Howick J, Maskrey N (2014) Evidence based medicine: a movement in crisis? BMJ 348:g3725 (published online 13.6.2014, Accessed 5 Nov 2016)
Greve C (2015) Ideas in public management reform for the 2010s: digitalization, value creation and involvement. Public Organ Rev 15(1):49–65
Guba EG, Lincoln YS (1989) Fourth generation evaluation. Sage, Newbury Park
Harrison S, Smith C (2013) Neo-bureaucracy and public management: the case of medicine in the National Health Service. Compet Chang 7(4):243–254
Head BW (2008) Wicked policy problems. Public Policy 3(2):101–118
Heclo H (1994) Poverty politics. In: Danziger SH et al (eds) Confronting poverty. Prescriptions for change. The Russell Sage Foundation/Harvard University Press, Cambridge, pp 396–437
Hedström P, Swedberg R (eds) (1998) Social mechanisms: an analytical approach to social theory. Cambridge University Press, Cambridge
Heinrich CJ (1999) Do government bureaucrats make effective use of performance management information? J Public Adm Res Theory 9(3):363–394
Hernes T (2014) A process theory of organization. Oxford University Press, Oxford
Hodges R (2012) Joined-up government and the challenges to accounting and accountability researchers. Financ Account Manag 28(1):26–51
Hood L, Flores M (2012) A personal view on systems medicine and the emergence of proactive P4 medicine: predictive, preventive, personalized and participatory. New Biotechnol 29(6):613–624
Howlett M, Migone A (2011) Charles Lindblom is alive and well and living in punctuated equilibrium land. Policy Soc 30(1):53–62
Hudson E, Nolan A (2015) Public healthcare eligibility and the utilisation of GP services by older people in Ireland. J Econ Ageing 6(4):24–43
Ikeda N, Saito E, Inoue M, Ikeda S, Satoh T, Wada K, Stickley A, Katanoda K, Mizoue T, Noda M, Iso H, Fujino Y, Sobue T, Tsugane S, Naghavi M, Ezatti M, Shibuya K (2011) What has made the population of Japan healthy? Lancet 378(9796):1094–1105
Innes JE, Booher DE (2016) Collaborative rationality as a strategy for working with wicked problems. Landsc Urban Plan 154(5):8–10
Kaivo-oja J, Virtanen P, Jalonen H, Stenvall J (2015) The effects of the internet of things and big data to organizations and their knowledge management practices. In: Luden L et al (eds) Knowledge management in organizations, vol 224. Springer, Heidelberg, pp 495–513
Kaivo-oja J, Virtanen P, Stenvall J, Jalonen H, Wallin J (2016) Future prospects for knowledge management in the field of health. KMO 2016. In: Proceedings of the 11th international knowledge management in organizations, Article no. 40. https://doi.org/10.1145/2925995.2926006, ACM, New York. http://dl.acm.org/icps.cfm
Kaplan RS, Norton DP (1996) The balanced scorecard. Translating strategy into action. Harvard Business School Press, Boston, MA
Karanikolos M, Mladovsky P, Cylus J, Thomson S, Basu S, Stuckler D, Mackenbach JP, McKee M (2013) Financial crisis, austerity and health in Europe. Lancet 381(9874):1323–1331
Kaufman H (1976) Are government organizations immortal? Brookings Institution Press, Washington, DC
Kaufmann X-F (1987) Prevention and intervention in the analytical perspective of guidance. In: Hurrelmann K et al (eds) Social intervention: chances and constraints. Walter de Gruyter, New York, pp 3–20
Koppell JGS (2005) Pathologies of accountability: ICANN and the challenge of “multiple accountabilities disorder”. Public Adm Rev 65(1):94–108
Kuhlmann E, Blank RH, Bourgeault IL, Wendt C (2015a) Healthcare policy and governance in international perspective. In: Kuhlmann E et al (eds) The Palgrave international handbook of healthcare policy and governance. Palgrave MacMillan, New York, pp 3–19
