A COMPARATIVE STUDY ON CRITERIA OF PERFORMANCE

MANAGEMENT IN MALAYSIAN HEALTHCARE

Mohd Khairolden Ghani 1, Zuhairi Abd Hamid 1, Syahrul Nizam
Kamaruzzaman2, Zairul Nisham Musa2, Ihfasuziella Ibrahim1
1
2

Construction Research Institute of Malaysia (CREAM)

Faculty of Built Environment, University of Malaya

khairolden@cidb.gov.my, zuhairi@cidb.gov.my,
syahrulnizam@um.edu.my, zairul@um.edu.my, ihfasuziella@cidb.gov.my
ABSTRACT
Facilities Management or better known as FM is often viewed as a
support services for an organization in running their business. FM is
relatively new in Malaysia, perhaps it still at the infancy stage.
Presently, the adoption and practice FM in Malaysia is predominantly
focused on multinational company (MNCs) and also little bit on the
government side. The issue of efficiency, productivity and
professionalism in the construction industry can be achieved through
the adoption of best practice. Facilities in healthcare especially hard
fm are very important to be considered in fm. It is found that
mechanical and electrical services maintenance had contributed major
percentage to the performance management. Through performance
management, requirement and solution will be presented to the clients
in an easy manner. This study focuses on criteria of performance
management within the meaning and understanding from various
researchers of performance management, and recommends the best
methods for Malaysian healthcare. The purpose of this study was to
identify the criteria of performance management in Malaysian
healthcare based on FM perspective, that underestimated by most
people. The mechanism used to analyze the definition of performance
management. From the analysis of the facility management definition,
criteria of performance management were highlight from various
researchers. Then, the criteria will be used as components to develop
a strategic performance management for hard FM in Malaysian
healthcare. Noted that the performance management in healthcare
are very important and therefore, performance management in
facilities management have to be the main agenda and need to be
managed efficiently.
Keywords: Performance management, criteria, facilities management,
hard FM and healthcare

INTRODUCTION
Facilities Management (FM) has emerged as buzz word in construction
industry today. (Atkin and Brooks, 2009) regarded FM has been
traditionally old-fashioned activities such as cleaning, repairs and
maintenance. Since the beginning of twenty-first century, FM as gradually
be recognized by property fraternity as a cost-centre that can contribute
to the performance of organization which requires effective management
(Lavy and Shohet, 2009). The evolvement of FM the most of the part in
the world is growing fast but in Malaysia still at the infancy stage. It was
started back in 1990 but however, most of the people feel that FM is just
maintenance per se. People especially in the construction business
fraternity still opine that FM is more on maintenance and not thinking of
beyond that boundary. Dealing with facilities needs to ensure the quality,
maintenance and performance has to be taken care of. In order to
maintain the facilities, one should look into the performance of facilities
itself. A good performance system has brought maintenance function into
the limelight (Muchiri et al., 2010). The need for management applies in a
FM context as a subset general management is performance
measurement (Amaratunga and Baldry, 2002). (Egan, 1998) recognized
the need for construction and facility managers to closely work as part of
integrated team to reduce the cost of maintenance. According to Ruslan
(2007) the key issue currently plaguing FM in Malaysia is low service
quality and performance. According to CREAM (2011), it was found that
performance measurement in FM context in Malaysia have been divided
into six components namely fire protection and maintenance, mechanical
services maintenance, electrical services maintenance, asset life cycle
management, management policy and administration and cleaning
services. It is found that mechanical and electrical services maintenance
had contributed major percentage to the performance management.
Through performance management, requirement and solution will be
presented to the clients in an easy manner.
RELATED WORKS
Definition and Scope of Performance Management
Performance management is a strategic tool used in measuring effective
organization. The success of organization is relying solely on clear
performance management process (NovaScotia, 2012). It is also
supported by (Ana-Maria et al., 2009) that performance management
plays pertinent roles in managing team and individual to achieve
organizational objective. Performance management definition made by
(Ana-Maria et al.,2009) is a strategic and integrated approach for
sustainable organization in improving the performance of the team and
individual. (Hay Group, 2008) also define performance management is
about improving team and individual performance through strategy

