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ACCA Strategic Professional · Advanced Performance Management · Performance improvement models and techniques

Dalton Hospital Group has a single performance target of reducing patient waiting times. Staff begin to move patients between queues and reclassify urgent cases to meet the target, while care quality falls. Which problem does this best illustrate?

This is measure fixation and gaming: staff manipulate classification and queues to hit the single target while the real aim of quality care deteriorates. A balanced set of measures covering quality and outcomes helps reduce such dysfunctional behaviour.

  1. AMeasure fixation and gaming, where behaviour is distorted to hit a target rather than serve the underlying objectiveCorrect
  2. BBenchmarking against a best-in-class competitor
  3. CBeyond budgeting, where targets are removed
  4. DControllability, where managers are judged on items they cannot influence

Explanation

Staff manipulate the measure to achieve the target while the real objective, quality care, suffers. This is gaming and measure fixation, typical of narrow targets in public services. Controllability is not the issue here since staff do influence the waiting-time figures.

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