Why, what and how do European healthcare managers use performance data? Results of a survey and workshop among members of the European Hospital and Healthcare Federation

Damir Ivankovic; Mircha Poldrugovac; Pascal Garel; Niek S. Klazinga; Dionne S. Kringos

doi:10.1371/journal.pone.0231345

Peer Review History

Original SubmissionJanuary 14, 2020
21 Feb 2020 Decision Letter - Itamar Ashkenazi, Editor PONE-D-20-01236 Why, what and how do European healthcare managers use performance data? Results of a survey and workshop among members of the European Hospital and Healthcare Federation PLOS ONE Dear Mr Ivankovic, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. We would appreciate receiving your revised manuscript by Apr 06 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. 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(Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: In this paper, the authors investigated the data for evidence-based decision-making by managers in hospitals and healthcare organization in Europe in 2019. From the discussion and conclusion, this paper emphasized the data how to be collected and used. This paper seems interesting for readers to understand Europe's managers why, what and how to use performance data. The authors may add the sections of suggestion and further study in this paper. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0231345.r001
Revision 1
11 Mar 2020 Author Response Dear Editor and Reviewer, Thank you for giving us the opportunity to submit a revised version of the manuscript entitled: “Why, what and how do European healthcare managers use performance data? Results of a survey and workshop among members of the European Hospital and Healthcare Federation” (PONE-S-20-01560). We greatly appreciate your comments and those of the reviewers. Please find below a point-by-point reply to the comments made. All revisions to the manuscript have been added using track changes. A “clean” revised version of the manuscript has also been submitted, in line with journal’s requirements. Comments from the Editor: E1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. We proceeded accordingly and aligned the supporting file names with PLOS ONE’s style requirements. Throughout the manuscript, when referring to the supporting files, appropriate amendments have also been made. E2. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. If there are ethical or legal restrictions on sharing a de-identified data set, please explain them. If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings. We apologise if this was not made clear enough in the original submission. The data set, underlying this paper’s findings, was made freely and publicly available using a data repository service. Before doing this, and due to collection of certain personal information in the questionnaire, we sought the advice of Amsterdam UMC’s Data Privacy Officer. Following their suggestion, and prior to making it publicly available, the data set was anonymised. Nevertheless, the available published anonymised data set allows for a complete reproduction of the analysis done in the paper. The data set is additionally complemented with a data codebook, awarded a digital object identifier (doi: 10.5281/zenodo.3607986) and make available on the following link: https://doi.org/10.5281/zenodo.3607986. Reviewers' comments: R1. In this paper, the authors investigated the data for evidence-based decision-making by managers in hospitals and healthcare organization in Europe in 2019. From the discussion and conclusion, this paper emphasized the data how to be collected and used. This paper seems interesting for readers to understand Europe's managers why, what and how to use performance data. The authors may add the sections of suggestion and further study in this paper. We proceeded accordingly and added a section with suggestions for further studies on the topic at the end of the discussion section of the paper (line numbers 524 – 541): “To further advance the field, building on key findings of this work but also on its limitations, we propose a number of potential future research topics and methodological approaches. Looking at a more homogenous sample of healthcare managers’ profiles, and including other geographical settings - beyond Europe, while accounting for the influences of characteristics of specific healthcare systems, would lead to more generalisable results. We also suggest unpacking the reasons that hinder a more wide-spread use of performance data in decision-making on the operational level and doing so by looking at the topics of the lack of confidence in (underlying) data, timeliness, appropriateness and actionability of metrics as well as the skills needed to effectively use (including communicate) the data. Additionally, exploring the drivers of reported differences between privately and publicly-owned healthcare organisations, in their use of performance data, could optimise cross-learning opportunities. When looking into skills, crucial for middle managers in order to enhance the use of data, we propose paying special attention to benchmarking, as an organisational learning tool, which currently seems underused. Based on our experience from this study, we also suggest study designs and research modalities that do not only focus on the ability to ask questions. In line with (participatory) action research methodologies, future research should also try to engage participants into a discussion, validating survey-based data and eliciting further contextual information and even disagreements, thus deepening our understanding of what drives effective and efficient use of performance data for decision-making.” Once again, thank you for giving us the opportunity to submit a revised version of the manuscript. Yours sincerely, Damir Ivankovic and co-authors Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0231345.r002
23 Mar 2020 Decision Letter - Itamar Ashkenazi, Editor Why, what and how do European healthcare managers use performance data? Results of a survey and workshop among members of the European Hospital and Healthcare Federation PONE-D-20-01236R1 Dear Dr. Ivankovic, We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements. Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication. Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. With kind regards, Itamar Ashkenazi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0231345.r003
Formally Accepted
26 Mar 2020 Acceptance Letter - Itamar Ashkenazi, Editor PONE-D-20-01236R1 Why, what and how do European healthcare managers use performance data? Results of a survey and workshop among members of the European Hospital and Healthcare Federation Dear Dr. Ivankovic: I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. For any other questions or concerns, please email plosone@plos.org. Thank you for submitting your work to PLOS ONE. With kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Itamar Ashkenazi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0231345.r004

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