Title: Relational mediating performance management systems: evidence from the Italian healthcare context

Authors: Rosanna Spanò; Luca Ferri; Andrea Tomo

Addresses: Department of Economics, Management, Institutions, University of Naples Federico II, Via Cintia 26, Naples, Italy ' Department of Economics, Management, Institutions, University of Naples Federico II, Via Cintia 26, Naples, Italy ' Department of Economics, Management, Institutions, University of Naples Federico II, Via Cintia 26, Naples, Italy

Abstract: Literature to date has quite overlooked the comprehension of the softer dimensions of performance management systems and their nature as means of mediation within complex contexts, and especially healthcare. Thus, the aim of this paper is to understand, what factors that shape PMSs discursive ability to act as means of mediation are and to foster positive responses to processes of change in healthcare. We refer to the PMS framework by Ferreira and Otley integrated with the refinements proposed by Broadbent and Laughlin in their middle range theory, and employ the case study of an Italian regional health service. The study illustrates how the Region Alfa could shape its PMS, focusing on a wide range of interrelated elements, such as changing context and environment, evolving models of rationality, PMS design, and PMS operationalisation. The study provides an analytical framework for examining PMS implementation that goes beyond the somewhat incomplete understanding that resistance or hybridisation occurs in all situations, and which allows a better comprehension of the nature of the discourse and its outcome.

Keywords: performance management systems; resistance; hybridisation; healthcare.

DOI: 10.1504/IJPSPM.2022.124121

International Journal of Public Sector Performance Management, 2022 Vol.10 No.1, pp.131 - 146

Received: 25 May 2019
Accepted: 21 Nov 2019
Published online: 14 Jul 2022 *

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