{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:07:42Z","timestamp":1754158062443,"version":"3.41.2"},"reference-count":43,"publisher":"Emerald","issue":"6","license":[{"start":{"date-parts":[[2011,11,8]],"date-time":"2011-11-08T00:00:00Z","timestamp":1320710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,11,8]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-heading\">Purpose<\/jats:title><jats:p>The purpose of this paper is to investigate the regulator's attempt at redesigning the patient care process (PCP) \u2013 a core business process in public hospitals \u2013 by introducing dichotomous process performance indicators as an innovative management tool intended to align the State health care policy with the everyday management of operations at a hospital ward.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Design\/methodology\/approach<\/jats:title><jats:p>The paper presents an ethnographic case study of redesigning the PCP according to the strategy originating outside the organization. The study employs competing theories that represent alternative epistemological and ontological views of the world in order to produce a tentative explanation of <jats:italic>why<\/jats:italic> the intended redesign of the PCP has not fully eventuated. Observational data and opportunistic interviewing are used to answer the research question of <jats:italic>whether<\/jats:italic> and <jats:italic>how<\/jats:italic> the information and operational flows on the ward were affected by introduction of process performance indicators. A business process redesign framework was employed for data analysis since it better reflects the objectives of the State\u2010wide initiative and offers a convenient tool in dealing with data complexity.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p>Introduction of the process performance indicators did not result in redesigning of the PCP as intended by health care authorities. Out of four process performance indicators, only one was consistently implemented, which merely produced a duplication of the previously collected information, therefore adding no value to the PCP. On a theoretical level, the results indicate that the emergent theory rather than the rational agent theory demonstrated a greater fidelity to the empirical observations.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>The paper assessed the feasibility of using innovative dichotomous process performance indicators as a tool for redesigning the business process at the ward level, in order to achieve macro\u2010level policy objectives. The failure to successfully implement a top\u2010down universal approach to redesigning business processes in health care is likely to reflect a lack of appreciation of emergent rationality that characterizes essential aspects of the PCP.<\/jats:p><\/jats:sec>","DOI":"10.1108\/14637151111182738","type":"journal-article","created":{"date-parts":[[2011,11,19]],"date-time":"2011-11-19T07:06:44Z","timestamp":1321686404000},"page":"1012-1038","source":"Crossref","is-referenced-by-count":7,"title":["Process performance indicators in redesigning the patient care process"],"prefix":"10.1108","volume":"17","author":[{"given":"Elena","family":"Gospodarevskaya","sequence":"first","affiliation":[]},{"given":"Leonid","family":"Churilov","sequence":"additional","affiliation":[]}],"member":"140","reference":[{"key":"key2022020519552414200_b1","unstructured":"Acute Health Division, State of Victoria Department of Human Services (2000), \u201cEffective discharge strategy: performance indicator development project\u201d, Discussion Document, State of Victoria Government Publishing, Melbourne."},{"key":"key2022020519552414200_b2","unstructured":"Acute Health Division, State of Victoria Department of Human Services (2001), Supplementary Information for the Effective Discharge Strategy Performance Indicators Audit, State of Victoria Government Publishing, Melbourne."},{"key":"key2022020519552414200_b3","unstructured":"Ajzen, I. 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(1995), \u201cHow can we argue with performance indicators?\u201d, Working Paper No. 54, Monash University, Centre for Health Program Evaluations, Melbourne."},{"key":"key2022020519552414200_b7","doi-asserted-by":"crossref","unstructured":"Bird, M., Cox, D., Farewell, V., Goldstein, H., Holt, T. and Smith, P. (2005), \u201cPerfomance indicators: good, bad, and ugly\u201d, Journal of Royal Statistical Society, Vol. 168, pp. 1\u201027 (Part 1).","DOI":"10.1111\/j.1467-985X.2004.00333.x"},{"key":"key2022020519552414200_b8","unstructured":"Cunningham, F.C. (1997), \u201cMedicare reform: via managed care or managed competition?\u201d, Healthcover, Vol. 7 No. 1, pp. 8\u201016."},{"key":"key2022020519552414200_b9","doi-asserted-by":"crossref","unstructured":"De Cock, C. and Hipkin, I. (1997), \u201cTQM and BPR: beyond the beyond myth\u201d, Journal of Management Studies, Vol. 34 No. 5, pp. 659\u201075.","DOI":"10.1111\/1467-6486.00067"},{"key":"key2022020519552414200_b10","unstructured":"Dwyer, J. and Jackson, T. (2001), Literature Review: Integrated Bed and Patient Management, State of Victoria Government Publishing, Department of Human Services, Victoria."},{"key":"key2022020519552414200_b11","unstructured":"Fishbein, M. and Aizen, I. (1975), Belief Attitude, Intention, and Behavior: An Introduction to Theory and Research, Addison\u2010Wesley, Reading, MA."},{"key":"key2022020519552414200_b12","unstructured":"Fulop, N., Allen, P., Clarke, A. and Black, N. (2001), Studying the Organisation and Delivery of Health Services: Research Methods, Rutledge, London."},{"key":"key2022020519552414200_b13","unstructured":"Geertz, C. (1973), \u201cThick description: toward an interpretive theory of culture\u201d, In the Interpretation of Cultures: Selected Essays, Basic Books, New York, NY."},{"key":"key2022020519552414200_b15","doi-asserted-by":"crossref","unstructured":"Grover, V. and Malhotra, M.K. (1997), \u201cBusiness process reengineering: a tutorial on the concept, evolution, method, technology and application\u201d, Journal of Operations Management, Vol. 15 No. 3, pp. 193\u2010213.","DOI":"10.1016\/S0272-6963(96)00104-0"},{"key":"key2022020519552414200_b16","doi-asserted-by":"crossref","unstructured":"Hammer, M. and Champy, J. (1993), Reengineering the Corporation: A Manifesto for Business Revolution, Harper Collins, London.","DOI":"10.1016\/S0007-6813(05)80064-3"},{"key":"key2022020519552414200_b17","doi-asserted-by":"crossref","unstructured":"Harrison, S.D., Hunter, D., Marnoch, G. and Politt, C. (1992), Just Managing. 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