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Le case della salute all’interno dei nuclei di cure primarie: efficacia del processo di cambiamento organizzativo

Il processo di sviluppo manageriale delle cure primarie ha conosciuto, negli ultimi anni, una significativa accelerazione anche all’interno del nostro Paese, specie in alcune realtà regionali. In questo mutato scenario sono divenuti particolarmente importanti gli strumenti di governo della medicina generale e si è, in un certo senso, intensificata l’esigenza di individuare gli elementi maggiormente efficaci, capaci di supportare detto cambiamento. Il presente lavoro si pone l’obiettivo di discutere se, e in che misura, i diversi strumenti gestionali adottati, impattino sulla capacità dell’azienda di raggiungere risultati in termini di efficacia, inserendosi nella prospettiva di analisi più ampia, ovvero analizzare come le cure primarie abbiano influito sulle performance delle singole aziende sanitarie coinvolte nel processo di cambiamento. La ricerca analizza cinque casi ritenuti significativi all’interno di un contesto regionale nel quale la medicina di base, gestita attraverso nuclei di cure primarie che si attivano con l’apertura di case della salute, ha sicuramente avuto una rilevanza non trascurabile. Il contributo si articola in una prima parte all’interno della quale si propone una contestualizzazione nell’ambito della principale letteratura di riferimento; una seconda parte nella quale si presentano le realtà analizzate e si propone la descrizione, all’interno di ognuna, dei fattori gestionali scelti a supporto del cambiamento; una terza parte nella quale, invece, si individuano quelli che possono essere alcuni importanti indicatori prestazionali cercando di spiegare e motivare la relazione esistente tra di loro ed i fattori di cui al punto procedente; un’ultima parte, infine, nella quale si cerca di addivenire a qualche importante conclusione proponendo poi possibili sviluppi futuri alla ricerca stessa. […]

Key – words: Aziende Sanitarie

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L’impiego dei costi standard per la valutazione delle prestazioni ospedaliere: alcune riflessioni sulle percezioni dei medici

A seguito dell’introduzione del sistema di rimborso mediante DRG l’utilizzo dei costi standard nella gestione delle aziende ospedaliere è divenuto uno strumento imprescindibile. Attraverso l’analisi di 81 questionari, compilati dai medici ospedalieri della regione Puglia, il presente studio esamina i benefici e i limiti derivanti dall’utilizzo dei costi standard, sia come sistema di controllo, per rispettare i limiti delle tariffe stabilite dai DRG, sia come strumento manageriale per il monitoraggio e la valutazione dell’attività dei singoli operatori. Le prime evidenze empiriche dimostrano che i medici riconoscono la validità dei costi standard per il raggiungimento degli obiettivi di efficienza ed efficacia delle aziende ospedaliere, anche se mostrano perplessità sull’utilizzo dei DRG per la valutazione delle loro prestazioni. Probabilmente, ciò è dovuto alla scarsa conoscenza delle logiche manageriali, le cui dinamiche sfuggono al loro modus operandi. I Dirigenti e i Responsabili di struttura, più consapevoli delle implicazioni dell’impiego dei costi standard, valutano, infatti, positivamente il loro utilizzo anche per il monitoraggio e la valutazione della performance dei singoli medici.

Key – words: Aziende Sanitarie

 

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Trends and tools for performance measurement in the healthcare sector

This article takes into consideration the new needs and the changes of the healthcare and the performance measurement tools. The research question is: do they fit? Are performance measurement tools coherent with the changes that are taking place in the healthcare sector? The conclusions are that Performance measurement tools are from the 1990s and they do not fit the needs of the 21st century patients any more.

Key-Words: Health and care organizations,  Performance Measurement, new needs, effectiveness

 

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Il processo di budget e l’interiorizzazione dei valori: il caso di un ospedale italiano

Il budget è tipicamente considerato uno strumento di controllo formale. Esso tuttavia incorpora valori aziendali e strategici che, se interiorizzati, favorirebbero sia la realizzazione degli obiettivi di budget sia il percorso strategico dell’azienda. Il paper studia, integrando letteratura di management accounting e letteratura relativa alla self-determination theory, un caso aziendale di un’azienda ospedaliera che, nel corso del tempo, ha introdotto meccanismi e strumenti di coinvolgimento e integrazione in un’ottica di allineamento degli obiettivi individuali rispetto ai valori aziendali. L’analisi evidenzia le criticità del settore sanitario, ma offre anche spunti sia ai practitioner sia agli studiosi che vogliano meglio comprendere i meccanismi di interiorizzazione dei valori aziendali.

