Human Resource Management (HRM) is widely believed to have a positive effect on the performance of company. However, empirical proof of this is hard to come by. In this study, we try to establish a linkage between HRM and financial output of two case studies in the profit sector. To do this, we have developed a performance measurement system that is tailored to the specific needs of measuring HRM-performance in for-profit of company. Although we do not try to generalize the outcome of this study, it looks promising in the way that more case studies should be conducted using this specific performance measurement system. If nothing else, management and controllers could use the system to evaluate the performance of their HRM-tools.
Background: A quality improvement collaborative is an intensive project involving a combination of implementation strategies applied in a limited “breakthrough” time window. After an implementation project, it is generally difficult to sustain its success. In the current study, sustainability was described as maintaining an implemented innovation and its benefits over a longer period of time after the implementation project has ended. The aim of the study was to explore potentially promising strategies for sustaining the Enhanced Recovery After Surgery (ERAS) programme in colonic surgery as perceived by professionals, three to six years after the hospital had successfully finished a quality improvement collaborative. Methods: A qualitative case study was performed to identify promising strategies to sustain key outcome variables related to the ERAS programme in terms of adherence, time needed for functional recovery and hospital length of stay (LOS), as achieved immediately after implementation. Ten hospitals were selected which had successfully implemented the ERAS programme in colonic surgery (2006–2009), with success defined as a median LOS of 6 days or less and protocol adherence rates above 70%. Fourteen semi-structured interviews were held with eighteen key participants of the care process three to six years after implementation, starting with the project leader in every hospital. The interviews started by confronting them with the level of sustained implementation results. A direct content analysis with an inductive coding approach was used to identify promising strategies. The mean duration of the interviews was 37 minutes (min 26 minutes – max 51 minutes). Results: The current study revealed strategies targeting professionals and the organisation. They comprised internal audit and feedback on outcomes, small-scale educational booster meetings, reminders, changing the physical structure of the organisation, changing the care process, making work agreements and delegating responsibility, and involving a coordinator. A multifaceted self-driven promising strategy was applied in most hospitals, and in most hospitals promising strategies were suggested to sustain the ERAS programme. Conclusions: Joining a quality improvement collaborative may not be enough to achieve long-term normalisation of transformed care, and additional investments may be needed. The findings suggest that certain post-implementation strategies are valuable in sustaining implementation successes achieved after joining a quality improvement collaborative.
Incentives are frequently used by governments and employers to encourage cooperation. Here, we investigated the effect of centralized incentives on cooperation, firstly in a behavioral study and then replicated in a subsequent neuroimaging (fMRI) study. In both studies, participants completed a novel version of the Public Goods Game, including experimental conditions in which the administration of centralized incentives was probabilistic and incentives were either of a financial or social nature. Behavioral results showed that the prospect of potentially receiving financial and social incentives significantly increased cooperation, with financial incentives yielding the strongest effect. Neuroimaging results showed that activation in the bilateral lateral orbitofrontal cortex and precuneus increased when participants were informed that incentives would be absent versus when they were present. Furthermore, activation in the medial orbitofrontal cortex increased when participants would potentially receive a social versus a financial incentive. These results speak to the efficacy of different types of centralized incentives in increasing cooperative behavior, and they show that incentives directly impact the neural mechanisms underlying cooperation.
