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

Brewster, Liz and Tarrant, Carolyn and Dixon-Woods, Mary (2016) A qualitative study of views and experiences of performance management for healthcare-associated infections. Journal of Hospital Infection, 94 (1). pp. 41-47. ISSN 0195-6701

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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 We aimed to characterise views and experiences of regulation and performance management relating to IPC in English hospitals. Methods We analysed two qualitative datasets containing 139 interviews with healthcare workers and managers. 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 mobilised action around specific infections. The benefits of establishing organisational 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 marginalisation of other potentially important issues. Financial sanctions were viewed particularly negatively; performance management was associated with risks of creating a culture of fearfulness, suppressing learning and disrupting inter-professional relationships. Conclusions Centrally-led performance management may have some important roles in infection prevention and control, 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.

Item Type:
Journal Article
Journal or Publication Title:
Journal of Hospital Infection
Additional Information:
This is the author’s version of a work that was accepted for publication in Journal of Hospital Infection. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Hospital Infection, 94, 1, 2016 DOI: 10.1016/j.jhin.2016.01.021
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Deposited On:
08 Feb 2016 09:20
Last Modified:
28 May 2023 03:00