Key-Words: Aziende sanitarie

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L’evoluzione del Project financing da “all inclusive” a “light”: analisi empirica nel contesto italiano

Gli interventi di edilizia sanitaria si collocano tra le opere a diretta utilizzazione da parte della P.A. con la previsione di tariffe/canoni verso le Aziende Sanitarie per i servizi connessi alla disponibilità ed alla gestione dell’opera, nonché per tutti gli altri servizi “no core” strumentali all’esercizio dell’attività sanitaria, resi dal concessionario (Falini A., 2008). Il soggetto privato, dunque, interviene nella costruzione della struttura ospedaliera e nella gestione dei servizi “no core” di supporto all’attività sanitaria, ad eccezione delle prestazioni mediche e delle attività di assistenza al paziente (c.d. servizi “core” che sono di stretta competenza dell’Azienda Sanitaria, in quanto trattasi di attività accreditate e riservate per legge a determinati soggetti). Assume la gestione dei servizi alberghieri e di quelli ospedalieri non medicali, consistenti nella manutenzione ordinaria e straordinaria dell’edificio, nei servizi alberghieri ed ospedalieri generali, nella pulizia del servizio di mensa ed eventualmente anche nella manutenzione delle attrezzature specialistiche di reparto (sale operatorie, radiologia, etc.). A tali servizi viene affiancata, secondo volumi e modalità differenti nei singoli casi, anche la gestione di spazi commerciali ricavabili nella struttura (Osservatorio Finlombarda, 2008). In effetti, nel caso di nuovi ospedali, la moderna concezione architettonica e progettuale prevede lo sviluppo della struttura intorno ad una “street”, un asse di comunicazione che ha la funzione di facilitare la mobilità degli utenti all’interno dell’ospedale ed eventualmente un inserimento nella viabilità esterna all’ospedale. In tale contesto è facile ricavare alcuni spazi commerciali gestiti dal concessionario, previo accordo con il concedente, normalmente mediante l’istituto della locazione. […]

Key-Words: Rapporti pubblico-privato

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The implementation of clinical risk management in Italy: a case study

The growth of health care costs as regards GDP and public expenditure in all countries reflects, on the one hand, the growth of health demand probably due to the change in the global epidemiological landscape and, on the other hand, a steady rise in health costs, significantly influencing the sustainability of the world health system. The international scientific literature and the laws of several countries have recently focused on treatment safety, with a growing interest in the issue of risk management and control in public health firms, aiming to curb costs and improve treatment outcome. In the healthcare organization clinical risk management (CRM) is a particular model of risk management. By concentrating on the clinical process it can be identified with the set of procedures, instruments and specific activities the staff refers to in order to identify, analyze, manage and stem the risks which are potentially dangerous for the general organization and to preserve the original standards in quality and safety.The clinical risk can be defined as the chance a patient has of falling victim to an adverse event. Therefore, the typical risk profile healthcare companies deal with fall into a specific category of pure risks, i.e., those responsibility-risks ensuing adverse events caused by clinical errors. This research aims: (i) to investigate how clinical risk management is implemented in Italian healthcare organizations; (ii) to understand whether the adoption of a new systematic approach, such as lean management, can affect on risk management processes. The research method to be used is the case study.

Key-Words: Health and care organizations, clinical risk management, lean management, care processes, healthcare organization, kaizen, business model

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Making performance measurement effective: from Knaves to Knights through the managerial approach

 

In healthcare the concept of value have been defined in different ways, however most commonly this involves the degree to which services are delivered effectively (higher quality) and efficiently (lower total cost of care). Health policies, mirroring this perspective, aim both at controlling public expenses, and at improving the quality of care, often through the development of frameworks for performance measurement (PM). Through PM frameworks, policy-makers set performance indicators and the associated targets for the achievement of healthcare improvement goals, and this allows the definition and setting of priorities, it expresses a commitment to achieve specified objective in a defined period, and it helps to monitor their progress (Smith et al 2009). This implies that the frameworks of PM are effective when they are able to promote the implementation of health policies, creating high-level political and administrative commitment to particular results, and providing a basis for follow up and evaluation (Smith et al 2009). However, a large part of literature demonstrates that healthcare organizations and professionals perceived the evaluation process as an exogenous, time-consuming, and potentially damaging exercise, and they often react through gaming behaviours, compromising the performance measurement effectiveness. The aim of this short paper is to contribute to the debate on the effective design and implementation of performance measurement system at governance level, with a specific focus on the healthcare sector. In particular, we propose a theoretical interpretation of the barriers affecting such initiatives – namely the implicit adoption of the agency theory assumptions –, and we propose the adoption of the pragmatic approach of management studies to overcome these obstacles. […]

Key-Words: Misurazione e valutazione delle performance

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Evidence-based policy making: the case of Sardinian patients mobility for hospital treatments

“Patients mobility” is a well-known and widespread phenomenon of increasingly importance both in Europe and worldwide. In Europe it has been regulated since the Seventies to allow people temporarily abroad to get treatments to be funded by their home healthcare systems (Legido-Quigley et al, 2007). Later, in the Nineties the European Court of Justice expanded the possibility for citizens to receive needed treatments in member states, even without authorization from the home country and quite recently the Directive 2011/24/EU allows European citizens the right to choose among health care providers across all member states (Brekke et al, 2014). Similarly, in the US citizens travel to get access to higher quality treatments (Laugesen & Vargas-Bustamente, 2010). Even within single countries there may be patients mobility. This happens wherever the national health system is organized on regional basis and there are “patient choice” policies in place so that a single citizen can choose where to receive the treatment freely. Italy perfectly fits such model and several studies have been conducted on Italian data (i.e. Agenas, 2012). Patient mobility has been widely studied both by scholars of Economics and Healthcare: the formers are interested mainly in understanding reasons and economic consequences of citizens’ search for healthcare services in different places from where they live (Glinos et al, 2012; Levaggi & Zanola, 2004; Cantarero, 2006; Glinos et al, 2010). As a matter of fact, mobility generates a flux of resources moving in the opposite direction of patients in order to reimburse the organizations providing the treatments for non-residents. […]

Key-Words: Aziende sanitarie

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Medical managers’ managerial self-efficacy and role clarity: how do they bridge the budgetary participation –performance link?

