Biomedical subjects

Penelope M Mullen

Publications and source records attributed to Penelope M Mullen.

3 recordsLinked to original sources

PubMed2004

Using performance indicators to improve performance.

The recent introduction of performance assessment within the UK NHS, incorporating numerous performance indicators (PIs) and league tables, has led to health care organisations facing large numbers of targets and a star rating system with associated rewards and penalties. However, there is considerable evidence that using PIs for judgement rather than learning provides perverse incentives and can prove counterproductive. Drawing on earlier PI systems which, supplemented by expert systems, were designed to promote learning and exploration particularly by encouraging analysis of interactions between different indicators, a series of 'mini case studies' is presented. These reveal interesting relationships and suggest explanations for variations in performance, areas worth exploring further and possible approaches to improving performance -- approaches not apparent from individual indicators and league tables. It is concluded that presentation of PIs in a format that encourages exploration and analysis could greatly enhance the potential of the current PIs to improve NHS performance.

Arthroplasty, Replacement, Hip↗

PubMed2004

Quantifying priorities in healthcare: transparency or illusion?

Explicit priority setting in healthcare, which often involves multiple criteria and value judgements, has come to prominence in a number of different healthcare systems over the past decade. Drawing on the results of a survey of priority setting in practice in the UK National Health Service, this paper analyses issues associated with quantification in priority setting, focusing on techniques for eliciting and aggregating values, the criteria and form of models used and their application in priority setting. The findings reveal a clear focus on equity, a strong concern to demonstrate openness, consistency and transparency in priority setting-leading to greater use of explicit multi-criteria models-and a notable focus on the quality of 'evidence'. However, reported difficulties in weighting over-long lists of non-commensurate and overlapping criteria, the inclusion of inappropriate criteria, and attributes of the form of models employed, lead to the conclusion that the implications of the methods are not always appreciated, the resulting priority 'scores' sometimes misunderstood and, in some cases, the concern for transparency and explicitness appears to outweigh concern for methodological understanding-leading to an illusion of transparency.

Decision Making, Organizational↗

PubMed2003

Delphi: myths and reality.

The last 20 years have seen increasing interest in the use of Delphi in a wide range of health-care applications. However, this use has been accompanied by attempts to codify and define a "true Delphi". Many authors take a narrow view of the purpose of Delphi and/or advocate a single prescriptive approach to the conduct of a Delphi study. However, as early as 1975, Linstone and Turoff pointed to the danger of attempting to define Delphi as one would immediately encounter a study that violated that definition. Through critical examination of some of the controversies and misunderstandings that surround Delphi, this paper aims to dispel some of the myths and demonstrates the wide scope and potential of this versatile approach.

Delphi Technique↗