Background Both the concept of performance and the role of hospitals in health systems evolved si... more Background Both the concept of performance and the role of hospitals in health systems evolved significantly in the last decades. Today, the performance in health could be defined as the ability to create ‘population value,’ and the hospitals’ role is to support this aim by providing acute care and by integrating and coordinating their activity with other settings of care. This research aims to assess how and with what degree the management of public hospitals have embraced in practice the updated concept of performance and their new role. Result The paper analyses 181 performance plans of 48 Italian autonomous public hospitals over a nine-year period through the topic modeling algorithm called Latent Dirichlet Allocation (LDA). This is a method that allows for analysing large textual corpora that generates a representation of the latent topics discussed therein. The concept of performance in public hospitals was framed into 15 topics resulting from the analysis of the hospitals’ pe...
International Journal of Environmental Research and Public Health, 2020
Health systems face challenges which are inherent to care demand and supply evolution (i.e., demo... more Health systems face challenges which are inherent to care demand and supply evolution (i.e., demographic change, new technologies) or are the results of unexpected occurrence originating outside the health system, such as economic shocks or epidemic outbreaks. Both challenges often require a paradigm shift in governance and organization, financing and resource allocation, accountability frameworks, as well as public health system responses. Based on key reviews and seminal papers of performance management, public health, sustainability and resilience, the article presents three emerging challenges for performance management systems in healthcare: i) the inclusion of the population approach; ii) the measurement and consideration of the multi-facets concepts of value; iii) the importance of resilience and sustainability. Performance management systems need to evolve to cope with this changing scenario. The article sheds light on uncovered areas by performance management, and it propos...
International Journal of Environmental Research and Public Health, 2021
In the last decades, public management has been subjected to a shift from the New Public Manageme... more In the last decades, public management has been subjected to a shift from the New Public Management (NPM) paradigm to the Public Value Management (PVM) one. Thus, management practices such as Planning and Control (P&C) systems have been called to evolve accordingly. The health care sector has not escaped this process. This paper focuses on the evolution of hospitals’ P&C systems to support the paradigm shift from the NPM paradigm to the PVM one. In particular, the paper aims at exploring whether hospitals’ P&C systems in Italy evolved, or are evolving, consistently with PVM and what are the expected benefits related to such a paradigm switch. To address the research aim, the paper is based on a review of scientific and grey literature and the case study of the diabetic-foot pathway in an Italian Regional Healthcare System. The results of this study show that the current P&C systems in Italian hospitals are not yet designed to support the shift toward the PVM approach and are still m...
This chapter faces the methodological issues that characterize the development of strategic plann... more This chapter faces the methodological issues that characterize the development of strategic planning for urban transportation. In particular, the need to adopt a strategic management perspective is tackled through the development and combination of two theoretical approaches: performance management and system dynamics. The first is used to provide planners and decision makers with the tools to define, monitor, and pursue the urban area’s goals with regard to transportation. The second enables us to widen the boundaries of analysis in terms of time and space.
Em Itália, a crise económica e fiscal e a instabilidade política colocaram o sistema de saúde sob... more Em Itália, a crise económica e fiscal e a instabilidade política colocaram o sistema de saúde sob tensão durante o período de 2010-2014, durante o qual ocorreram diversas mudanças políticas. A intervenção governamental no sistema de nacional de saúde italiano assumiu a forma de decretos urgentes ou itens na lei do orçamento anual em vez de se terem realizado reformas sistemáticas e consistiu essencialmente em cortes em áreas específicas de despesas (recursos humanos, bens e serviços, medicamentos). Ao mesmo tempo, aumentaram as comparticipações dos doentes nos copagamentos das taxas moderadoras e medicamentos, aumentando a despesa privada com saúde. Por outro lado, o período político de 2015-2017 deixou mais espaço de manobra para o desenvolvimento de políticas reformistas de longo prazo, abordando aspetos do macrossistema (adequação e qualidade dos cuidados hospitalares e plano nacional contra a dor). Contudo, o desempenho em termos da proteção da saúde e qualidade dos cuidados mos...
