Date of Award

Spring 3-24-2026

Embargo Period

11-16-2027

Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Jillian Harvey

Second Advisor

Jami Jones

Third Advisor

Aaron Kinney

Abstract

Performance measurement is central to healthcare leadership, yet the proliferation of measures has raised concerns about administrative burden and measurement fatigue. Although performance measures are intended to improve quality and accountability, less is known about how senior leaders determine which measures meaningfully contribute to organizational priorities.

This qualitative study explored how senior leaders within a large nonprofit U.S. health system evaluate the value and burden of performance measures. Semi-structured interviews were conducted with 10 leaders responsible for clinical and operational oversight across hospital and ambulatory settings. Data were analyzed using reflexive thematic analysis.

Four themes emerged. Leaders defined measure value primarily through actionability and contextual interpretation alone; measurement systems created cognitive, operational, and moral burdens; governance structures shaped which measures received attention; and improvement efforts involved trade-offs across priorities. These findings highlight the leadership role in aligning performance measurement with organizational priorities.

Rights

Copyright is held by the author. All rights reserved.

Available for download on Tuesday, November 16, 2027

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