process that links people and jobs. They also outline performance is a
shared understanding process of what to be achieved, managing people
process and also a process to ensure the most effective ways of people do
the process. (Eckerson, 2009) define performance management is a
discipline that aligns performance with strategy. Performance
management relates with information technology in order to monitor the
execution of business. (Amaratunga and Baldry, 2001) defines
performance measurement is a mechanism to evaluate trends in facilities
from the past. Through the collection, interpretation and analysis of
information will give the key to better planning and design for the future.
Perspectives of Performance Management for FM in Healthcare
Managing performance has become important to support management
and practice within FM organization. Performance has contribute lot to the
FM in organization in many ways including strategy, culture, control of
resources, service delivery, supply chain management and change
management (Amaratunga and Baldry, 2002). According to KPMG (2010),
a performance management framework would consist of interlinked
processes, system, tools used for arranging knowledgeable people to
drive the strategy. The framework will only be succeed when individuals
transforms their decisions in line with strategy. KPMG (2010) through
their research found that a strategy must be agreed upon by all. If agreed
strategy does not exist, an effective balanced scorecard will not be
developed further. In order to translate strategy and corporate mission to
be realized, a coherent set of measurement need to be developed. The
measure is to drive people with skills and capability to align with core
values in organization. To achieve this, the organization should establish
business planning and budgeting as part of the performance process with
good reporting and efficient information system.
Criteria in Performance Management
Tucker and Pitt (2009) in their study have adopted ranking system in
assessing performance customer feedback;
Efficiency of service delivery
Criticality to business operation
Service provision (in-house/outsourced)

Table 1 FM Customer Benchmarks- Service Ranking

(Source: Tucker and Pitt, 2009)

In analyzing the Table 1 above, the mechanical and electrical engineering
(M&E) services rated as most critical but reciprocally rated as least in
terms of efficiency. While, other hard services such as building fabric and
waste management are rated least critical as compared to M&E
engineering. These two components of hard services also rated least in
terms of quality and efficiency (Tucker and Pitt, 2009). The assumption
could be made from these findings. Firstly, customers are always put the
soft services or known as front line as most importance and the most
quality job done by FM. It will give the good image and reputation of such
organization in business. (Bassioni et al., 2005) through their study had
outlined seven (7) driving factors in performance measurement
framework. The identified criteria are;
I. Leadership
II.
Stakeholders focus customer and other stakeholders
III.
Strategic management
IV.
Function and programme management-people, partners, suppliers,
physical resources, intellectual capital and risk management
V.
Process management
VI.
Information and analysis
VII.
Work culture
The commonly used measured in maintenance performance has divided
into three (3) categories based on their focus. The categories are
measures for equipment performance, cost performance and process
performance (Campbell, 1995). (Boussabaine and Kirkham, 2006) have
advocates that one of the component to consider in utilizing capital
resources is cost structure of hospital facilities management (FM). The
benefits of cost efficiency not only impart to organizations services,
facilities and activities but to the improvements of whole life cycle costs.
(Kennerley and Neely, 2002) in other views highlighted performance
measurement system should have four main criteria in organization i.e
effective processes, skills and human resources, appropriate culture and
flexible system.
(Harris et al., 2007) had highlighted some of the issues concerns with the
link between human resource management (HRM) and performance. The
implication of human resource would also play significant impact in terms
of relationship between human resource practices, policies systems and
performance. The HRM practices would certainly contribute to
performance by motivating employees to adopt desired attitudes and
behaviours to enhance organizational performance.
(Taticchi and Balachandran, 2008)
measurement and management (PMM)
constitutes the baseline for effective
integration. The interrelationship of that

have developed performance

in the organization. This system
and implementable design for
comprise five system used;

a) Performance system
b) Cost system
c) Capability evaluation system
d) Benchmarking system and;
e) Planning system
(Silva and Ferreira, 2010) had found that in their study of public
healthcare services (PHS) in Portugal, the strategic control process is
critical. The level of strategic process shows the significant flaws in terms
of communication between parent institution, Health Sub Region (HSR)
and PHS. This problems if not control would lead to the motivational of
staff, poor information flow mechanisms and low level of accountability.
In the scope of facilities, the cost is always the main criteria need to be
considered. The assessment made is only focus to the competitiveness of
procurement rather than the cost effectiveness. (Williams, 1996) found
that cost effectiveness of facilities can control the process of service
delivery. Three financial control facets are critical in order to achieve costeffective facilities. Three facets are budgetary control; value engineering
and competitiveness procurement are shown in the figure below. He also
stressed the measurement of facilities should relate with three main
components namely physical, functional and financial. Physical
performance relates to the behavior of buildings such as structural
integrity, heating. Functional performance relates to the buildings
occupier such as space, layout and ergonomics while financial
performance will touch on capital expenditures, depreciation and the
efficiency of the money spent.

Figure 1 Three Facets of Financial Control Interrelationship

(Source: Williams, 1996)
Figure 1 below made up of success in service performance really lie on
the customer satisfaction. Once the customer satisfied, it will add value to
the quality and will become more perfect match in service performance.
The cost factors will give the value of money in terms of cost per patient
and thus all these factors will reduce operating costs tremendously across
its core and non-core activities (Tranfield and Akhlaghi, 1995).