In this paper we argue that the use of System Dynamics modelling applied to Business Model design... more In this paper we argue that the use of System Dynamics modelling applied to Business Model design and representation may result in an entrepreneurial learning approach to support potential entrepreneurs in exploring and learning how a business operates and reacts according to alternative strategic choices. As such, a Dynamic Business Modelling approach provides useful insights to start-up entrepreneurs learning processes by capturing and explaining how critical Business Model elements interact to produce enduring competitive advantages over time.
Purpose This paper aims to analyse how emerging technologies (ETs) impact on improving performanc... more Purpose This paper aims to analyse how emerging technologies (ETs) impact on improving performance in disaster management (DM) processes and, concretely, their impact on the performance according to the different phases of the DM cycle (preparedness, response, recovery and mitigation). Design/methodology/approach The methodology is based on a systematic review of the literature. Scopus, ProQuest, EBSCO and Web of Science were used as data sources, and an initial sample of 373 scientific articles was collected. After abstracts and full texts were read and refinements to the search were made, a final corpus of 69 publications was analysed using VOSviewer software for text mining and cluster visualisation. Findings The results highlight how ETs foster the preparedness and resilience of specific systems when dealing with different phases of the DM cycle. Simulation and disaster risk reduction are the fields of major relevance in the application of ETs to DM. Originality/value This paper...
This chapter discusses a key topic of strategic planning that is often under-evaluated by urban t... more This chapter discusses a key topic of strategic planning that is often under-evaluated by urban transportation planning studies: dealing with the institutional framework, stakeholders, and the community. The chapter presents and explains a tailored approach to stakeholder analysis and engagement in urban transportation planning processes. In particular, it discusses how Dynamic Performance Management may offer an instrumental solution to identify the key stakeholders of an urban transportation system, to make a diagnosis of the urban context, and to support policy development and the implementation phase through the development of performance measures.
Economic and fiscal crisis and political instability has put the Italian health system under stra... more Economic and fiscal crisis and political instability has put the Italian health system under strain during the 2010-2014 period that saw accelerated ongoing political changes. Government interventions in the Italian NHS have taken the form of either urgent decrees or measures in the annual state budget law rather than systematic reforms and have mostly consisted in caps on specific spending areas [1]. At the same time, higher co-payments for outpatient care and drugs have been introduced, adding to private spending on health. On the other hand, the 2015-2017 policy period provided more room for designing and developing long-term policy reform tackling macro-system aspects (appropriateness and quality of hospital care or national chronic care plan). However, performance in terms of health protection and quality of care has showed large variation across regions, mainly (but not exclusively) between the northern and southern regions. The worsening economic conditions had a negative ef...
This chapter provides an overview of the key aspects of urban transportation strategic planning. ... more This chapter provides an overview of the key aspects of urban transportation strategic planning. It outlines the “what,” “who,” and “how” of urban transportation planning, discussing the opportunities and challenges that characterize these processes. The key message that emerges is related to the need to adopt a strategic management perspective in the planning and management of urban transportation systems.
Building on the extant literature on business modelling and focussing on start-up firms, this art... more Building on the extant literature on business modelling and focussing on start-up firms, this article aims at exploring the combination between conventional business model schemes and System Dynamics methodology with the intent to overcome those limitations related to a static design approach. By mapping the multiple key elements underlying value creation processes – linked according to a cause-and-effect perspective – and with the support of a simulation-based methodology, entrepreneurs may experiment and understand how the firm reacts to strategic and organizational changes in terms of performance, innovation and value creation.
