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

被引:28
作者
Brewster, L. [1 ]
Tarrant, C. [1 ]
Dixon-Woods, M. [1 ]
机构
[1] Univ Leicester, Dept Hlth Sci, 22-28 Princess Rd West, Leicester LE1 6TP, Leics, England
基金
英国惠康基金;
关键词
Performance management; Infection prevention and control; Hospital management; Qualitative; CLOSTRIDIUM-DIFFICILE INFECTION; PATIENT SAFETY PROGRAM; HOSPITALS; IMPROVEMENT; BACTEREMIA; GOVERNMENT; MICHIGAN; ENGLISH; ENGLAND; MRSA;
D O I
10.1016/j.jhin.2016.01.021
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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: To characterize views and experiences of regulation and performance management relating to IPC in English hospitals. Methods: Two qualitative datasets containing 139 interviews with healthcare workers and managers were analysed. 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 mobilized action around specific infections. The benefits of establishing organizational 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 marginalization of other potentially important issues. Financial sanctions were viewed especially negatively; performance management was associated with risks of creating a culture of fearfulness, suppressing learning and disrupting inter-professional relationships. Conclusion: Centrally led performance management may have some important roles in IPC, 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. (C) 2016 The Authors. Published by Elsevier Ltd
引用
收藏
页码:41 / 47
页数:7
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