Performance measurement system innovations in hospitals as translation processes

Purpose – The purpose of this paper is to highlight how the variety of the actors involved in a performance measurement system (PMS) innovation are spread out in time and space. Healthcare contests are examined, where such an innovation is influenced by present and past systems and practices (spread out in time), and by managerial and health-professional actors (spread out in space). Design/methodology/approach – Drawing on Callon’s actor network theory, the authors describe PMS innovations as processes of translation, and distinguish between incremental and radical innovations. The theoretical arguments are used to explain the evidence drawn from a longitudinal case study carried out in an Italian public teaching hospital, referring to the period from 1998 up to 2003. Findings – The conceptual framework shows how the translation moments lead to a recognition of the different actants involved in a PMS innovation, how their interests are interrelated and mobilized. Moreover, it shows how the interaction among the actants involved in the process is related to the type of PMS innovation, i.e. radical vs incremental. The case evidence offers detailed insights into the phenomenon, testing the explanatory power of the framework, and highlights how the failure of one of the translation moments can compromise the success of a PMS innovation. Originality/value – This study differs from the extant accounting literature on PMS innovations as it highlights how the introduction of a new PMS can be affected by some elements of the previous systems “package,” which are relevant for the mobilization of the actants through the new project. Keywords Actor network theory, Health organizations, Accounting innovations