I servizi sanitari di prevenzione sono caratterizzati da un'elevata complessita principalment... more I servizi sanitari di prevenzione sono caratterizzati da un'elevata complessita principalmente legata al contesto inter-organizzativo e ambientale in cui operano. Da cio consegue una notevole difficolta nel misurarne e valutarne i risultati. Per tali motivi, il controllo e la gestione della performance delle attivita di prevenzione si avvalgono di diversi meccanismi, formali e informali, che hanno l'obiettivo di orientare i comportamenti e le decisioni degli individui e delle organizzazioni coinvolte verso fini comuni. Lo scopo del presente lavoro e quello di approfondire i sistemi di controllo e gestione della performance impiegati nei servizi di prevenzione che operano in contesti inter-organizzativi - e in particolare nell'ambito dei controlli frontalieri sugli alimenti - al fine di supportare il disegno e l'implementazione degli stessi. Per fare cio, la ricerca si concentra sui casi di studio delle infrastrutture portuali di Genova e Livorno. Parole chiave: preve...
Chronic diseases are the leading cause of disability and mortality in the world and represent a g... more Chronic diseases are the leading cause of disability and mortality in the world and represent a global health emergency due to the increase in frequency and complexity that has been occurring in recent years. The outcomes related to chronic care needs depend on the joint effort of a multi-provider, multi-disciplinary, and multi-professional service network, which operates along a clinical pathway. However, all the different players involved in the provision of services may have different interests and goals derived from their organizational structure and their role in the overall health system. This context of fragmented governance makes performance management of care services problematic. It requires the assessment of interorganizational relationships of the multiplicity of providers involved in the service delivery. This chapter aims to show how a dynamic performance-based perspective may effectively support chronic care management and help decision-makers focus on critical driver...
Food safety management (FSM) is a public health issue characterised by a high degree of ‘wickedne... more Food safety management (FSM) is a public health issue characterised by a high degree of ‘wickedness’ which requires the adoption of collaborative practices to align the interests and expectations o...
Purpose This study aims to systematically review the literature on the use of customer value for ... more Purpose This study aims to systematically review the literature on the use of customer value for the evaluation of inter-organizational performance, with a wide perspective embracing different contexts and settings. Design/methodology/approach Searching within the Scopus and ISI Web of Science databases, a systematic literature review has been conducted analyzing 41 papers published between 1991 and 2020. Findings Categorization of customer value and inter-organizational performance measures were developed and the main differences among different settings were discussed. Practical implications The results presented in this study may be helpful for practitioners and managers who, in the completion of their activities, have to maintain strong and frequent relationships with other organizations. In fact, practitioners and managers interested in enhancing customer value and measuring inter-organizational performance may find an innovative perspective linking the two dimensions. They cou...
International Journal of Environmental Research and Public Health
Co-production is an approach to designing, delivering, and evaluating public services through str... more Co-production is an approach to designing, delivering, and evaluating public services through strict collaboration among professionals and the people using services with an equal and reciprocal relationship. Health promotion initiatives that include education services rarely use the co-production approach. Nevertheless, the value of co-production is widely recognized, although it is considered a normative good, and scarce and mixed evidence is available in literature. The purpose of this paper is to provide evidence supporting the hypothesis that a co-production approach, applied to an intervention for preventing obesity, can be effective and efficient. To this end, an evaluation of the processes, outputs meant as intermediate results, and behavioral and economic outcomes of a public health-promotion initiative co-produced and co-delivered with adolescents (beFood) was conducted. Mixed methods were used, including field-observations, two self-reported questionnaires, and an opportun...