The introduction of New Public Management inspired reforms in healthcare has encountered the resistance of many healthcare professionals who perceived the managerial approach to healthcare as a challenge to their professional culture, legitimacy, autonomy, and power (see, for example, 1, 2). The emergence of professional hybrids, such as medical managers in healthcare, i.e. individuals with a professional education and background who enter managerial roles was expected to avoid clashes between managerial and professional demands and reduce resistance to a more “managerial thinking” by healthcare professionals (e.g.: 4,5,6). Despite their potentially pivotal role in addressing professional resistance to managerialism, medical doctors entering hybrid roles might experience organizational-professional conflicts, i.e. an inconsistency experienced by employed professionals between the requirements of their employer and those of their vocation (7). Such an inconsistency experienced by professionals in the requirements of their employer and those of their vocation might have significant effects on hospital performance, in which quality-oriented objectives and economic-oriented objectives should be balanced in order to satisfy stakeholders. Although hybrid roles in healthcare have increasingly attracted a great deal of political and research interest (4, 3) and a body of research has already focused on professional identity and role conflict experienced by clinicians entering managerial positions how conflicts associated with hybrid roles could be overcome still remains unclear. […]

Key-Words: Aziende sanitarie

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The validity in hospitals’ performance planning

The present research aims to discuss the theoretical conditions for validity in performance planning in hospitals.  In doing so, the research draws on a new emerging research paradigm, called Pragmatic Constructivism (Nørreklitet al., 2010). It conceives accounting as a social reality constructed through the integration of four ontological dimensions: facts, possibilities, values and communication.  The conditions for validity in performance planning in hospitals are examined drawing on Nørreklit et al. (2007), specifically we investigate theoretical conditions for validity in accounting performance measurement, analysing the ontological and epistemological nature of accounting data. The theoretical framework is applied to interpret the empirical evidence coming from a case of an Italian hospital located in the south of Italy. The empirical results showed how the theoretical framework helps to better understand the validity in performance planning in hospitals: the validity of knowledge of past results is examined by verifying the correspondence of performance measures with the past activity of the hospital; while the validity of the estimations of future results is analysed by verifying their coherence and consistency.

Key-Words: Health and care organizations

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PMSs and health policy choices. The need for a health technology balanced assessment framework

Commonly used as the multidisciplinary evaluation pathway of technical innovations in the health sector, Health Technology Assessment (HTA) represents the process which supports decision makers in order to obtaining the best achievements among all the possible intervention alternatives in healthcare. Biomedical engineers and clinicians usually run this process, considering mainly clinical and economic perspectives; thus, its main limit regards the lack of managerial competences in supporting the decision-making process at the base of the managing of a health organization’s performance. Accordingly, it is argued in this paper that a comprehensive performance management (PM) framework can help to design a multilevel process for the evaluation of health technologies (HTs) that combines different evaluation perspectives of business performance (both financial and no financial ones) with the clinical and ethical assessment needs of a hospital institution. More precisely, after the comprehension of the main features of the hospital-based HTA model and its potential implication with the management control activities in resources consumption, PMS framework (included those tool with a diagnostic and interactive use in management) will be used as the conceptual foundation for the development of the main argument. As a result, the Health Technology Balanced Assessment (HTBA) conceptual framework is presented and discussed. To this end, the strategic and measurement potentialities of PM are contrasted with the managerial needs of HTA, by drawing on the existing literature on the broad theme. Based on different choices for different perspectives and on the definition of appropriate key performance indicators (KPIs) for a structured assessment pathway, HTBA should bring: 1) a reduction in decision makers’ potentially misleading behaviours (related to external influences and pressures); and 2) a better multilevel balanced evaluation of HT; 3) a more structured pathway in coherence with the organization’s mission, context and values.

