Design and Implementation Factors for Performance Measurement in Non-profit Organizations: A Literature Review.

Purpose: Performance measurement systems (PMS) in Non-profit Organizations (NPOs) are more complex than in for-profit organizations. NPOs have an orientation toward social mission and values, and they consider not only organizational efficiency and viability, but also the social impact of the organization. This research provides a comprehensive synthesis of PMSs in NPOs. Design/Methodology/Approach: Using a literature review, supported by bibliometric and network analyses. A paper set of 240 articles related to this research field is examined. Topics that are the most prevalent in this research area and their interrelationships are identified, presenting an outline of current efforts. Findings: Despite the descriptive analyses for the paper set, a framework is proposed for organizing the design-implementation factors of PMSs in non-profit organizations, identifying the main requirements for their successful development. Originality/Value: Investigation on performance measurement in non-profit organizations is still in its early stages of development with many opportunities to further develop the field. Conceptual frameworks and models, as well as specific theories, are being generated for this field of research, and the process of adapting models from the general field of performance measurement is taking place. The meta-framework that organizes the main research topics of PMS in non-profit organizations and the framework that consolidates factors that influence the design-implementation of PMSs in non-profit organizations developed represents this paper contribution.

Monitoring complexity and resilience in construction projects: The contribution of safety performance measurement systems.

Although complexity and resilience are key inter-related characteristics of construction projects, little is known on how to monitor these characteristics and their implications for safety management. This study investigates the contribution of Safety Performance Measurement Systems (SPMS) as a means for monitoring and understanding of sources of complexity and resilience in construction. It is based in three empirical studies carried out in construction projects, two in Chile and one in Brazil. Two main tools were applied in these studies: (i) the Technical, Organizational and Environmental (TOE) framework, focused on complexity; and (ii) the Resilience Assessment Grid (RAG), focused on resilience. Improvement opportunities were identified for existing SPMS. Also, a set of guidelines for the design of SPMS emerged from these studies as well as a model that explains the connections between the main constructs encompassed by the guidelines.

Discrete event simulation as a decision-making tool for end-of-life tire reverse logistics in a Brazilian city consortium.

Tires require adequate disposal at the end of their useful life due to the environmental damage that improper disposal can cause. Since the 1990s, Brazilian legislation has laid out specific rules for tire disposal. This brought about results in 2017, when 93% of the target was met for environmentally correct tire disposal, according to the Brazilian Institute of the Environment and Renewable Natural Resources. To reach this index, consumers, business people, city halls, and manufacturers had to work together. However, cities with fewer than 100,000 inhabitants continued to encounter difficulties to carry out the process efficiently. Thus, the objective of this study is to propose new alternatives so that small cities can plan and implement reverse logistics management for unusable tires. The tool used to verify improvement was discrete event simulation, which allowed for the creation of scenarios, experimenting with changes to the consortium's operation. The analysis confirms that the consortium of cities can have a more efficient process in the destination of tires, with the possibility of reducing costs by 15%, emission of pollutant gases by 71%, and CO2 by 57%.

Age-Friendly Cities Performance Assessment Indicators System hierarchization / Jerarquización de un Sistema de indicadores para la evaluación de desempeño de las Ciudades Amigas de los Ancianos / Hierarquização de um Sistema de Indicadores para avaliação das Cidades Amigas dos Idosos

This study aimed to validate and prioritize a system of indicators to assess the performance of age-friendly cities. The methodological procedures consisted of the application of the system indicators content validation model developed by Fehring in 1987 and used the multicriteria method Analytical Hierarchy Process for priorization. These analyzes, there was a satisfactory level of consistency and correspondence between the position of the experts on the prioritization of active ageing issues in urban environments.

Este estudio tuvo como objetivo validar y priorizar un sistema de indicadores para evaluar el desempeño de las ciudades amigables de los mayores. Los procedimientos metodológicos consistieron en la aplicación del modelo de validación de contenido de indicadores del sistema desarrollado por Fehring en 1987 y utilizaron el método de jerarquización analítica multicriterio para la priorización. En estos análisis, hubo un nivel satisfactorio de coherencia y correspondencia entre la posición de los expertos sobre la priorización de los problemas de envejecimiento activo en entornos urbanos.

Este estudo teve como objetivo validar e priorizar um sistema de indicadores para avaliar o desempenho de Cidades Amigas do Idoso. Os procedimentos metodológicos consistiram na aplicação do modelo de validação de conteúdo de indicadores do sistema desenvolvido por Fehring em 1987 e utilizou o método multicritério Analytical Hierarchy Process para priorização. Nestas análises, houve um nível satisfatório de consistência e correspondência entre a posição dos especialistas na priorização de questões de envelhecimento ativo em ambientes urbanos.

Improving rates of cotrimoxazole prophylaxis in resource-limited settings: implementation of a quality improvement approach.

OBJECTIVE: To demonstrate the effectiveness of quality improvement methods to monitor and improve administration of cotrimoxazole (CTX) prophylaxis to improve health outcomes among adults living with HIV/AIDS in low resource countries. DESIGN: Program evaluation. SETTING: HIV/AIDS health care facilities in Uganda, Mozambique, Namibia and Haiti. INTERVENTION: Performance measures based on national guidelines are developed in each country. These may include CD4 monitoring, ART adherence and uptake of CTX prophylaxis. CTX prophylaxis is routinely selected, because it has been shown to reduce HIV-related morbidity and mortality. Patient records are sampled using a standard statistical table to achieve a minimum confidence interval of 90% with a spread of ±8% in participating clinics. If an electronic medical record is available, all patients are reviewed. Routine review of performance measures, usually every 6 months, is conducted to identify gaps in care. Improvement interventions are developed and implemented at health facilities, informed by performance results, and local/national public health priorities. MAIN OUTCOME MEASURE: Median clinic rates of CTX prophylaxis. RESULTS: Median performance rates of CTX prophylaxis generally improved for adult HIV+ patients between 2006 and 2013 across countries, with median clinic rates higher than baseline at follow-up in 16 of 18 groups of clinics implementing CTX -focused improvement projects. CONCLUSIONS: Quality management offers a data-driven method to improve the quality of HIV care in low resource countries. Application of improvement principles has been shown to be effective to increase the rates of CTX prophylaxis in national HIV programs in multiple countries.