The productivity of medical staff within a polyclinic is not an easy task due to the multiple act... more The productivity of medical staff within a polyclinic is not an easy task due to the multiple activities that physicians must perform at the same time: not only healthcare for patients, but also academic activities, such as scientific research and teaching. Hybrid professionals are healthcare professionals who have to play multiple roles, often not precisely identified. This analysis examines the case study of the University Polyclinic of Messina (Italy) where three university departments and 7 Dipartimenti di Attivita Integrate (DAI) are distinguished and physicians (both professors and researchers) are called to reconcile multiple tasks. Given the distinction between university departments and DAIs, the aim of this contribution is to identify the organizational elements that prove to be predictors of scientific efficiency and productivity. To what extent does the inclusion in a DAI or within a university department affect individual incentives? A new dataset is built for the present research containing information on University Polyclinic of Messina physicians (full professors, associate professors, researchers). From the Scopus online database (https://www.scopus.com/home.uri) individual information relating to the number of publications, the number of citations, h-index was obtained. The latter is used to assess the quality of individual research; in order to evaluate the teaching activity, the number of hours dedicated to didactical activities is taken into account, together with the number of teaching hours required by one’s role. Information related to remuneration and the circumstance of carrying out intramural activities has also been included. A thorough statistical analysis is carried out and the individual groups (DAI and university departments) are compared through the Kruskal Wallis test. Estimating a Poisson Gamma mixture model highlights those variables that are significant predictors of scientific productivity. Attention paid to organizational methods should allow identifying the ideal setting for hybrid professionals to practice the medical profession, while carrying out managerial duties, without compromising the quality of teaching and research. An efficient solution could thus be proposed to the complex multi-objective optimization problem that healthcare professionals are called to answer.
System Dynamics for Performance Management & Governance
This chapter develops a general framework to analyze urban transportation dynamics. This allows p... more This chapter develops a general framework to analyze urban transportation dynamics. This allows planners and decision makers to model urban transportation system according to the instrumental view of performance and the feedback relationships that link the key modules to one another. These are: travel demand, transport supply, travel mode choice, the economy, and the population. Each module is analyzed in depth, and various examples are provided to explain the criteria that should be followed when adapting the general framework to the urban system analyzed.
Background Both the concept of performance and the role of hospitals in health systems evolved si... more Background Both the concept of performance and the role of hospitals in health systems evolved significantly in the last decades. Today, the performance in health could be defined as the ability to create ‘population value,’ and the hospitals’ role is to support this aim by providing acute care and by integrating and coordinating their activity with other settings of care. This research aims to assess how and with what degree the management of public hospitals have embraced in practice the updated concept of performance and their new role. Result The paper analyses 181 performance plans of 48 Italian autonomous public hospitals over a nine-year period through the topic modeling algorithm called Latent Dirichlet Allocation (LDA). This is a method that allows for analysing large textual corpora that generates a representation of the latent topics discussed therein. The concept of performance in public hospitals was framed into 15 topics resulting from the analysis of the hospitals’ pe...
International Journal of Environmental Research and Public Health, 2020
Health systems face challenges which are inherent to care demand and supply evolution (i.e., demo... more Health systems face challenges which are inherent to care demand and supply evolution (i.e., demographic change, new technologies) or are the results of unexpected occurrence originating outside the health system, such as economic shocks or epidemic outbreaks. Both challenges often require a paradigm shift in governance and organization, financing and resource allocation, accountability frameworks, as well as public health system responses. Based on key reviews and seminal papers of performance management, public health, sustainability and resilience, the article presents three emerging challenges for performance management systems in healthcare: i) the inclusion of the population approach; ii) the measurement and consideration of the multi-facets concepts of value; iii) the importance of resilience and sustainability. Performance management systems need to evolve to cope with this changing scenario. The article sheds light on uncovered areas by performance management, and it propos...
International Journal of Environmental Research and Public Health, 2021
In the last decades, public management has been subjected to a shift from the New Public Manageme... more In the last decades, public management has been subjected to a shift from the New Public Management (NPM) paradigm to the Public Value Management (PVM) one. Thus, management practices such as Planning and Control (P&C) systems have been called to evolve accordingly. The health care sector has not escaped this process. This paper focuses on the evolution of hospitals’ P&C systems to support the paradigm shift from the NPM paradigm to the PVM one. In particular, the paper aims at exploring whether hospitals’ P&C systems in Italy evolved, or are evolving, consistently with PVM and what are the expected benefits related to such a paradigm switch. To address the research aim, the paper is based on a review of scientific and grey literature and the case study of the diabetic-foot pathway in an Italian Regional Healthcare System. The results of this study show that the current P&C systems in Italian hospitals are not yet designed to support the shift toward the PVM approach and are still m...
