Assisting allied health in performance evaluation: a systematic review

Background: Performance evaluation raises several challenges to allied health practitioners and there is no agreed approach to measuring or monitoring allied health service performance. The aim of this review was to examine the literature on performance evaluation in healthcare to assist in the establishment of a framework that can guide the measurement and evaluation of allied health clinical service performance. This review determined the core elements of a performance evaluation system, tools for evaluating performance, and barriers to the implementation of performance evaluation. Methods: A systematic review of the literature was undertaken. Five electronic databases were used to search for relevant articles: MEDLINE, Embase, CINAHL, PsychInfo, and Academic Search Premier. Articles which focussed on any allied health performance evaluation or those which examined performance in health care in general were considered in the review. Content analysis was used to synthesise the findings from individual articles. Results: A total of 37 articles were included in the review. The literature suggests there are core elements involved in performance evaluation which include prioritising clinical areas for measurement, setting goals, selecting performance measures, identifying sources of feedback, undertaking performance measurement, and reporting the results to relevant stakeholders. The literature describes performance evaluation as multi-dimensional, requiring information or data from more than one perspective to provide a rich assessment of performance. A range of tools or instruments are available to capture various perspectives and gather a comprehensive picture of health care quality. Conclusions: Every allied health care delivery system has different performance needs and will therefore require different approaches. However, there are core processes that can be used as a framework to evaluate allied health performance. A careful examination of barriers to performance evaluation and subsequent tailoring of strategies to overcome these barriers should be undertaken to achieve the aims of performance evaluation. The findings of this review should inform the development of a standardised framework that can be used to measure and evaluate allied health performance. Future research should explore the utility and overall impact of such framework in allied health service delivery.