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The purpose of this paper is to explore the sensitivity of economic efficiency rankings of water businesses to the choice of alternative physical and accounting capital input measures.

Data envelopment analysis (DEA) was used to compute efficiency rankings for government-owned water businesses from the state of Victoria, Australia, over the period 2005/2006 through 2012/2013. Differences between DEA models when capital inputs were measured using either: statutory accounting values (historic cost and fair value), physical measures, or regulatory accounting values, were scrutinised.

Depending on the choice of capital input, significant variation in efficiency scores and the ranking of the top (worst) performing firms was observed.

Future research may explore the generalisability of findings to a wider sample of water utilities globally. Future work can also consider the most reliable treatment of capital inputs in efficiency analysis.

Regulators should be cautious when using economic efficiency data in benchmarking exercises. A consistent approach to account for the capital stock is needed in the determination of price caps and designing incentives for poor performers.

DEA has been widely used to explore the role of ownership structure, firm size and regulation on water utility efficiency. This is the first study of its kind to explore the sensitivity of DEA to alternative physical and accounting capital input measures. This research also improves the conventional performance measurement in water utilities by using a bootstrap procedure to address the deterministic nature of the DEA approach.

Purpose – The numbers of health care transparency initiatives are increasing. Despite the growing availability of quality data, there seems to be a shortage of evidence about the effects and effectiveness of such initiatives. The aim of this systematic review is to document the effects of transparency, defined as the public release of quality performance data, on hospital care outcomes.

Design/methodology/approach – Through a review of the literature, we chose 46 keywords to use in our searches and focused on empirical studies published in English between 2010 and 2015. The use of combinations of these keywords in searches of four databases (PubMed, Scopus, Web of Science, and the Cochrane Library) generated 13,849 publications. The removal of duplicates and exclusion of studies that were not empirical or not relevant to transparency and quality resulted in 39 studies to be reviewed.

Findings – Our review of the literature confirmed the growth of health care transparency efforts, led by the United States, and found mixed results regarding the effects of transparency on hospital care outcomes. For example, mortality, the most frequently researched performance measure (n = 15), exhibited this mixed pattern by having studies showing a reduction (n = 4), increase (n = 1), mixed findings (n = 4), and no significant relationship (n = 6) as a result of public release. We also found a limited number of articles related to unintended consequences of public reporting. When compared with earlier systematic reviews, there seems to be a trend in the reduction of unintended consequences. Therefore, we recommend exploration of this potential trend in future studies empirically.

Practical Implications – The research findings summarized in this systematic review can be used to understand the results of existing transparency efforts and to develop future transparency initiatives that may better enhance hospital quality performance.

Originality/value – This is the latest and most comprehensive systematic review summarizing the effects of transparency of quality metrics on hospital care outcomes.

This paper aims to discuss and present research findings from a proof of concept pilot, set up to test whether a teaching intervention which incorporated a dual reporting and learning approach from adverse incidents, could contribute towards individual and organisational approaches to patient safety.

The study formed part of a series of six iterative action research cycles involving the collaboration of students (all National Health Service (NHS) staff) in the co‐creation of knowledge and materials relating to understanding and learning from adverse incidents. This fifth qualitative study involved (n=20) anaesthetists who participated in a two phase teaching intervention (n=20 first phase, n=10 second phase) which was premised on transformative learning, value placed on learning from adverse incidents and reframing the learning experience.

An evaluation of the teaching intervention demonstrated that how students learned from adverse incidents, in addition to being provided with opportunities to transform negative experiences through re‐framing learning, was significant in breaking out of practices which had become routine; propositional knowledge on learning from adverse incidents, along with the provision of a safe learning environment in which to challenge assumptions about learning from adverse incidents, were significant factors in the re‐framing process. The testing of a simulated dual learning/reporting system was indicated as a useful mechanism with which to reinforce a positive learning culture, to report and learn from adverse incidents and to introduce new approaches which might otherwise have been lost.

The use of a “re‐framed learning approach” and identification of additional leverage points (values placed on learning and effects of dual reporting and learning) will be of significant worth to those working in the field of individual and organisational learning generally, and of value specifically to those whose concern is the need to learn from adverse incidents.

This paper contributes to individual and organisational learning by looking at a specific part of the learning system associated specifically with adverse incidents.