This chapter faces the methodological issues that characterize the development of strategic plann... more This chapter faces the methodological issues that characterize the development of strategic planning for urban transportation. In particular, the need to adopt a strategic management perspective is tackled through the development and combination of two theoretical approaches: performance management and system dynamics. The first is used to provide planners and decision makers with the tools to define, monitor, and pursue the urban area’s goals with regard to transportation. The second enables us to widen the boundaries of analysis in terms of time and space.
Em Itália, a crise económica e fiscal e a instabilidade política colocaram o sistema de saúde sob... more Em Itália, a crise económica e fiscal e a instabilidade política colocaram o sistema de saúde sob tensão durante o período de 2010-2014, durante o qual ocorreram diversas mudanças políticas. A intervenção governamental no sistema de nacional de saúde italiano assumiu a forma de decretos urgentes ou itens na lei do orçamento anual em vez de se terem realizado reformas sistemáticas e consistiu essencialmente em cortes em áreas específicas de despesas (recursos humanos, bens e serviços, medicamentos). Ao mesmo tempo, aumentaram as comparticipações dos doentes nos copagamentos das taxas moderadoras e medicamentos, aumentando a despesa privada com saúde. Por outro lado, o período político de 2015-2017 deixou mais espaço de manobra para o desenvolvimento de políticas reformistas de longo prazo, abordando aspetos do macrossistema (adequação e qualidade dos cuidados hospitalares e plano nacional contra a dor). Contudo, o desempenho em termos da proteção da saúde e qualidade dos cuidados mos...
In this paper we argue that the use of System Dynamics modelling applied to Business Model design... more In this paper we argue that the use of System Dynamics modelling applied to Business Model design and representation may result in an entrepreneurial learning approach to support potential entrepreneurs in exploring and learning how a business operates and reacts according to alternative strategic choices. As such, a Dynamic Business Modelling approach provides useful insights to start-up entrepreneurs learning processes by capturing and explaining how critical Business Model elements interact to produce enduring competitive advantages over time.
Purpose This paper aims to analyse how emerging technologies (ETs) impact on improving performanc... more Purpose This paper aims to analyse how emerging technologies (ETs) impact on improving performance in disaster management (DM) processes and, concretely, their impact on the performance according to the different phases of the DM cycle (preparedness, response, recovery and mitigation). Design/methodology/approach The methodology is based on a systematic review of the literature. Scopus, ProQuest, EBSCO and Web of Science were used as data sources, and an initial sample of 373 scientific articles was collected. After abstracts and full texts were read and refinements to the search were made, a final corpus of 69 publications was analysed using VOSviewer software for text mining and cluster visualisation. Findings The results highlight how ETs foster the preparedness and resilience of specific systems when dealing with different phases of the DM cycle. Simulation and disaster risk reduction are the fields of major relevance in the application of ETs to DM. Originality/value This paper...
This chapter discusses a key topic of strategic planning that is often under-evaluated by urban t... more This chapter discusses a key topic of strategic planning that is often under-evaluated by urban transportation planning studies: dealing with the institutional framework, stakeholders, and the community. The chapter presents and explains a tailored approach to stakeholder analysis and engagement in urban transportation planning processes. In particular, it discusses how Dynamic Performance Management may offer an instrumental solution to identify the key stakeholders of an urban transportation system, to make a diagnosis of the urban context, and to support policy development and the implementation phase through the development of performance measures.
Economic and fiscal crisis and political instability has put the Italian health system under stra... more Economic and fiscal crisis and political instability has put the Italian health system under strain during the 2010-2014 period that saw accelerated ongoing political changes. Government interventions in the Italian NHS have taken the form of either urgent decrees or measures in the annual state budget law rather than systematic reforms and have mostly consisted in caps on specific spending areas [1]. At the same time, higher co-payments for outpatient care and drugs have been introduced, adding to private spending on health. On the other hand, the 2015-2017 policy period provided more room for designing and developing long-term policy reform tackling macro-system aspects (appropriateness and quality of hospital care or national chronic care plan). However, performance in terms of health protection and quality of care has showed large variation across regions, mainly (but not exclusively) between the northern and southern regions. The worsening economic conditions had a negative ef...
