Table 2 Ranks within dimension and scores of practices
From: Hospital management practices in county-level hospitals in rural China and international comparison
Dimensions and rank within the dimension | Management practice | Description | Management question example | Score, mean (SD); range |
|---|---|---|---|---|
Operations-1 | Rationale for introducing standardization and pathway management | Tests the motivation/impetus behind changes to operation, what change story was communicated | How often do you challenge/streamline the patient pathway? | 2.83 (0.56); 1.00–4.00 |
Operations-2 | Layout of patient flow | Tests how well the patient pathway is configured and improved | Can you briefly describe the patient journey or flow for a typical episode? | 2.72 (0.47); 1.50–4.08 |
Operations-3 | Good use of human resources | Tests whether staff are deployed to do what they are best qualified for | How do you know which tasks are best suited to different staff? | 2.71 (0.72); 1.00–4.33 |
Operations-4 | Standardization and protocols | Tests if there are standardized procedures that are applied and monitored systematically | How clear are clinical staff members about how specific procedures should be carried out? | 2.60 (0.73); 1.00–4.67 |
Monitoring-1 | Consequence management | Tests whether differing levels of performance (NOT personal but plan/process-based) lead to different consequences | How long is it between when a problem is identified to when it is solved? Can you give me a recent example? | 3.00 (0.81); 1.00–4.83 |
Monitoring-2 | Continuous improvement | Tests processes for, and attitudes towards, continuous improvement; and whether learning is captured and documented | How do problems typically get exposed and fixed? | 2.71 (0.73); 1.00–4.00 |
Monitoring-3 | Performance review | Tests whether performance is reviewed with appropriate frequency and communicated to staff | How do you review your main performance indicators? | 2.55 (0.76); 1.00–4.00 |
Monitoring-4 | Performance tracking | Tests whether performance is tracked using meaningful metrics and with appropriate regularity | What kind of performance or quality indicators would you use for performance tracking? | 2.50 (0.62); 1.00–4.33 |
Monitoring-5 | Performance dialogue | Tests the quality of review conversations | How are these meetings structured? How is the agenda determined? | 2.42 (0.77); 1.00–4.50 |
Targets-1 | Stretch of targets | Tests whether targets are appropriately difficult to achieve | How tough are your targets? How pushed are you by the targets? | 2.57 (0.71); 1.00–3.83 |
Targets-2 | Interconnection of targets | Tests whether targets are tied to hospital objectives and how well they cascade down the organization | What is the motivation behind these goals? | 2.57 (0.76); 1.00–4.67 |
Targets-3 | Balance of targets metrics | Tests whether targets cover a sufficiently broad set of metrics | What types of targets are set for the hospital? What are the goals for your specialty? | 2.46 (0.73); 1.00–4.25 |
Targets-4 | Time horizon of targets | Tests whether the hospital has a ‘3 horizons’ approach to planning and targets | What kind of time scale are you looking at with your targets? | 2.45 (0.82); 1.00–4.33 |
Targets-5 | Clarity and comparability of targets | Tests how easily understandable performance measures are and whether performance is openly communicated | Does anyone complain that the targets are too complex? | 1.98 (0.65); 1.00–3.42 |
Personnel-1 | Managing talent | Tests what emphasis is put on talent management | How do you ensure you have enough staff/nurses of the right type in the hospital? | 3.03 (0.58); 1.67–5.00 |
Personnel-2 | Removing poor performers | Tests whether the hospital can deal with underperformers | How long is under-performance tolerated? How difficult is it to dismiss a nurse/clinician? | 2.93 (0.61); 1.17–4.50 |
Personnel-3 | Promoting high performers | Tests whether promotion is performance based | How do you make decisions regarding progression/promotions within the unit/hospital? | 2.73 (0.54); 1.08–4.00 |
Personnel-4 | Rewarding high performers | Tests whether good performance is rewarded proportionately | How does your staff’s pay relate to the results of this review? How does the bonus system work? | 2.58 (0.70); 1.00–4.17 |
Personnel-5 | Attracting talent | Tests the strength of the employee value proposition | If I were a top nurse/clinician and you wanted to persuade me to work at your hospital, how would you do this? | 2.23 (0.46); 1.17–3.17 |
Personnel-6 | Retaining talent | Tests whether the hospital will go out of its way to keep its top talent | If you had a top performing manager, nurse, or clinician who wanted to leave, what would the hospital do? | 1.85 (0.39); 1.00–3.33 |