Learning Objectives

• List the various groups to which an organization may be accountable.

• Describe why accrediting agencies are interested in the accountability of the organizations and programs that they evaluate.

• State reasons for measuring productivity.

Learning Objectives

• Differentiate among quantitative, qualitative, and outcome productivity measures.

• Describe how to measure productivity for various types of workers.

• State why fiscal accountability is necessary.

• Determine why it is necessary for an organization to be accountable to its employees.

Learning Objectives

• List various ways organizations measure accountability to their employees.

• Distinguish between quality control and quality assurance.

• Discuss the standard systems used for quality management, including quality assurance, continuous quality improvement, and total quality management.

Learning Objectives

• Define benchmarking.• Differentiate between internal and

external benchmarking.

Overview

• Accountability – The state of being responsible or liable for

actions taken.

• Managers are accountable to suppliers, employees, customers, and other constituencies for what they do as well as for the work of their subordinates.

• Accountability includes a sense of duty to ensure that the proper services and goods are provided and individuals are treated fairly.

Overview

• Accountability includes a variety of measures:– Productivity measures– Financial – Human resources

• Benchmarking - comparison of an organization's measures with past measures, other organizations, or industry standards

Constituencies

• Vendors– Entitled to payment

• Financial backers– Should receive a reasonable return on

investment– In the case of taxpayers, should receive a

level of quality in service

• Employees– Safe work environment– Equitable treatment and 2-way

communication

Constituencies

• Customers– External Customer - The end user of the

product made by an organization.– Internal Customers - Those individuals

within an organization who provide direct service to the external customers.

– Captive Clientele - Customers who must use a product or a service because they have no other options.

Constituencies

• Professional/accrediting agencies– Provide expert judgment regarding whether

goods/services are appropriate when this cannot be determined by customers

– ex:• Joint Commission on Accreditation of Healthcare

Organizations at http://www.jcaho.org/ • Commission on Accreditation for Dietetics

Education at http://www.eatright.org/Public/CADE/7782_7984.cfm

Productivity

• Productivity – Measurement of the relationship

between outputs or products and inputs such as time, money, labor, and raw material.

– Productivity may be measured quantitatively, qualitatively, or in terms of outcomes.

Productivity

• Measuring productivity– Quantitative Measure - A type of

productivity measure that focuses on the quantity of product produced.

Productivity

Productivity

• Measuring productivity– Qualitative Measurement – A type

of productivity measure that is concerned with the accuracy and quality of what is produced.

– Outcome Measurement - A type of productivity measure that determines whether the product did what it was supposed to do.

Productivity

• Measuring productivity (hospitals)– Occupied Beds - A measure

hospitals use to quantify the work that they do; the number of patients in the facility for a 24-hour period. • These data are often obtained by

determining the number of patients who are physically present at a specific hour during the night (for example, 2 a.m.).

Productivity

• Measuring productivity (hospitals)– Adjusted Occupied Beds - A measure

generated through the use of a mathematical formula to adjust the actual number of occupied beds to reflect the work that is done in the hospital for patients who are not actually admitted for 24 hours or are not in residence at the time when the occupied bed census is taken.

• The formula is based on the hospital’s usual activity patterns, volumes of outpatient visits, day surgeries, patient acuity, and so on.

Productivity

• Measuring productivity (foodservice)– Meals - A group of foods that are usually

eaten together. • Typically, a meal includes an entrée, a starch, a

side dish, and a dessert (it may also include an appetizer and/or a salad).

– The number of meals prepared is often used to quantify the productivity of cooks.

– Meal Equivalents - A measure of foodservice productivity defined as the amount of all food sales divided by the average cost of a meal within the facility.

Productivity

• Measuring productivity (foodservice)– Qualitative

measurements in foodservice:• Sensory characteristics of

food• Food safety

Productivity

• Use of productivity records– Determination of staffing needs– Monitoring staff during change– Quality management

Quality Management

• Quality assurance– In healthcare, the focus has moved from

quality control to quality assurance.– Quality Control (QC) - A method to

determine if the products being made meet minimum standards of acceptability.

– Quality Assurance (QA) - The process of identifying and solving problems within a department or area of an organization.

Quality Management

• Continuous Quality Improvement (CQI) – The process of identifying areas in a

department that can be strengthened and working to make those areas better.

• Total Quality Management (TQM)– The application of quality management

processes throughout the organization. – This includes working on problems and

strengthening areas that cross departmental lines.

Use of Outcome Data

• Used in public health to measure the impact of programs– Quantitative data justify funding

• Used to demonstrate effectiveness of MNT for diabetes, renal disease– Justifies Medicare reimbursement

• Used to refine foodservice forecasts

Benchmarking

• Benchmarking - The practice of measuring an organization’s performance and productivity against standards, either internal or external.

Benchmarking

• Internal Benchmarking– The process of comparing an organization’s

current data on productivity with its own past records to determine how its current performance compares with past performance.

– Variations alert the manager to changes– Patterns and trends guide staffing/work

processes

Benchmarking

• External Benchmarking– The process of an organization

comparing its performance and productivity with those of other comparable organizations to determine whether it is performing at, above, or below the industry standard.

Benchmarking

• External Benchmarking– Obstacles to meaningful

benchmarking:• Finding organizations similar enough to

compare• Competitive nature of business

Conclusion

• Organizations are accountable to a variety of constituencies, including those who contribute resources, both human and material, and the end users of the product.

• When the customer is identified as the public, the organization is often accountable to an oversight group, representing the public.

Conclusion

• Productivity is measured in relation to quantity, quality, and outcome.

• The measurement of productivity is a management tool. It is most effective when productivity is monitored in both the short term and in the long range.

• Discrete measures, other than productivity, are used to demonstrate fiscal accountability and accountability to staff.

Conclusion

• Quality management programs include quality control, quality assurance, Continuous Quality Improvement and Total Quality Management.

• Benchmarking is one of the processes used to measure an organization’s performance against internal and external standards.