Chapter 14 – Operational Performance Measurement: Sales, Direct-Cost Variances, and The Role of
Nonfinancial Performance Measures
X14-53Research Assignment: Service-Based Innovation; Strategy (45-60 minutes)
1. Chapter 14 covers (among other topics) the control of labor and raw material
resource inputs to the manufacturing process. Traditional financial control systems for
these resource inputs consist of the use of standard costs, flexible budgets, and end-of-
period standard cost variance analyses (for example, for price/rate and
quantity/efficiency components of an overall cost variance). At the end of the chapter
the discussion is expanded to make the point that operational control extends beyond
short-term financial control to include a focus on business (including operating)
processes. In this context the importance of non-financial performance
indicators/measures is discussed. The assigned article looks at a method that has been
used successfully to improve operating processes in the health-care sector. As such, it
relates directly to the material covered at the end of Chapter 14. Students should find
the discussion interesting both because of the non-manufacturing context of the
discussion and because, at a macro level, the article deals with a method that if widely
used could improve health-care practice. The latter point is particularly important given
the current health care debate in the U.S.
2. Kaiser Permanente (KP) (www.kaiserpermanente.org/) is one of the nation’s largest
not-for-profit health plans, serving more than 8.8 million members, with headquarters in
Oakland, CA. Innovation Consultancy comprises a small group of
individuals(“innovation specialists”) within KP whose function it is to help develop better,
more efficient ways of performing activities related to the health-care delivery process.
(Go to http://xnet.kp.org/newscenter/opexcellence/2010/081810hbr.html for additional
information.) Innovation Consultancy uses what the unit calls “human-centered design”
or “design thinking” to address operational issues in health-care delivery.) In some
respects, this approach parallels the industrial engineering approach (“time-and-motion
studies”) used in the development of labor standards in a manufacturing context. By
contrast, however, Innovation Consultancy focuses on operating process improvements,
not time-based labor-hour specifications. Specific projects assumed recently by
Innovation Consultancy relate to medication administration error (MedRite), nurse shift
handoff (Nurse Knowledge Exchange), and pain management (Painscape). (See part 4,
below.)
3. Design thinking (or, “human-centered design”) is the term used for the research
methodology used by KP to develop improvements in operating activities/processes
associated with the health-care delivery process. In this method, the consultants work
with nurses (i.e., frontline staff) and patients as collaborators to develop process
innovations to what can be viewed as universal problems in health care (such as the
three problems listed above in part 2). Design thinking is a particularly useful innovation
tool because it brings both health care providers and patients together into the process
to design solutions that result in patient-centric care. Team members observe how
health care providers interact with one another, with patients, with technology, and how
patients respond. To learn more about how Kaiser Permanente’s Innovation
Consultancy has used design thinking, please go to:
http://xnet.kp.org/innovationconsultancy/.
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Education.