This chapter provides an overview of the key aspects of urban transportation strategic planning. ... more This chapter provides an overview of the key aspects of urban transportation strategic planning. It outlines the “what,” “who,” and “how” of urban transportation planning, discussing the opportunities and challenges that characterize these processes. The key message that emerges is related to the need to adopt a strategic management perspective in the planning and management of urban transportation systems.
Building on the extant literature on business modelling and focussing on start-up firms, this art... more Building on the extant literature on business modelling and focussing on start-up firms, this article aims at exploring the combination between conventional business model schemes and System Dynamics methodology with the intent to overcome those limitations related to a static design approach. By mapping the multiple key elements underlying value creation processes – linked according to a cause-and-effect perspective – and with the support of a simulation-based methodology, entrepreneurs may experiment and understand how the firm reacts to strategic and organizational changes in terms of performance, innovation and value creation.
I servizi sanitari di prevenzione sono caratterizzati da un'elevata complessita principalment... more I servizi sanitari di prevenzione sono caratterizzati da un'elevata complessita principalmente legata al contesto inter-organizzativo e ambientale in cui operano. Da cio consegue una notevole difficolta nel misurarne e valutarne i risultati. Per tali motivi, il controllo e la gestione della performance delle attivita di prevenzione si avvalgono di diversi meccanismi, formali e informali, che hanno l'obiettivo di orientare i comportamenti e le decisioni degli individui e delle organizzazioni coinvolte verso fini comuni. Lo scopo del presente lavoro e quello di approfondire i sistemi di controllo e gestione della performance impiegati nei servizi di prevenzione che operano in contesti inter-organizzativi - e in particolare nell'ambito dei controlli frontalieri sugli alimenti - al fine di supportare il disegno e l'implementazione degli stessi. Per fare cio, la ricerca si concentra sui casi di studio delle infrastrutture portuali di Genova e Livorno. Parole chiave: preve...
Chronic diseases are the leading cause of disability and mortality in the world and represent a g... more Chronic diseases are the leading cause of disability and mortality in the world and represent a global health emergency due to the increase in frequency and complexity that has been occurring in recent years. The outcomes related to chronic care needs depend on the joint effort of a multi-provider, multi-disciplinary, and multi-professional service network, which operates along a clinical pathway. However, all the different players involved in the provision of services may have different interests and goals derived from their organizational structure and their role in the overall health system. This context of fragmented governance makes performance management of care services problematic. It requires the assessment of interorganizational relationships of the multiplicity of providers involved in the service delivery. This chapter aims to show how a dynamic performance-based perspective may effectively support chronic care management and help decision-makers focus on critical driver...
Food safety management (FSM) is a public health issue characterised by a high degree of ‘wickedne... more Food safety management (FSM) is a public health issue characterised by a high degree of ‘wickedness’ which requires the adoption of collaborative practices to align the interests and expectations o...
Purpose This study aims to systematically review the literature on the use of customer value for ... more Purpose This study aims to systematically review the literature on the use of customer value for the evaluation of inter-organizational performance, with a wide perspective embracing different contexts and settings. Design/methodology/approach Searching within the Scopus and ISI Web of Science databases, a systematic literature review has been conducted analyzing 41 papers published between 1991 and 2020. Findings Categorization of customer value and inter-organizational performance measures were developed and the main differences among different settings were discussed. Practical implications The results presented in this study may be helpful for practitioners and managers who, in the completion of their activities, have to maintain strong and frequent relationships with other organizations. In fact, practitioners and managers interested in enhancing customer value and measuring inter-organizational performance may find an innovative perspective linking the two dimensions. They cou...
