The impact of performance management on internal customer satisfaction in inpatient institutions: Sample of Ankara Numune Education and Research Hospital

Hospitals play an important role in improving public health as well as serving as centers for the treatment of patients and the injured. Hospitals are the most important infrastructural system of the healthcare system with regards service delivery capacity and healthcare costs. In Turkey, a great majority of the healthcare workforce is recruited by hospitals.The available resources are limited in today?s world where demands have rapidly increased and diversified. New methods are being developed in management science to avoid inefficiency while transforming the scarce resources into goods and services. One such method, Performance-Based Management, is a method aiming to measure, assess and increase performance with the purpose of distinguishing between the hardworking and the not so hardworking people, both on the corporate level and on an individual basis.Performance assessment is an important process to increase efficiency and establish principles of decision-making in training, developing, rewarding, qualifying and relocating managers in a place of business.The Ministry of Health, too, aims to effectively and equally offer healthcare services with its performance management practice. The purpose in performance-based payouts is the encouragement of healthcare staff in offering efficient and high-quality healthcare services and rewarding the positive contributors.This study aims to investigate, theoretically, the place and importance of internal customers in healthcare services through the performance management approach; find out the attitudes and opinions of nurses, who are internal customers at Ankara Numune Training and Research Hospital, about performance management and Performance-Based Payout Schemes; and to discuss the outcomes.The findings of the survey study suggest that the proposition ?Our workload has increased since the PBPS?, which is one of the key aspects of nurse satisfaction, is the best-supported proposition based on arithmetic mean. There is, however, a lower consensus on the proposition ?PBPS is fairly practiced?. The proposition ?PBPS results in conflicts among the staff? is one of the best-supported propositions according to arithmetic mean calculations. There is a lower consensus on the propositions ?PBPS encourages the staff to work more? and ?The payouts we receive increased pro rata to the increase in the workload.? There is a higher consensus on the proposition ?Healthcare and examinations have improved in quality?, and the proposition ?PBPS has positively contributed to the quality of services received by patients? received a low consensus.We consider that the work processes of non-physicians were left undefined and outside the scope of the performance criteria in the performance management approach, and that the assessment of the performance of non-physician personnel according to clinical or hospital average has a negative impact on motivation among nurses. The work processes of nurses should be defined and included in the performance criteria. All patient care procedures carried out by nurses are scored for the physician they practice under, thus affecting the performance of the nurses over the clinic?s average. The nurses are by no means getting a share from the proceeds pro rata for their individual contribution to team performance.Efforts to explain the effect of PBPS on services, based on the opinions of healthcare staff, and the exclusion of the objective indicators of healthcare services from assessment are important shortcomings. It is obvious that new arrangements, on an operational level, are needed during the practice of encouraging schemes, such as performance management, especially considering that the resistance of the staff to such schemes is mostly due to the operation of the plan, rather than the design of the scheme.