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The purpose of this study is to contribute to the knowledge base on how performance measurement drives improvements in healthcare practice.

The study is based on a single in-depth case study. The critical incident technique (CIT) has been applied in order to identify significant occurrences of performance measurement in terms of events, incidents, processes, and issues identified by respondents from the case organization. These critical incidents have been analysed and interpreted using a theoretical framework suggesting that performance measurement may be applied for exploratory or regulatory purposes as well as ad hoc or continuously in healthcare practice.

The study suggests that performance measurement may be a versatile method for driving improvement in healthcare organizations. Six types of activities directly or indirectly drive improvement in the clinical department: continuous follow-up in formal arenas and meetings; improvement work; professional efforts; goal deployment; reporting based on external demands; and creating awareness in everyday clinical work. Healthcare organizations that strive to practice performance measurement as a driver for improvement need to find infrastructures in which it is being integrated into the daily life of organizational healthcare practice.

The study provides an original account of the prerequisites and actions for driving improvement through performance measurement in a healthcare setting. Since the operations management perspective in healthcare is significantly lacking, the study offers a unique perspective which may be the basis for both practice development and further scholarly inquiry and theory development.