International Journal of Environmental Research and Public Health
Co-production is an approach to designing, delivering, and evaluating public services through str... more Co-production is an approach to designing, delivering, and evaluating public services through strict collaboration among professionals and the people using services with an equal and reciprocal relationship. Health promotion initiatives that include education services rarely use the co-production approach. Nevertheless, the value of co-production is widely recognized, although it is considered a normative good, and scarce and mixed evidence is available in literature. The purpose of this paper is to provide evidence supporting the hypothesis that a co-production approach, applied to an intervention for preventing obesity, can be effective and efficient. To this end, an evaluation of the processes, outputs meant as intermediate results, and behavioral and economic outcomes of a public health-promotion initiative co-produced and co-delivered with adolescents (beFood) was conducted. Mixed methods were used, including field-observations, two self-reported questionnaires, and an opportun...
The productivity of medical staff within a polyclinic is not an easy task due to the multiple act... more The productivity of medical staff within a polyclinic is not an easy task due to the multiple activities that physicians must perform at the same time: not only healthcare for patients, but also academic activities, such as scientific research and teaching. Hybrid professionals are healthcare professionals who have to play multiple roles, often not precisely identified. This analysis examines the case study of the University Polyclinic of Messina (Italy) where three university departments and 7 Dipartimenti di Attivita Integrate (DAI) are distinguished and physicians (both professors and researchers) are called to reconcile multiple tasks. Given the distinction between university departments and DAIs, the aim of this contribution is to identify the organizational elements that prove to be predictors of scientific efficiency and productivity. To what extent does the inclusion in a DAI or within a university department affect individual incentives? A new dataset is built for the present research containing information on University Polyclinic of Messina physicians (full professors, associate professors, researchers). From the Scopus online database (https://www.scopus.com/home.uri) individual information relating to the number of publications, the number of citations, h-index was obtained. The latter is used to assess the quality of individual research; in order to evaluate the teaching activity, the number of hours dedicated to didactical activities is taken into account, together with the number of teaching hours required by one’s role. Information related to remuneration and the circumstance of carrying out intramural activities has also been included. A thorough statistical analysis is carried out and the individual groups (DAI and university departments) are compared through the Kruskal Wallis test. Estimating a Poisson Gamma mixture model highlights those variables that are significant predictors of scientific productivity. Attention paid to organizational methods should allow identifying the ideal setting for hybrid professionals to practice the medical profession, while carrying out managerial duties, without compromising the quality of teaching and research. An efficient solution could thus be proposed to the complex multi-objective optimization problem that healthcare professionals are called to answer.
System Dynamics for Performance Management & Governance
This chapter develops a general framework to analyze urban transportation dynamics. This allows p... more This chapter develops a general framework to analyze urban transportation dynamics. This allows planners and decision makers to model urban transportation system according to the instrumental view of performance and the feedback relationships that link the key modules to one another. These are: travel demand, transport supply, travel mode choice, the economy, and the population. Each module is analyzed in depth, and various examples are provided to explain the criteria that should be followed when adapting the general framework to the urban system analyzed.
Stakeholder engagement is well recognized to be critical to the success of local strategic planni... more Stakeholder engagement is well recognized to be critical to the success of local strategic planning. A strategic plan aims at identifying skills and resources of an urban area and tries to coordinate these towards the realization of common goals. However, local resources and skills are rarely managed by the same actor. When drafting a strategic plan, at first, the promoter of the planning activity faces the challenge of both identifying the key actors holding the strategic resources of the local area, and coordinating their contribution in a Performance Management perspective. A second issue is then related to the need of enabling the wider community with the right tools to participate to the planning process in a proactive way. This paper, through the deepening of three case studies, aims at providing new managerial implications for planners dealing with complex urban contexts where a multiplicity of actors is involved.
Urban mobility is characterized by an intrinsic complexity. Due to that, when designing and imple... more Urban mobility is characterized by an intrinsic complexity. Due to that, when designing and implementing solutions to improve transportation systems performance, policy makers often run into 'wicked' issues. These issues are hard to define and manage because they often lead to counterintuitive behaviours when actions are taken to resolve them. In order to deal with such kind of issues, this paper suggests an innovative approach to plan mobility in urban complex environments. This approach is based on Performance Management theory and System Dynamics modelling. A case study based on an urban area in Argentina is developed and results are discussed.
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