Performance measurement for the strategic management of health-care estates

• Published in: Journal of facilities management 2018-05, Vol.16 (2), p.217-232
• Main Authors: Rodríguez-Labajos, Laura, Thomson, Craig, O’Brien, Geraldine
• Format: Article
• Language: English
• Subjects: Asset management; Decision making; Facilities management; Health care; Health care expenditures; Long term planning; Performance evaluation; Politics; Public sector; Research methodology; Strategic management
• ISSN: 1472-5967; 1741-0983
• DOI: 10.1108/JFM-10-2017-0052

Purpose The purpose of this study is to explore the role of performance measurement in current practices for strategic management of health-care estates. Design/methodology/approach The research adopts a constructivist grounded theory approach, combining different methodologies of a pan-European qualitative questionnaire, interviews with international health-care providers and a case study of National Health Services (NHS) Scotland. Here, documentation analysis, observations and in-depth interviews involving NHS stakeholders were undertaken. Findings The analysis shows evidence that measuring estate performance has limited value for individual NHS boards regarding strategic decisions related to long-term planning and investment. This was due to design issues and the prioritisation of clinical delivery, which contribute to the neglect of the estate as a consideration in long-term strategic planning. This misalignment results in a tool which is valuable for accountability but which is less helpful to NHS boards in shaping future decisions around the estate. Practical implications Responding to a gap in understanding of the application of performance measurement in the context of health-care estates, this research provides three recommendations to promote a more effective and relevant performance measurement system. These actively recognise the importance of the estate within strategic decision-making as helping to inform the long-term planning and management of the estate within the individual NHS boards. Originality/value This paper shows the current role of performance measurement for the strategic management of health-care estates and identifies issues related to its applicability and value.