Kuhlmann E, Blank RH, Bourgeault IL, Wendt C (eds) (2015b) The Palgrave international handbook of healthcare policy and governance. Palgrave MacMillan, New York
Kuhn T (2012) The structure of scientific revolutions. Chicago University Press, Chicago (originally published in 1962)
Lane J-E (2005) Public administration and public management: the principal-agent perspective. Routledge, London
Lee G, Park JY, Shin S-Y, Hwang JS, Jeong Ryu H, Lee JH, Bates DW (2015) Which users should be the focus of mobile personal health records? Analysis of user characteristics influencing usage of a tethered mobile personal health record. Telemed E-Health 22(5):419–428
Lewens T (2015) The meaning of science. Pelican Books, London
Leyland AH, Groenewegen PP (2003) Multilevel modelling and public health policy. Scand J Public Health 31(4):267–274
Long A (2006) Evaluation of health services: reflections on practice. In: Shaw IF et al (eds) The SAGE handbook of evaluation. Policies, programs and practices. Sage, London, pp 461–485
March JG (1978) Bounded rationality, ambiguity and the engineering of choice. Bell J Econ 9(2):587–608
Mayne J (2008) Contribution analysis: an approach to exploring cause and effect. ILAC Brief 16 (May 2008). www.cgiar-ilac.org
Michels A, Meijer A (2008) Safeguarding public accountability in horizontal government. Public Manag Rev 10(2):165–173
Mowery D, Smith HA, Cheney T, Bryan C, Conway M (2016) Identifying depression-related tweets from Twitter for public health monitoring. Online J Public Health Inf 8(1), https://doi.org/10.5210/ojphi.v8i1.6561. Accessed 23 Dec 2016
Naples NA (2014) Grassroots warriors. Activist mothering, community work, and the war on poverty. Routledge, London
Neely A, Kennerly M, Walters A (2006) Performance measurement and management: public and private. Cranfield School of Management, Cranfield
Newcomer KE, Hatry HP, Wholey JS (eds) (2015) Handbook of practical program evaluation. Jossey-Bass, New Jersey
Niven PR (2011) Balanced scorecard. Step by step for government and non-profit agencies. Wiley, New Jersey
Nørreklit H (2003) The balanced scorecard: what is the score? A rhetorical analysis of the balanced scorecard. Acc Organ Soc 28(6):591–619
North DC (2005) Understanding the process of economic change. Princeton University Press, Princetown, NJ
Papanicolas I, Cylus J (2015) Comparison of healthcare systems performance. In: Kuhlmann E et al (eds) The Palgrave international handbook of healthcare policy and governance. Palgrave MacMillan, New York, pp 116–132
Patton MQ (1997) Utilization-focused evaluation: the new century text. Sage, Thousand Oaks, CA
Pawson R (2013) The science of evaluation. A realist manifesto. Sage, London
Pawson R, Tilley N (1997) Realistic evaluation. Sage, London
Peters GB (2005) The problem of policy problems. J Comp Policy Anal Res Pract 7(4):349–370
Pfeffer J, Sutton RI (2006) Hard facts, dangerous half-truths and total nonsense. Profiting from evidence-based management. Harvard Business School Press, Boston, MA
Porter ME, Olmsted Teisberg E (2006) Redefining health care. Creating value-based competition on results. Harvard Business School Press, Boston, MA
Power M (1994) The audit explosion. Demos, London
Power M (2005) The theory of audit explosion. In: Ferlie E et al (eds) The Oxford handbook of public management. Oxford University Press, Oxford, pp 326–344
Robson C (2002) Real world research. Blackwell, Oxford
Schillemans T (2011) Does horizontal accountability work? Evaluating potential remedies for the accountability deficit of agencies. Adm Soc 43(3):387–416
Scriven M (1991) Evaluation thesaurus. Sage, Newbury Park
Shadish WR, Luellen JK (2004) Donald Campbell: the accidental evaluator. In: Alkin MC (ed) Evaluation roots: tracing theorists’ views and influences. Sage, London, pp 80–87
