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

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A qualitative study of views and experiences of performance management for healthcare-associated infections. / Brewster, Liz; Tarrant, Carolyn; Dixon-Woods, Mary.
In: Journal of Hospital Infection, Vol. 94, No. 1, 09.2016, p. 41-47.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

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Brewster L, Tarrant C, Dixon-Woods M. A qualitative study of views and experiences of performance management for healthcare-associated infections. Journal of Hospital Infection. 2016 Sept;94(1):41-47. Epub 2016 Feb 12. doi: 10.1016/j.jhin.2016.01.021

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Brewster, Liz ; Tarrant, Carolyn ; Dixon-Woods, Mary. / A qualitative study of views and experiences of performance management for healthcare-associated infections. In: Journal of Hospital Infection. 2016 ; Vol. 94, No. 1. pp. 41-47.

Bibtex

@article{12d1b8e69db74ae8ba17940c3ac0887f,
title = "A qualitative study of views and experiences of performance management for healthcare-associated infections",
abstract = "BackgroundCentrally-led performance management regimes using standard-setting, monitoring and incentives have become a prominent feature of infection prevention and control (IPC) in health systems. AimWe aimed to characterise views and experiences of regulation and performance management relating to IPC in English hospitals.MethodsWe 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.FindingsParticipants 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 {\textquoteleft}tunnel vision{\textquoteright} 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.ConclusionsCentrally-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. ",
keywords = "Performance management, Infection prevention and control, Hospital management, Qualitative",
author = "Liz Brewster and Carolyn Tarrant and Mary Dixon-Woods",
note = "This is the author{\textquoteright}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",
year = "2016",
month = sep,
doi = "10.1016/j.jhin.2016.01.021",
language = "English",
volume = "94",
pages = "41--47",
journal = "Journal of Hospital Infection",
issn = "0195-6701",
publisher = "W.B. Saunders Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - A qualitative study of views and experiences of performance management for healthcare-associated infections

AU - Brewster, Liz

AU - Tarrant, Carolyn

AU - Dixon-Woods, Mary

N1 - 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

PY - 2016/9

Y1 - 2016/9

N2 - BackgroundCentrally-led performance management regimes using standard-setting, monitoring and incentives have become a prominent feature of infection prevention and control (IPC) in health systems. AimWe aimed to characterise views and experiences of regulation and performance management relating to IPC in English hospitals.MethodsWe 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.FindingsParticipants 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.ConclusionsCentrally-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.

AB - BackgroundCentrally-led performance management regimes using standard-setting, monitoring and incentives have become a prominent feature of infection prevention and control (IPC) in health systems. AimWe aimed to characterise views and experiences of regulation and performance management relating to IPC in English hospitals.MethodsWe 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.FindingsParticipants 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.ConclusionsCentrally-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.

KW - Performance management

KW - Infection prevention and control

KW - Hospital management

KW - Qualitative

U2 - 10.1016/j.jhin.2016.01.021

DO - 10.1016/j.jhin.2016.01.021

M3 - Journal article

VL - 94

SP - 41

EP - 47

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

SN - 0195-6701

IS - 1

ER -