Figure2 Mutual Gains and Guarantee to Meet Service Performance

(Source: Tranfield and Akhlaghi (1995)
American National Standard (2012), Feedback is an essential feature of
all stages of the performance review process.During the performance
planning process, both behavioral and results expectations should have
been set. Performance in both of these areas should be discussed and
feedback provided on an ongoing basis throughout the performance
evaluation and rating processes. In addition to providing feedback
whenever exceptional or ineffective performance is observed, providing
periodic feedback about day-to-day accomplishments and contributions is
recommended. For the feedback process to work well, it should be a twoway communication process that is the joint responsibility of both
managers and employees.
This method requires training both managers and employees about their
responsibilities in the performance feedback process. Effective feedback
should be timely, constructive, specific and balanced, and should include
both positive and development information based on what the employee
did or did not do in terms of his or her behaviour. It is critical that
feedback be based on behaviours rather than on personal characteristics
and that these behaviours are linked to effective versus ineffective
performance.
However, according to (Azlan shah Ali et al., 2010), there are 5 criterias
need to be highlighted such as time schedule performance, cost, quality
performance, functionality technical performance and communication
among parties. (Purbey et al., 2006) stated, the performance
measurement parameters can be categorized into following three
categories:
1)
Efficiency
2)
Effectiveness
3)
Flexibility.
Efficiency measure deals with the success with which hospital
management uses its funds or resources to produce outputs or outcomes.

Efficiency measurement consists of following sub-indicators such as

resource utilization
and cost reduction. The second dimension is
effectiveness. The review of literatures indicates that effectiveness will
include dimensions like customer satisfaction, quality of service
etc.Effectiveness can be measured by measuring the following dimensions
such
as
service
quality,
customer
satisfaction,
growth
and
safety.Flexibility is a lead performance measure, which focuses on
analyzing forward looking, predictive and future performance
comparisons. This can measure a systems ability or the adaptability to
respond to diversity or change. There are professional flexibility,
instrument
flexibility,
process
flexibility,volume
flexibility,mix
flexibility,expansion flexibility, and new service flexibility.
METHODOLOGY
The method used in this research is a comparison method. Data that will
be produced is in the form of a matrix. The purpose of the comparison
method used is to compare each of the criteria in performance
management. It is based on each different researchers opinion. Then,
each of the same criteria will be matched with the same opinion with each
other. The same criteria will be aggregated. Total criteria between 2-6
times the frequency range to be considered. Thus, the criteria will be used
in this study to produce a model performance management.
ANALYSIS

Table 2 Matrix comparison of performance management criteria

Discussion of Result
The table 2 shows that the thirteen criteria from twelve different
researchers. Criteria will used to develop a model of performance
management in healthcare. Among the criteria taken into account is the
Efficiency of Service, Process Management, Work Culture, Communication
/ feedback process, Physical Performance, Time Schedule Performance,
Cost Performance, People-skills and Human Performance and Quality. For
Efficiency criteria of Service, four researchers have the same opinion of
Tucker and Pitt 2009, the Campbell (1995), Purbey et al., (2006) and
Kennerley and Neely (2002). For Process Management, there are 2
servings researchers have the same opinion of Harris et al., (2007) and
Bassioni et al., (2005). Then, the criteria of Communication / feedback
process, researchers are unanimous is Silva and Ferreira (2010) and Shah
Ali A et al., (2010), while the criteria are expressions of a work culture
Kennerley and Neely (2002) and Bassioni et al., (2005). For physical
performance, the researchers involved are Campbell (1995) and Williams
(1996). For Cost Performance, researchers are unanimous is Campbell
(1995), Boussabaine and Kirkham (2006), Silva and Ferreira (2010),
Williams (1996), Taticchi and Balachandran (2008), and Shah Ali A et al. ,
(2010). For the People-skills and human resources involved researchers
are Kennerley and Neely (2002), Harris et al., (2007) and Azlan Shah Ali
et al., (2010). For Quality Performance, the researchers involved are
Taticchi and Balachandran (2008) and Azlan Shah Ali et al., (2010).
Accordingly, there are nine criteria that are important in develop a model
performance management in healthcare.
Conclusion
In conclusion, this study is to develop a strategic management model for
hard fm performance in healthcare. Focus is given to hard fm because the
problems are more focused on hard fm and the cost to operate is large
compared to soft FM.Healthcare is considered as a very important
institution for people and had been recognized providing medical care for
people. FM in healthcare need to be given priority compared to other
sectors because its dealing with human life. The service delivery and
performance in healthcare sector required most sophisticated approach
compared with other organization. People would always express their
views in media with regards to the quality services rendered by
healthcare. The issue of service quality and performance are plaguing
among the healthcare throughout the country over the years. Therefore,
it stated clearly in healthcares vision and mission is to provide a high top
quality of services and keep improving customer satisfaction from time to
time. According to Ruslan (2007) the key issue currently plaguing FM in

Malaysia is low service quality and performance. Therefore, a strategic

model of performance management for mechanical and electrical services
of FM healthcare project will be established to address these issues. A
model will be detailed out pertinent consideration and key criteria of
service level in determining the successful of FM performance
management in healthcare.
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