High performance in healthcare priority setting and resource allocation: a literature- and case study-based framework in the Canadian context

Neale Smith, Craig Mitton, William Hall, Stirling Bryan, Cam Donaldson, Stuart Peacock, Jennifer L. Gibson, Bonnie Urquhart

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Abstract

Priority setting and resource allocation, or PSRA, are key functions of executive teams in healthcare organizations. Yet decision-makers often base their choices on historical patterns of resource distribution or political pressures. Our aim was to provide leaders with guidance on how to improve PSRA practice, by creating organizational contexts which enable high performance. We carried out in-depth case studies of six Canadian healthcare organizations to obtain from healthcare leaders their understanding of the concept of high performance in PSRA and the factors which contribute to its achievement. Individual and group interviews were carried out (n = 62) with senior managers, middle managers and Board members. Site observations and document review were used to assist researchers in interpreting the interview data. Qualitative data were analyzed iteratively with the literature on empirical examples of PSRA practice, in order to develop a framework of high performance in PSRA.

The framework consists of four domains - structures, processes, attitudes and behaviours, and outcomes - within which are 19 specific elements. The emergent themes derive from case studies in different kinds of health organizations (urban/rural, small/large) across Canada. The elements can serve as a checklist for ’high performance’ in PSRA. This framework provides a means by which decision-makers in healthcare might assess their practice and identify key areas for improvement. The findings are likely generalizable, certainly within Canada but also across countries. This work constitutes, to our knowledge, the first attempt to present a full package of elements comprising high performance in health care PSRA.
Original languageEnglish
Pages (from-to)185-192
Number of pages8
JournalSocial Science and Medicine
Volume162
Early online date21 Jun 2016
DOIs
Publication statusPublished - Aug 2016

Fingerprint

Resource Allocation
Delivery of Health Care
Organizations
resources
Canada
performance
Interviews
decision maker
Urban Health
Patient Care Team
manager
leader
Executive Function
Checklist
interview
Research Personnel
Pressure
literature
Healthcare
health care

Keywords

  • resource allocation
  • healthcare management
  • Canada
  • priority setting

Cite this

Smith, Neale ; Mitton, Craig ; Hall, William ; Bryan, Stirling ; Donaldson, Cam ; Peacock, Stuart ; Gibson, Jennifer L. ; Urquhart, Bonnie. / High performance in healthcare priority setting and resource allocation: a literature- and case study-based framework in the Canadian context. In: Social Science and Medicine. 2016 ; Vol. 162. pp. 185-192.
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High performance in healthcare priority setting and resource allocation: a literature- and case study-based framework in the Canadian context. / Smith, Neale; Mitton, Craig ; Hall, William; Bryan, Stirling ; Donaldson, Cam; Peacock, Stuart; Gibson, Jennifer L.; Urquhart, Bonnie.

In: Social Science and Medicine, Vol. 162, 08.2016, p. 185-192.

Research output: Contribution to journalArticle

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