Key-Words: Health and care organizations, Performance Management (PM), Performance Management System (PMS), Health Technology Assessment (HTA), Health Technology (HT), Health Policy

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L’introduzione di un sistema di prezzi di trasferimento per i servizi offerti dal Dipartimento di Anestesia e Rianimazione nell’AOU Pisana

Le strutture ospedaliere si configurano come organizzazioni collaborative, nelle quali, all’elevato livello di integrazione verticale e di diversificazione, si associa una forte complessità organizzativa che molto spesso, il sistema di rilevazione interno fatica a descrivere nel suo funzionamento coordinato. All’interno di questo tipo di organizzazioni, a causa delle modalità con cui il servizio viene reso, che implica la partecipazione di più unità organizzative, si verificano intensi scambi interni di beni e servizi tra i centri di responsabilità, la tecnica dei prezzi di trasferimento può assumere rilevanza strategica a fini conoscitivi sia per quantificare i costi dei servizi intermedi, in modo da determinare un costo pieno del servizio quanto più possibile aderente al rispetto del principio funzionale, sia per promuovere comportamenti organizzativi coerenti con l’ottenimento del servizio e con l’utilizzo adeguato delle risorse. La riduzione costante delle risorse disponibili e le crescenti misure regionali di contenimento di alcune voci di spesa, imposte dalle direttive nazionali e regionali nel triennio 2013-2015, hanno imposto alle aziende sanitarie, e quindi anche all’ Azienda Ospedaliero Universitaria Pisana (AOUP), l’introduzione di meccanismi stringenti di controllo dei costi. In un contesto a risorse incerte e vincolate, la volontà di sostenere la mission aziendale ha indotto il management a ricercare misure in grado di esplicare la propria efficacia in maniera durevole e nel lungo periodo, restituendo consapevolezza alle politiche operative e contrastando al contempo la convinzione distorta che i sistemi contabili possano agire in modo distaccato o autonomo dall’operatività aziendale. […]

Key – words: Aziende sanitarie

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Sommario IX Sezione

Convegno Sidrea 2016

IX Sezione – Amministrazioni Pubbliche

Sommario Volume Elettronico – ISBN 978-88-917-3660-4

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Luca Anselmi

Introduzione

p. 5
Maura Campra, Paolo Esposito, Paolo Ricci

Il governo e il controllo dell’integrità pubblica per la creazione di valore: consonanze e dissonanze strategiche e gestionali

» 7
Arianna Rosi

Il pay for performance nelle Utilities italiane. Un’analisi esplorativa dei sistemi retributivi del top management

» 27
Alessia Patuelli

L’autorità di regolazione dei trasporti in Italia: primi effetti nel trasporto ferroviario passeggeri

» 47
Laura Broccardo, Francesca Culasso, Elisa Giacosa, Giuseppe Grossi, Elisa Truant

Innovation and smart city projects. Explorative analysis of italian municipalities

» 61
Vincenzo Sforza, Riccardo Cimini

National and governmental accounting in EU member states. A temporal study

» 69
Eleonora Cardillo, Daniela Ruggeri

Performance Measurement innovations in the organizational routines: theoretical insight and empirical evidences from an italian local government

» 87
Paolo Biancone, Silvana Secinaro, Valerio Brescia

The Popular Financial Reporting as tool of transparency and accountability

» 109
Vincenzo Vigneri, Angelo Guerrera, Giovanni Scirè

Tourism Governance at Stake: supporting decision makers in a small town through an Interactive Learning Environment

» 127

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Ulteriori paper presentati al Convegno Sidrea 2016

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Luca Ferri, Clelia Fiondella, Marco Maffei, Rosanna Spano’

Corruption prevention and reporting. Legitimacy concerns in the Italian Regional Governments

Alessandro Spano, Benedetta Bello’

The (in)dependence of public managers from politicians in public sector organizations: a comparative research

Elena Gori, Alberto Romolini, Silvia Fissi

The local authorities’ role in disseminating gender equality. Evidence from Italy

Giacomo Manetti, Marco Bellucci, Luca Bagnoli

The management of the plague in Florence at the beginning of Renaissance: the role of the partnership between the Republic and the Confraternita of Misericordia

Lucia Biondi, Anita Masi

The Result of Administration and the Fiscal Year Result:Evidence from the Accounting Experimentation in Italian Local Authorities

Anita Masi

Accounting and mathematical models for the management of public resources in a spendig review context

Carlotta Del Sordo, Rebecca Orelli, Emanuele Padovani, Marco Tieghi

Higher Education Reform in Italy: Results of Accounting Change by Law

Vania Palmieri

Cutback management in Italian Territorial Entities: main approaches and HRs cost-cutting strategies impact

 

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Il governo e il controllo dell’integrita’ pubblica per la creazione di valore: consonanze e dissonanze strategiche e gestionali

Il presente contributo si caratterizza per il tentativo di osservare ed analizzare la capacità dei modelli e degli strumenti di performance measurement (Bovaird T. 2003; Holzer M., Yang K., 2004; Borgonovi E., 2008; Bianchi C., 2013), nell’attività di emersione e concorso alla produzione e alla generazione del valore pubblico (Benington J. 2009, Benington J., Moore M., 2011), con particolare riferimento all’integrità pubblica, e all’ azione svolta dall’Autorità Nazionale Anticorruzione (ANAC),  nell’attività di prevenzione e fronteggiamento del rischio aziendale della corruzione e contestuale distruzione di valore pubblico (Esposito P., Ricci P., 2015).

