SETTING GOALS AND TARGETS FOR PERFORMANCE STANDARDS WITHIN THE SWEDISH HEALTH-CARE SYSTEM

The development of any health care system towards setting goals and ta rgets and intended outcomes - with national guidelines, a legislative framework, limited resources, consumer influence and competitive force s-makes great demands on the control mechanisms required. The Swedish health care system has no tradition of goal formulation of this type. Hence, the purpose of this article is to clarify the goal-setting proc ess of performance standards, and to examine whether goal setting is a relevant method within the organization of a Swedish county council. Goal setting can be seen partly as a control method and partly as an a dministrative process. The approach used is a combination of qualitati ve and quantitative methods. Data have been collected from interviews, observations, notes taken in the field and available performance stat istics. The analysis shows that working towards a goal is made easier through a common and simple concept. It 'stands and falls' with the ma nagement of the work and its manager. Good communications and informat ion are important prerequisites if goal formulation, through dialogue, is to succeed, This process takes time and can be described as an ite rative process, in which a common behaviour pattern develops a 'we-fee ling' which spreads among the staff. It is important that the goal is relevant and directly related to the basic objects of the work. It is also crucial that the goal is realistic and reflects a priority. Goal formulation relating to performance standards can be a contributing fa ctor to staff's experience of job satisfaction through increased engag ement and motivation, and to the satisfaction of patients/relatives wi th the care given. It is difficult to formulate performance standards; there are many problems and obstacles. If goal formulation as a contr ol method within the health care system in Sweden is to work, clearer manifestations of political will are necessary and also better measuri ng methods in order to guage achievement.