The public management literature argues that performance measurement is the ‘Achilles Heel’ of many public sector reforms (Bouckaert and Peters, 2002). The availability of performance measurement systems (PMSs) is a necessary – but not sufficient – condition for enhancing performance. Recent studies have shown that two important factors influence the link between PMSs and performance, namely: (i) the use of PMSs (eg., Arts, Homburg and Rajad, 2012; Graftoj, Lillis, Widener, 2010; Macinati and Anessi Pessina, 2014; Speklé and Verbeeten, 2014); (ii) the consensus on strategy implementation (eg. Ho, Wu and Wu, 2014).
However, three limitations can be found. First, the availability of performance information is often assumed, while it has been suggested that professionals may encounter difficulties in accessing performance indicators, as far as healthcare organizations are concerned (Jacobs, Marcon and Witt, 2004). Second, even though the increasing relevance of primary care settings, scant knowledge is available about the use of PMSs by primary care physicians and about the multidimensional nature of their individual performance (Silva and Ferreira, 2010). Third, a relevant, but uninvestigated, factor affecting the strategic consensus is the “line of sight” to an organization’s strategic objectives, i.e. the clear understanding of an organization’s objectives and how to contribute to them (Boswell, 2006).
This paper is aimed at analyzing the relationship between individuals’ use of performance measures, their line of sight, and individual multidimensional performance. In particular, we intend to respond to the following research question: How does individuals’ use of PMS affect their light of sight and, in turn, their individual performance? We collected data on 128 general practitioners belonging to one of the most relevant local health authorities (LHA) in the Italian NHS. We administered a survey questionnaire to collect data on individuals’ use of PMS, as well as about individual line of sight. We also collected secondary data on their individual performance. OLS and logistic regression results indicate that the use of PMS is significantly associated to the line of sight of single physicians. Moreover, we found that line of sight is in turn positively correlated with various dimensions (e.g. financial, clinical, and appropriateness) of physicians’ individual performance. In the conclusion of our article, we discuss our research findings and delineate a number of theoretical and managerial implications for researchers and healthcare administrators.