Key-Words: Amministrazioni pubbliche, valore pubblico, disvalore pubblico, corruzione, ANAC, performance measurement

Box 2

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Il pay for performance nelle utilities italiane. Un’analisi esplorativa dei sistemi retributivi del top management

Il settore dei servizi pubblici locali è stato interessato, negli ultimi decenni, da profondi cambiamenti che hanno portato a un ripensamento delle logiche manageriali delle imprese affidatarie dei singoli servizi. Si tratta di aziende chiamate a misurarsi con le attese di una vasta serie di stakeholder e che, di conseguenza, devono tenere in considerazione non solo i classici obiettivi di tipo economico-finanziario, ma anche altri maggiormente legati alla qualità dei servizi e all’impatto sulla qualità della vita e sullo sviluppo del territorio (Badia et al. 2005). Il tema dei diversi assetti proprietari possibili (a partecipazione totalmente pubblica, a capitale misto con prevalenza pubblica o privata, oppure a capitale interamente privato) per tali società di gestione ha da tempo suscitato un intenso dibattito tra studiosi di diverse materie circa i vantaggi e le criticità delle varie opzioni (Grossi e Reichard 2008, Elefanti e Cerrato 2009, Ricci e Landi 2009, Cafferata 2010, Fici 2010, Romano et al. 2013, Fissi et al. 2013, Monteduro 2014, Geroldi 2014, Romano e Guerrini 2014). In assetti di mercato in cui la domanda è data, la presenza del pubblico può contribuire a rendere il gestore più attento ad aspetti poco remunerativi che, se trascurati, nel lungo periodo, comporterebbero il manifestarsi di “perdite di valore” per la collettività (si pensi, ad esempio, agli investimenti per la manutenzione o il potenziamento delle reti e delle infrastrutture per l’erogazione del servizio, all’impatto sui livelli di inquinamento, alla fornitura di aree o clienti marginali, ecc.). In fondo anche il noto esito del “referendum sull’acqua pubblica” svoltosi nel 2011 nel nostro Paese può essere letto in questa prospettiva. […]

Key-Words: Amministrazioni Pubbliche

Tab. 1 – Le attività esercitate e il profilo societario

Tab. 3- Il pay mix dei Presidenti e degli AD (anno 2015)

Tab. 4 – La componente variabile della retribuzione nelle politiche attuali, sintesi .

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L’Autorità di regolazione dei trasporti in Italia: primi effetti nel trasporto ferroviario passeggeri

Tra le autorità di regolazione più antiche nel nostro Paese, un esempio fondamentale è quello della Banca d’Italia, fondata nel 1893 e oggi finalizzata a garantire la stabilità della moneta e del sistema creditizio. La Consob, istituita nel 1974, rappresenta invece l’autorità di regolazione degli andamenti borsistici. Altri esempi di autorità di regolazione dei mercati sono l’Isvap, fondata nel 1982 e riguardante il settore assicurativo, il Garante per l’editoria del 1981, l’Autorità garante della concorrenza e del mercato (Agcm) del 1990, l’Autorità per l’energia elettrica e il gas (AEEG), istituita nel 1995, e l’Autorità per le garanzie nelle comunicazioni (AGCOM), istituita nel 1997 (Clarich, 2005; Merusi & Passaro, 2003). A livello europeo, l’Autorità in campo ferroviario è l’ERA (European Railway Agency), fondata nel 2004, a seguito dell’approvazione del Regolamento n. 881/2004, destinata a “elaborare soluzioni comuni in materia di sicurezza e di interoperabilità ferroviaria” e con il compito di sviluppare una network ferroviario integrato a livello europeo, con i medesimi alti standard di funzionamento e sicurezza,  finalizzato all’incremento della concorrenza e della qualità dei servizi di trasporto. Operativa dal 1 maggio 2006, l’Agenzia ha contribuito a sviluppare specifiche tecniche e di sicurezza comuni, collaborando con aziende ferroviarie e istituzioni nazionali ed europee. […]

Key-Words: Amministrazioni Pubbliche

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Innovation and smart city projects. Explorative analysis of Italian municipalities

 This work focuses on the smart city concept and on the main measures that can be undertaken at local level to support the development of Italian cities, in a smart perspective. This is a working paper that aims to understand how a city can facilitate the sustainability of its social, economic and technological environment, to ensure significant improvements for the quality of life of its inhabitants. The research methodology is based on a qualitative approach, using the case study of the City of Turin.

Key-Words: Public Sector Administration, smart city, Italian cities, innovation processes, business management, strategic planning

 

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National and governmental accounting in EU Member States. A temporal study

This paper aims at showing that the divergences (adjustments) between the measures of debt in national (net borrowing lending, NBL) and governmental accounting (working balance, WB) vary over time to provide future research opportunities around the factors that, affecting temporal divergences between NBL and WB, enhances fiscal fragility within the EU public sector accounting system. Analysing the Excessive Deficit Procedure (EDP) tables issued by 28 EU countries over the period 2010-2015, the paper uses novel approaches in measuring adjustments based on network analysis and regression models, showing that they are significantly different over time.

