Performance Measurement
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Modern technology allows us to measure almost anything. You may have a watch which can measure your heartbeat as you go about your normal day, or which measures the number of steps you take and distance traveled. At work, every time you enter some information to a database, there is a time stamp recording, to the millisecond, when you logged that record, or changed it. This means that it is now relatively easy to measure the thousands of actions workers take and to report upon performance.
A supermarket checkout operator may be measured against average number of items scanned in a given time, delivery drivers can be measured in regards to adherence to the delivery route, or mean time between deliveries.
This kind of business intelligence is priceless in terms of planning and decision making. If a supermarket has footfall data showing its busiest time, it can staff accordingly and offset this by reducing staff numbers when it knows the shop will be quiet. Technology makes this possible on a store by store basis, with computers churning out dashboards, reports, graphs and alerts 24/7/365.
If you can measure someone or something's performance, you can reward or penalise for good or poor performance respectively. This is nothing new, workers have been paid on piecework for years. What is relatively new is the measurement of service provision.
Approximately 10 years ago, the UK Government introduced a target for hospital A&E departments whereby patients should be seen and cleared within 4 hours 95% of the time. The A&E staff were justifiably worried about the imposition of this Key Performance Measure (KPI) and started to think of ways of getting around it. The solution was easy.
Because the measure was taken from the patient database where timestamps are used when a patient is booked in to A&E then again when either discharged or admitted, all they had to do was make sure that one of these things happened within 4 hours. The wards had no KPI to meet, so instead of checking with the ward before sending patients to them, the patients were simply sent before the 4 hours was up.
If the ward did not have any available beds, the patient was simply left on the trolley they had been delivered on, usually in the corridor outside. Never mind though; the performance target had been met.
This became almost the only goal for Emergency Departments and hospital management. Now, instead of allocating a part of their budget to improving throughput or facilities to improve efficiency, they continued to spend the money on contract labour to fill gaps at huge cost and wasting money by commissioning white papers and other reports.
It is easy to see how Senior Management would have put the A&E staff under immense pressure to perform, regardless of care needs. In fact it was probably only the caring nature of these front line staff that stopped "Sent to Mortuary" being an acceptable clock stop for the A&E timer.
Because it is now winter and the population has grown, we find that A&E departments are stretched even beyond their ability to fill corridors with trolleys. This has made it impossible to fudge the figures, so we are suddenly in a crisis. A crisis that has been there for years but swept under the carpet, or could have been lessened with a bit of planning and foresight by senior managers.
A supermarket checkout operator may be measured against average number of items scanned in a given time, delivery drivers can be measured in regards to adherence to the delivery route, or mean time between deliveries.
This kind of business intelligence is priceless in terms of planning and decision making. If a supermarket has footfall data showing its busiest time, it can staff accordingly and offset this by reducing staff numbers when it knows the shop will be quiet. Technology makes this possible on a store by store basis, with computers churning out dashboards, reports, graphs and alerts 24/7/365.
If you can measure someone or something's performance, you can reward or penalise for good or poor performance respectively. This is nothing new, workers have been paid on piecework for years. What is relatively new is the measurement of service provision.
Approximately 10 years ago, the UK Government introduced a target for hospital A&E departments whereby patients should be seen and cleared within 4 hours 95% of the time. The A&E staff were justifiably worried about the imposition of this Key Performance Measure (KPI) and started to think of ways of getting around it. The solution was easy.
Because the measure was taken from the patient database where timestamps are used when a patient is booked in to A&E then again when either discharged or admitted, all they had to do was make sure that one of these things happened within 4 hours. The wards had no KPI to meet, so instead of checking with the ward before sending patients to them, the patients were simply sent before the 4 hours was up.
If the ward did not have any available beds, the patient was simply left on the trolley they had been delivered on, usually in the corridor outside. Never mind though; the performance target had been met.
This became almost the only goal for Emergency Departments and hospital management. Now, instead of allocating a part of their budget to improving throughput or facilities to improve efficiency, they continued to spend the money on contract labour to fill gaps at huge cost and wasting money by commissioning white papers and other reports.
It is easy to see how Senior Management would have put the A&E staff under immense pressure to perform, regardless of care needs. In fact it was probably only the caring nature of these front line staff that stopped "Sent to Mortuary" being an acceptable clock stop for the A&E timer.
Because it is now winter and the population has grown, we find that A&E departments are stretched even beyond their ability to fill corridors with trolleys. This has made it impossible to fudge the figures, so we are suddenly in a crisis. A crisis that has been there for years but swept under the carpet, or could have been lessened with a bit of planning and foresight by senior managers.