Shortell SM, Rundall TG, Hsu J (2007) Improving patient care by linking evidence based medicine and evidence-based management. JAMA 298(6):673–676
Silver H (1996) Culture, politics, and national discourses of the new urban poverty. In: Mingione E (ed) Urban poverty and the underclass. Blackwell, Oxford, pp 105–138
Stenvall J, Virtanen P (2015) Intelligent public organizations? Public Organ Rev, published on-line 2.12.2015. https://doi.org/10.1007/s11115-015-0331-1
Talbot C (2005) Performance management. In: Ferlie E et al (eds) The Oxford handbook of public management. Oxford University Press, Oxford, pp 491–517
Vakkuri J (2010) Struggling with ambiguity: public managers as users of NPM-oriented management instruments. Public Adm 88(4):999–1024
Vakkuri J (2013) Interpretive schemes in public sector performance: measurements creating managerial problems in local government. Int J Public Sect Perform Manag 2(2):156–174
Van Helden GJ, Johnsen Å, Vakkuri J (2012) Evaluating public sector performance management: the life cycle approach. Evaluation 18(2):159–175
Vedung E (1997) Public policy and program evaluation. Transaction, New Brunswick
Vedung E (2010) Four waves of evaluation diffusion. Evaluation 16(3):263–277
Virtanen P, Laitinen I (2004) Beyond evaluation standards? Eur J Spat Dev (http:/www.nordregio.se/EJSD). ISSN 1650-9544-Refereed articles Oct 2004 no 13
Virtanen P, Stenvall J (2014) The evolution of public services from co-production to co-creation and beyond – an unfinished trajectory for the New Public Management? Int J Leadersh Public Serv 10(2):91–107
Virtanen P, Uusikylä P (2004) Exploring the missing links between cause and effect. A conceptual framework for understanding micro-macro conversions in programme evaluation. Evaluation 1(10):77–91
Virtanen P, Vakkuri J (2015) Searching for organizational intelligence in the evolution of public sector performance management. NISPAcee J Public Adm Policy 8(2):89–99
Virtanen P, Vakkuri J (2016) Julkisen toiminnan tuloksellisuusarviointi [Public sector performance assessment and management, in Finnish]. Tietosanoma, Helsinki
Virtanen P, Kaivo-oja J, Ishino Y, Stenvall J, Jalonen H (2016a) Ubiquitous revolution, customer needs and business intelligence. Empirical evidence from Japanese healthcare sector. Int J Web Eng Technol 11(3):259–283
Virtanen P, Uusikylä P, Jalava J, Tiihonen S, Laitinen L, Noro K (2016c) Valtioneuvoston yhtenäisyys – kansainvälinen vertaileva tutkimus [available in only in Fiinish, The unity of government – an international comparative study]. Valtioneuvoston kanslia, Helsinki. Accessed at www.tietokauttoon.fi
Walshe K, Rundall TG (2001) Evidence-based management: from theory to practice in health care. Milbank Q 79(3):429–457
Weber EP, Khademian AN (2008) Wicked problems, knowledge challenges, and collaborative capacity builders in network settings. Public Adm Rev 68(2):334–349
Weiss C (1998) Evaluation. Prentice-Hall, New Jersey
Wholey JS, Hatry HP (1992) The case for performance monitoring. Public Adm Rev 52(6):604–610
Winter S, Lasch R (2016) Recommendations for supplier innovation evaluation from literature and practice. Int J Oper Prod Manag 36(6):643–664
Yee AS (1996) The causal effects of ideas on policies. Int Organ 50(1):69–108
Zarefsky D (1986) President Johnson’s war on poverty. Rhetoric and history. The University of Alabama Press, Tuscaloosa
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Virtanen, P., Stenvall, J. (2018). Intelligent Evaluation and Performance Measurement in Public Health Policy and Public Service Systems. In: Intelligent Health Policy. Springer, Cham. https://doi.org/10.1007/978-3-319-69596-9_7
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