Key-Words: Contabilità pubblica, comparative international governmental accounting, governmental sub-sectors, deficit/surplus measurement

Figure 1

Table 1

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Performance measurement innovations in the organisational routines: theoretical insights and empirical evidences from an Italian local government

The aim of the study is to understand the dynamics of performance measurement (PM) routine when a PM innovation is introduced in the context of local governments. In doing so, we observe the ostensive and the perfomative aspects of the routine in order to comprehend if the convergence/divergence between these two aspects can explain the accomplished/unaccomplished PM innovation process. To investigate this phenomenon, we need proper theoretical lenses which shed light on routine dynamics. So, we drawn on two main theories: the Actor Network Theory (ANT) and the New Institutional Sociology (NIS). The theoretical combination of NIS and ANT helps to understand how the multitude of actors’ behavioural responses to the institutional pressures affect both the convergence/divergence between the ostensive and performative aspects of the PM routine and the unaccomplished translation process.

Key-Words: Contabilità pubblica

 

 

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The Popular Financial Reporting as tool of transparency and accountability

The aim of the article is to analyze the role of the Popular Financial Reporting as tool of transparency and accountability.  Our analysis examines the case of “Popular Financial Reporting of the City of Turin”: by a questionnaire of analysis of the stakeholder satisfaction the study consider the different social variables because they influence the content and the comprehension. The method is based on data analysis reporting frequencies and percentages of answers of the questionnaire and, when possible, evaluating these results according to the level of instruction. The Chi-Square test was used to identify statistically significant differences among categories of educational level. Globally, the feedbacks were positive and the document could be defined as an important and strategic way to keep aware the stakeholders about the policies of the City. However, some improvement could be made, especially considering the differences observed among the educational level categories.

Key-Words: Public Sector Administration

Table I – Description sample

Table II – Opinion about the Popular Financial Reporting

Table III – Opinion about the Popular Financial Reporting according to the educational level

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Tourism Governance at Stake: supporting decision makers in a small town through an Interactive Learning Environment

Governing interdependence between public and private organizations are central themes in designing tourism development policies. Due to spending review policies, cutbacks and budget shrinking, this aspect has assumed a crucial role in small local institutions. This study aims to show how small town policy makers, may improve their learning and therefore performance through a System Dynamics-based (SD) interactive learning environment (ILE). Such a learning tool was built to frame the governance setting, to identify sustainable growth strategies, to support the development of a small tourism destination in Sicily. To this end, three major decision makers – playing a crucial role in such environment – have been identified: the Mayor of the town, the museum’s director and a restaurant owner (as sample of the entire business sector). The ILE supports decision makers in outlining policies oriented to increase sustainably the flow of tourists over a 12-year time horizon. A two phase workshop setting was designed to allow the three players to initially run individually the “Dynamic Tourism Governance” ILE, under a predefined non-cooperative scenario. After a few runs and a short debriefing session, a collaborative scenario was run. In this second phase, the three decision makers might share ideas and strategies to foster the growth of flow of tourist in the small town. The use of “Dynamic Tourism Governance” ILE enables policy makers to: i) review their own mental models, ii) understand interdependence between different actors, perceive time delays between decision and results; iii) link short-term with long-term sustainable policies under financial, social and competitive point of view.

Key-Words: Rapporti pubblico-privato

Figure 1 A systemic framework embodying both the public and private sector and their capabilities to generate value through governance (Adaptation from Bianchi, 2016- 60)

Figure 2 The conceptual governance model of a destination, and the different dimensions of performance

Figure 3 Double loop learning (Sterman, 2000- 19)

Figure 4 The educational package architecture, as composed by the SD-based ILE and the debriefing sessions

Figure 5 The ILE interface- the home page (left) and the _Municipality_ control panel (right).

Figure 6 The causal loop diagram

Table 2 Loops dominance analysis and simulation graphs

Table1 Decision makers, policy levers, unit of measure and explanations

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Corruption prevention and reporting. Legitimacy concerns in the Italian Regional Governments

 

The paper examines the degree of thoroughness of the information provided in the Anti-corruption plans by Italian regions, to understand whether these are driven by symbolic legitimacy purposes or accountability needs. Employing a meaning oriented content analysis and a multiple correspondence analysis, the research discusses the thoroughness and the heterogeneity of the plans, identifying possible factors explaining any differences. Our results provide an interesting overview of the degree of implementation of the policies promoted by the on-going reforms, and allow to recognize which regions are ‘lagging behind. Thus, they suggests that it may be worthwhile promoting the adoption of additional ex ante measures to ensure the proper, formalized and shared implementation of corruption prevention systems. Yet, the results shed light on the type of change that regulation has fostered, emphasizing that the weaknesses of corruption prevention disclosure do not represent a question of compliance but might reflect the inefficiencies of regulation per se.