Measuring Diabetes Care Performance Using Electronic Health Record Data: The Impact of Diabetes Definitions on Performance Measure Outcomes.

The objective was to examine the use of electronic health record (EHR) data for diabetes performance measurement. Data were extracted from the EHR of a health system to identify patients with diabetes using 8 different EHR data-based methods of identification. These EHR-based methods were compared to the gold standard of a manual medical record review. The study team then assessed whether the method of identifying patients with diabetes could affect performance measurement scores. The sensitivity of the 8 EHR-based methods of identifying patients with diabetes ranged from moderate to high. The use of certain data elements in the EHR to identify patients with diabetes selectively identified those who had better performance measures. Diabetes performance measures are influenced by the data elements used to identify patients. As EHR data are used increasingly to measure performance, continuing to improve our understanding of how EHR data are collected and used will be critical.

Conceptual model of comprehensive research metrics for improved human health and environment: [review] / Modelo conceitual de indicadores de desempenho abrangentes para a melhoria da saúde humana e do meio ambiente: [revisão]

Performance measurement predominantly consisted of near-term outputs measured through bibliometrics, but the recent focus is on accountability for investment based on long-term outcomes. Our objective is to build a logic model and associated metrics through which to measure the contribution of environmental health research programs to improvements in human health, the environment, and the economy. We developed a logic model that defines the components and linkages between extramural environmental health research grant programs and the outputs and outcomes related to health and social welfare, environmental quality and sustainability, economics, and quality of life, focusing on the environmental health research portfolio of the National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research and Training and delineates pathways for contributions by five types of institutional partners in the research process. The model is being applied to specific NIEHS research applications and the broader research community. We briefly discuss two examples and discuss the strengths and limits of outcome- based evaluation of research programs.

A avaliação de desempenho compreendia predominantemente resultados de curto prazo avaliados através de bibliometria, mas recentemente a ênfase voltou-se à prestação de contas dos investimentos com base em resultados a longo prazo. Nosso objetivo é criar um modelo lógico e métricas associadas através dos quais possamos avaliar a contribuição de programas de pesquisa em saúde ambiental para melhorar a saúde humana, o meio ambiente e a economia. Desenvolvemos um modelo lógico que define os componentes e elos entre os programas de pesquisa em saúde ambiental extramuros subsidiados e os resultados relacionados à saúde e ao bem-estar social, qualidade ambiental e sustentabilidade, economia e qualidade de vida, com ênfase no portfólio de pesquisa em saúde ambiental do National Institute of Environmental Health Sciences (NIEHS), divisão de pesquisa e treinamento extramuros, delineando caminhos para as contribuições de cinco tipos de parceiros institucionais no processo de pesquisa. O modelo está sendo usado em aplicações específicas do NIEHS e na comunidade de pesquisa como um todo. Analisamos brevemente dois exemplos e os pontos fortes e limitações da avaliação baseada em resultados dos programas de pesquisa.

Experiências de avaliação do setor suplementar de saúde: contribuições da integralidade / Evaluation experiences of the supplementary care sector: contributions of integrality

Este trabalho identifica aspectos de integralidade nas propostas de avaliação de assistência à saúde da Agência Nacional de Saúde Suplementar (ANS), no Brasil, e do National Commitee for Quality Assurance (NCQA), nos Estados Unidos. A metodologia adotada foi a da análise documental das propostas encontradas nos sítios eletrônicos das instituições no segundo semestre de 2006. Os dados foram sistematizados numa matriz analítica com atributos das práticas de gestão e organização de serviços; dos conhecimentos e práticas dos trabalhadores de saúde; e das práticas de controle pela sociedade. Os resultados apresentados destacam, no caso brasileiro, uma ênfase no primeiro e terceiro atributos, com a avaliação centrada nas operadoras os planos de saúde não foram avaliados. No caso americano, houve um equilíbrio nos três conjuntos de atributos, sendo a avaliação direcionada aos planos de saúde. Ambas as propostas mensuraram a satisfação dos beneficiários e divulgam os resultados das avaliações em sítios eletrônicos. Em conclusão, destaca-se a importância de conceitos e abordagens avaliativas da integralidade nas operadoras de planos privados de saúde no setor suplementar brasileiro.

This work identifies aspects of comprehensiveness in the proposals for healthcare evaluation of the Agência Nacional de Saúde Suplementar (ANS) in Brazil, and of the National Commitee Quality Assurance (NCQA) in the U.S.A. The investigation was based on a documental analysis of the proposals found in the websites of both institutions in the second semester of 2006. The data were systemized according to pre-established attributes, building an analytical matrix for evaluating the following three dimensions: management practices and service organization; quality of knowledge and of practices of the health workers; and quality of the control practices of the society. In the Brazilian case there was an emphasis on the first and the third dimensions. The evaluation focalized the operators; the health plans were not evaluated. In the American case there was a balance between the three sets of attributes and the evaluation was focused on the health plans. Both proposals measured the satisfaction of the beneficiaries and made the results of the evaluations available in their websites. In conclusion we emphasize the importance of evaluative concepts and approaches for measuring the integrality of private health plan operators in the Brazilian supplementary health sector.