A STUDY OF EFFICIENCY MANAGEMENT IN NEW ZEALAND PUBLIC HOSPITAL SERVICES
There is increasing policy interest in ensuring that resources are used efficiently within New Zealand public hospitals which are under increasing constraint. This thesis presents a narrative based on a qualitative analysis of the impact of the regular provision of efficiency management information on manager behaviour and achievements based on a single exploratory case study research of 11 senior service managers in New Zealand’s largest public hospital. How performance information is currently used by service managers is unknown. The research questions seek to understand to what extent managers’ use the information, what behaviours and actions result, if these managers know what they need to learn to improve performance, and what barriers impede their actions. A qualitative research design was used to collect data from hospital service managers over a six month period. A model for a three stage information response was re-developed from existing processes and applied to the service managers who all received the hospital’s routine monthly performance information; while some participants also received specific efficiency related information. In each of the months, the participant’s perceptions of the performance information and the management of service improvement was obtained. The methodological approach is inductive using both observational and ethnographic approaches to collect qualitative data from regular surveys and interviews with participants. The findings appear to show enhanced collaboration in performance improvement discussions by managers who are provided with the specific performance information than is seen in those managers provided with the routine hospital management information. The enhanced collaboration appears to lead to greater improvements in service efficiency. The qualitative data provides a rich supplementary database of the participant managers’ experience of using performance management information, and from applying a formal Thematic Analysis (TA), management themes are identified to define the experience of the hospital service managers in using performance information. The TA provides a deeper understanding of the use of performance information by hospital service managers. The four themes were identified as: (1) direct leadership, (2) operational feedback; (3) performance signal; and (4) management development. These provide contextual meaning to purposeful management response and performance improvement.