Key-Words: Amministrazioni pubbliche

 

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The (in)dependence of public managers from politicians in public sector organizations: a comparative research

 

The politics-administration dichotomy represents a formally accepted and frequently used model in many advanced countries, but, recently, it has proven incapable of capturing the reality of the public sector, where the distinction between political and administrative staff is more theoretical than real. This paper aims to investigate how politicians influence managerial activities in the Italian public sector contrasting three different segments: Regional Governments, Municipalities and Health-care. The research is based on a questionnaire completed by 916 managers (568 working for Regions, 241 for Municipalities and 104 for the Health-care sector), that includes a specific scale to measure political influence (Bellò and Spano, 2015). The results show some similarities and differences in the way politicians exert their influence on managers’ activity in the cited segments. Politicians mainly influence what objectives must be given priority and the setting of action plans even though in Municipalities and Health-care sector the political influence is perceived to be stronger than at Regional level. In addition, the article reports on the distribution of managers among four types based on a model that categorizes public managers on two dimensions related to a) managerial responsibility and b) managerial autonomy/power to act on this responsibility (Bellò and Spano, 2015) Practical implications and research future perspectives are also discussed.

Key-Words: Amministrazioni pubbliche, New Political Governance, Politics-Administration Dichotomy, Political Influence, Managerial Autonomy and Power, Managerial Responsibility

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The local authorities’ role in disseminating gender equality. Evidence from Italy

The European Institute for Gender Equality (EIGE), born in 2010 in order to contribute and to strengthen the promotion of gender equality, is an autonomous body of the European Union (EIGE, 2015a). It aims to become the Europe’s knowledge center on gender equality by collecting knowledge and by sharing useful experiences and expertise. Its activities focuses mainly on supporting gender mainstreaming in all EU and national policies in order to decrease gender discrimination (EU, 2006). Within the gender equality approach, the strategy and the tools used to promote gender equality are known as “gender mainstreaming” (EIGE, 2015b). For EU countries, the progress in gender equality is due mainly to the adoption of EU directives and to the use of EU funds inspired to gender mainstreaming theory. In 2013 the EIGE developed the Gender Equality Index as a unique measurement tool that summarizes the complexity of gender equality into a user-friendly and easily interpretable measure (EIGE, 2015c). The Gender Equality Index’s result has been designed for policymakers in the European Union as it is based on the EU policy framework. The Gender Equality Index 2015 provides results for all Member States and the EU as a whole, on domain and sub-domain levels. The index shows a slight advance in gender equality between 2005 and 2012: the score for the 28 Member States rises from 51.2 in 2005 to 52.9 (out of 100) in 2012. […]

Key-Words: Amministrazioni pubbliche

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The management of the plague in Florence at the beginning of Renaissance: the role of the partnership between the Republic and the Confraternita of Misericordia

The role of charities in the administration of healthcare and poverty and the use of accounting in their control mechanisms is a relatively unexplored topic in the accounting history literature. The present study aims to enrich the literature by studying how accounting systems were used in the management of the plague by a charity organization – the Confraternita of Misericordia – during the first decades of the Renaissance in Florence, focusing on the role of the partnership between the Republic of Florence and the Misericordia. This research is the result of the analysis of rare documents, statutes, and account books concerning the administration of the Misericordia from 1490 to 1530. Our analysis employs ideas on institutional theory, Foucault’s theories on the “government of the poor,” and Dean’s thoughts on “technologies of government” and “policing the poor.”

 Key-Words: Rapporti pubblico-privato, plague, Renaissance, Florence, Misericordia, institutional theory, accounting, government of the poor, technologies of government

 

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The Result of Administration and the Fiscal Year Result: Evidence from the Accounting Experimentation in Italian Local Authorities

Purpose: this work aims to analyse the recent accounting reform introduced by means of a pilot project within the Italian local governments in order to investigate whether the implementation of the new accounting system, which flanks accrual to cash accounting, improves the information provided to managers and citizens, increasing transparency and accountability. Design/methodology/approach: a quantitative empirical analysis grounded on the examination of the experimental financial statements has been adopted. Findings: evidence provided by this paper demonstrate that the adoption of the new accounting regulations affects the financial statement making changes in numbers and that the adoption of the “enhanced” cash basis along with the introduction of accrual accounting, even if just for informative purposes, provides a more complete information on the use of the public resources. Research limitations/implications: this research focuses on the Italian public sector, analyzing the Italian accounting reform for local governments under a technical lens. Therefore, a more in depth analysis of the socio-political aspects of the reform should be carried out in order to reach more widely applicable conclusions. Even though it analyses a single-country case study, this paper can be of interest for an international audience in that it investigates how different results occur applying similar processes (such as the adoption of accrual accounting in the public sector) in different national contexts. Originality/value: analysing the combined adoption of the two accounting systems for the management of public resources (cash accounting and accrual accounting), this research represents a contribution towards (i) the implementation of European and International Accounting Standards (EPSAS and IPSAS), as the criticalities highlighted by the local authorities can be translated into suggestions for the elaboration of accounting standards; (ii) the identification of new elements and information useful for citizens and decision-makers.

