Measure what you manage, manage what you measure
Target met; MRSA cases in the UK halved over three years. I wonder what lesson the people quoted a year ago, who were in full supply pontificating about how this shows that targets can't work and blah blah managerialism have drawn from this? Note the Tory spokesman accusing the government department responsible for this achievement of "moving the goalposts" by ... errr ... not talking about C difficile - ie, not moving the goalposts.
I'm no believer in the stumblingandmumbling school of "manageralism is the root of all evil" but I think it is fair to say that since C. Diff cases have tended to rise as manageralist targets have triumphantly driven MRSA down, then a formulation of a target for "sometimes deadly hospital originated, antibiotic resistant infections" might not only have been more honest, but also more beneficial to patients...
ReplyDeleteAnd that is the actual issue with targets, they are a blunt tool and this government seems to wield them with all the subtlety of Alex Ferguson criticising a referee.
What anonymous said. It's easy to bubble-push, hard to make sure that your targets really cover everything you care about, including the intangibles.
ReplyDeleteGiven that the real thing they are trying to manage is "public satisfaction with the NHS", why not have that as the one and only target? It famously worked for Enterprise car rental.
Targets can work if they're tightly focused, are not easily gamed and there aren't going to be unintentional negative side affects. This is pretty hard to achieve, particularly if you include incentives for cheating by incentivising performance. They can also have incredibly destructive affects on staff morale. These things and more have the government achieved with their incentives.
ReplyDeleteOn the MRSA thing - depends upon how its been achieved and at what cost. One way to reduce MRSA after all would be to close hospitals that have it...
"it is fair to say that since C. Diff cases have tended to rise as manageralist targets have triumphantly driven MRSA down"
ReplyDeleteCan you name a strategy for reducing MRSA rates that would have a negative (or even a zero) impact on c.diff rates? Cos I certainly can't think of one...