The Professional Researcher as Change Agent in the Government–Performance Movement

Although academic and professional publications give the impression that performance measurement is a growing government practice, in actuality the use of this technology is not as deep or as widespread as it may appear. Even when performance measures are used, governments rarely integrate them into planning, budget, personnel, and other management processes. Most professional researchers located primarily in academic institutions, but also in research and government organizations, approach performance measurement as though governmental officials, elected or otherwise, are already sold on its usefulness. Instead, they need to function as "change agents," using a variety of strategies to gain acceptance and understanding of the strengths and limitations of performance measurement. This article draws on the authors' experiences with the Community Benchmarks Program of the Maxwell School in Onondaga County and a review of the current literature. It suggests guidelines for professional researchers who want to increase the use of performance measures by governments at all levels.     

Outcomes–Based Performance Management in the Public Sector: Implications for Government Accountability and Effectiveness

Requirements for outcomes–based performance management are increasing performance–evaluation activities at all government levels. Research on public–sector performance management, however, points to problems in the design and management of these systems and questions their effectiveness as policy tools for increasing governmental accountability. In this article, I analyze experimental data and the performance–management experiences of federal job–training programs to estimate the influence of public management and system–design factors on program outcomes and impacts. I assess whether relying on administrative data to measure program (rather than impacts) produces information that might misdirect program managers in their performance–management activities. While the results of empirical analyses confirm that the use of administrative data in performance management is unlikely to produce accurate estimates of true program impacts, they also suggest these data can still generate useful information for public managers about policy levers that can be manipulated to improve organizational performance.     

Social Support, Risk-Level and Safety Actions Following Acute Assessment of Suicidal Youth

The purpose of the pilot study was to examine the interrelationship between social support, risk-level, and safety actions for 2 groups of suicidal adolescents (50 attempters and 50 ideators), who had presented for an acute assessment at an outpatient mental health service. A social support model was proposed in which it was thought that information related to patients' social support would impact upon the types of risk-level and safety actions made by clinicians. Data was collected from a total of 100 patient files, utilizing the acute assessment reports (e.g., reports assessing risk of self-harm). Findings show that groups differed significantly on indices of negative support severity, positive support, and risk-level. Limited support was found for the proposed social support model. Limitations and implications for future research are discussed.     

Arterial-esophageal fistulae in patients requiring nasogastric esophageal intubation

A rare and potentially fatal cause of hematemesis is fistula formation between the esophagus and the vascular system. A case report of a 39-year-old woman with congenital aortic arch anomalies hospitalized for treatment of head injuries demonstrates the potential for iatrogenic esophageal trauma to initiate fistula formation between the esophagus and an anomalous arterial system. A literature review revealed 6 other cases of vascular-esophageal fistulae caused by nasogastric esophageal intubation. It is concluded that aortic arch anomalies increase the risk of esophageal injury and subsequent fistula formation from nasogastric esophageal intubation. In addition, the clinical features and pathologic findings of vascular-esophageal fistulae are reviewed.