Key-Words: Contabilità pubblica, local government, public sector accounting, reform, accrual accounting, cash accounting

Figure 1– Profitability indicators

Table 1 – Yearly variation (2013-2012 and 2014-2013) of the result of administration (RA) per municipality

Table 2 – Total available part of the result of administration (E) for the year per local authority

Table 3 – Composition of the result of administration

Table 4– Comparison between 2013 and 2014 fiscal year results

Table 5 – Matrix of the relationships between result of administration and fiscal year result (2013)

Table 6 – Matrix of the relationships between result of administration and fiscal year result (2014)

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Accounting and mathematical models for the management of public resources in a spending review context

Following the 2008 economic crisis our society has been going through a difficult period, which affects various social classes in different ways and imposes remarkable social changes. In such phases the citizen tends to reduce his or her expenditure and tries to identify new sources of income. In these situations we tend to observe a transition from individualism to sharing. The role of the state is enhanced, together with its responsibilities. The quality and quantity of work and services supplied by public administrations represent a critical factor for business competitiveness and citizen wealth. Public administration management requires knowledge of the rules that govern corporate reality, while remembering that the public administration has its peculiar traits. The aim of this research is to identify new ways of improving the whole circuit, starting with tax payments made by citizens and ending with the supply of goods and/or services to the public, while enhancing the use of the res publica and its value when shared and managed with transparency and in an appropriate way. […]

Key-Words: Contabilità pubblica

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Government, Accounting and Change in Italian Universitis

The paper is aimed at investigating the extent to which quantification transformed ways of governing and control in the public services, particularly in universities. To that aim we took into account the recent public sector accounting reform in Italy with a particular focus on its effects in on universities. In this context, the introduction of new accounting technologies was claimed to made it possible to articulate and operationalize the notions of efficiency of the entire university domain. In this vein, the new technologies represent the ways to introduce new programs of government. Findings demonstrates that universities reform in Italy on one hand produced to a strong emphasis on accounting technologies, rules and figures imposed by the law, without a strong connection with the claimed efficiency; on the other hand, people involved in the change process find difficulties in following the new rules/technologies, feeling to produce numbers without understanding the mining and the end of such effort.

Key-Words: Public Sector Administration, Accounting, public sector reform, change, subjectivity, universities

 

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Cutback management in Italian Territorial Entities: main approaches and HRs cost-cutting strategies impact

The recent financial crisis, since the beginning transformed in a worldwide economic and fiscal one, triggered a necessary mechanism of organizational responses aimed at surviving and exceeding such a difficult period. In the necessity to understand the situation and to find some plausible ways to manage the austerity and overcome the decline at the organizational level, the interest on the cutback management literature in the public administration field has been revived after more than twenty years. Previous literature on the topic, that is mostly the one of the 80s, chiefly focused on the different cutback approaches public managers can resort to in a retrenchment period (looking at the advantages and disadvantages of each one of them), on the usual sequence of cuts in different expenditure categories (capital expenditures, operating cuts and program measures), and on the public management changes that ordinarily characterize a declining organization (Raudla et al., 2013). The awakening of this interest, in addition to benefit from the aspects already considered by the foregoing literature, has also highlighted the limitations of previous studies. Indeed they seem to consist of conceptual papers or single case studies (Maher and Deller, 2007), missing empirical evidence on a national and international base.

Key-words: Amministrazioni Pubbliche

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Sommario VIII Sezione

Convegno Sidrea 2016

VIII Sezione – Imprenditorialità e Family Business

Sommario Volume Elettronico – ISBN 978-88-917-3660-4

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Rosa Lombardi

Introduzione

p. 5
Gaia Bassani, Cristiana Cattaneo, Elena Cristiano, Antonio Leotta

Governing family businesses. A research map

» 7
Francesca Maria Cesaroni, Denisse Chamochumbi, Annalisa Sentuti

Did medium-sized family businesses perform better during the recent economic crisis? Empirical evidence from Italy

» 37
Tiziano Onesti, Mauro Romano, Alessandro Cirillo

One family-one vote? Rewarding family loyalty with multiple voting rights. First evidence from Italy

» 55

Velia Gabriella Cenciarelli, Paola Ferretti, Giuseppina Iacoviello

Credito e family business: il ruolo della soft information

» 77
Davide Rizzotti, Claudia Frisenna, Federica Tragno

The impact of family ownership on investment decisions

» 93
Andrea Caputo, Vincenzo Zarone, Mariacristina Bonti, Maria Zifaro

Gestione dei conflitti e negoziazioni nel passaggio generazionale delle aziende familiari: evidenze esplorative dalla Toscana

» 103
Cinzia Vallone, Barbara Iannone

Il legame tra sostenibilità, corporate reputation e passaggio generazionale nel family business. Un caso di successo nel settore vitivinicolo italiano

» 123
Lucrezia Songini, Paola Vola

The role of CFO in family owned businesses: a literature review

» 149
Alessandra Faraudello, Lucrezia Songini, Maurizio Comoli

Women in family business: a literature review

» 169
Patrizia Riva, Lucrezia Songini

Going public as a driver to break the glass ceiling. Piquadro Spa case history

» 187

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Ulteriori paper presentati al Convegno Sidrea 2016

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Jonathan Bauweraerts, Salvatore Sciascia, Pietro Mazzola

Sales internationalization of small- and medium-sized family firms: family leadrship as a double-edged sword

Silvia Bacci, Alessandro Cirillo, Donata Mussolino, Simone Terzani

The relationship between equity dispersion and debt levels in Italian family firms