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  • A qualitative study of views and experiences performance management 22012016 final submitted

    Rights statement: This is the author’s version of a work that was accepted for publication in Journal of Hospital Infection. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Hospital Infection, 94, 1, 2016 DOI: 10.1016/j.jhin.2016.01.021

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    Available under license: CC BY-NC-ND: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

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A qualitative study of views and experiences of performance management for healthcare-associated infections

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<mark>Journal publication date</mark>09/2016
<mark>Journal</mark>Journal of Hospital Infection
Issue number1
Volume94
Number of pages7
Pages (from-to)41-47
Publication StatusPublished
Early online date12/02/16
<mark>Original language</mark>English

Abstract

Background
Centrally-led performance management regimes using standard-setting, monitoring and incentives have become a prominent feature of infection prevention and control (IPC) in health systems.
Aim
We aimed to characterise views and experiences of regulation and performance management relating to IPC in English hospitals.
Methods
We analysed two qualitative datasets containing 139 interviews with healthcare workers and managers. Data directly relevant to performance management and IPC were extracted. Data analysis was based on the constant comparative method.
Findings
Participants reported that performance management regimes had mobilised action around specific infections. The benefits of establishing organisational structures of accountability were seen in empirical evidence of decreasing infection rates. Performance management was not, however, experienced as wholly benign, and setting targets in one area was seen to involve risks of ‘tunnel vision’ and the marginalisation of other potentially important issues. Financial sanctions were viewed particularly negatively; performance management was associated with risks of creating a culture of fearfulness, suppressing learning and disrupting inter-professional relationships.
Conclusions
Centrally-led performance management may have some important roles in infection prevention and control, but identifying where it is appropriate and determining its limits is critical. Persisting with harsh regimes may affect relationships and increase resistance to continued improvement efforts, but leaving all improvement to local teams may also be a flawed strategy.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Journal of Hospital Infection. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Hospital Infection, 94, 1, 2016 DOI: 10.1016/j.jhin.2016.01.021