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Purpose

In the last few decades, the effectiveness of the evaluation of human resources and their performances has become a crucial theme in the debates of the public sector. The purpose of this paper is to analyze key design characteristics of performance management system (PMS) that may be effectively adopted and deployed by management to enable the assessment for a health system improvement.

Design/methodology/approach

This paper falls under the field of studies that focuses on the design and implementation of PMS in the healthcare sector. This research adopted a qualitative approach across the case study method to understand the role of different contextual factors and their impact upon the design of PMS. Mainly drawing on previous studies on the Italian regional health systems, a target region has been selected for these purposes.

Findings

As a result, the new PMS was effectively working and was structured with a balanced focus on the region and the single healthcare organizations. The need for improving the information systems within the healthcare organizations was strongly emphasized. The crucial element of the new PMS was the transparency about the assessment procedures.

Originality/value

This paper contributes to the debate on factors that can influence the design of PMS in healthcare. Relying on a contingent approach, the authors put forward the need of a more comprehensive and integrated frameworks encompassing organic conception of PMSs, as well as of the interdependencies among their components.

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