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As a way of alleviating nursing workforce shortages, health care managers are employing two types of workforce flexibility: supplemental staffing and floating among units. In this paper, the authors investigate the moderating effects of two critical situational variables – namely, job-level workload and severity of illness (SOI) in a given unit – on the relationship between workforce flexibility and quality of care as assessed by the nurses at the unit-level.

The authors empirically test the relationship between a unit's floating of nurses and the use of supplemental workforce on the quality of patient care and the moderating role of patient SOI and job-level workload on this relationship using 357 hospital-unit observations.

The authors find that situational variables play a critical role in flexible staffing strategies and they should be accounted for carefully to obtain the best quality of care outcomes. The authors find that the well-known negative effect of supplemental staffing on quality of care is not universal and appears to be moderated by the situational factors studied in this paper.

For best outcomes, staffing manager who oversee multiple units should use supplemental staff on units that have lower job-level workload and on units that have high severity of illness. The authors also find that managers of units with patients who are less-severely ill should encourage nurses to float out and return to their home unit. This strategy will improve quality of patient care in the home unit.

While some research analyzes the direct link between flexibility and quality performance, how this relationship is affected by varying situational factors within a unit has not been studied so far.

The authors examine how physician staffing, human capital and knowledge spillovers are related to multiple dimensions of hospital operational and financial performance at the organizational level.

The authors use a data set assembled from multiple sources for more than 1,300 US hospitals and employ hierarchical linear regression to test this study’s hypotheses. The authors use multiple quality, efficiency and financial measures of performance for these hospitals.

The authors find that higher levels of staffing, skills and knowledge spillovers associated with physicians were positively associated with multiple dimensions of hospital performance. The authors find linear and nonlinear relationships between experience and performance, with the relationships primarily negative, and nonlinear relationships between spillovers and quality performance.

Hospital managers should consider increasing physician staffing levels if possible. In addition, the overall Final MIPS Score from the Centers for Medicare and Medicaid Services might be included as a factor in determining which physicians practice in a hospital. Finally, if possible, encouraging physicians to practice at multiple hospitals will likely be beneficial to hospital performance.

This study’s findings are original in that they explore how physician-specific staffing and human capital, which have received comparatively little attention in the literature, are related to several different dimensions of hospital-level operational and financial performance. To the best of the authors’ knowledge, this paper is also the first to examine the relationship between the construct of physician knowledge spillovers and hospital-level operational and financial performance.

This paper presents a theoretical framework that extends the benefits of some core elements of operations strategy to the field of entrepreneurship. We show that the field of operations strategy, with its predominant focus on fit among configuration, competencies, and logistics, offers valuable insights into many strategic and tactical challenges that entrepreneurs face as they try to create business models and enter new markets or establish footholds in existing, but well‐defended markets. It is our aim to highlight the need for future endeavors linking the two fields.

This paper aims to examine the relationship between the four cultural dimensions of the competing values framework (CVF) (group, developmental, hierarchical, and rational cultures) and four types of performance: product quality, process quality, product innovation, and process innovation. Theoretically, this represents the contrasts among the four quadrants of CVF in terms of their respective outcomes, with quality and innovation reflecting the contrast between control and flexibility orientations, and product and process reflecting the contrast between external and internal orientations.

Data were collected from 194 middle and senior managers of Australian firms who had knowledge of past and present organizational practices relating to quality and innovation‐related aspects in the organization.

Developmental culture was found to be the strongest predictor among the four cultural dimensions, as it shows relationships with three of the performance measures: product quality, product innovation, and process innovation. Rational culture shows a relationship with product quality, and along with group and hierarchical cultures, it also plays a role in predicting process quality.

The results provide key insights for managers to appropriately understand the fit between the culture and the strategic direction of the firm. The findings also encourage firms to appreciate the balanced view on what seems to be multiple cultural characteristics within the same organization.

By simultaneously examining the relationships between different cultural dimensions and different types of performance, this paper extends the previous empirical studies which linked CVF with a specific measure of performance.

This empirical study explores the relationship between total quality management (TQM) practices and organizational culture with the purpose of identifying the particular cultures that determine the successful implementation of TQM practices. Specifically, it tests two competing views on the relationship; the unitarist and pluralist views.

The empirical data was drawn from 194 organizations in Australia. The research model employs the Malcolm Baldrige National Quality Award criteria as TQM framework and builds on the competing values model to frame organizational culture. The data was analysed using structural equation modelling technique.

The findings support the pluralist view, wherein different subsets of TQM practices are determined by different types of cultures. Interestingly, hierarchical culture was found to have a significant relationship with certain practices of TQM. Additionally, the findings indicate that although the cultural factors underpinning different elements of TQM are dissimilar, even antagonistic, organizations can implement them in harmony.

The major implication of this study is that organizations need to accommodate divergent goals by developing a system and/or structure that allows enough flexibility for adapting different (even contrasting) management styles, between control and flexibility and between internal and external orientations, so that they may gain benefits from the multiple dimensions of TQM.

This paper provides empirical evidence on the multidimensionality of TQM practices along with their association with different types of culture.

The present study aims to empirically explore the relationships between selected operations strategies and the associated operations activities. Specifically, for service firms targeting specific competitive priorities, it examines the extent to which there are significant differences in the relationships between these priorities and the operations activities among high‐ versus low‐performing firms.

The empirical data for this study were drawn from 190 managers of the Australian service organisations whose primary responsibilities were related to the daily operations of the firms. The targeted service organisations encompassed various sectors including transportation, communication, banking, insurance, health care, education, wholesale, retail, and professional services.

The results show that high‐performing firms have stronger relationships between their operations strategies and operations activities than low‐performing firms. The results also reveal how different operations strategies need to be deployed into different operations activities.

The design of this study was exploratory in nature, and therefore, can be improved in terms of the robustness of the scales and observations. Also, the cross‐sectional design of the study could not capture potential unique characteristics of some service sectors that affect the examined relationships.

These findings suggest the importance of implementing operations activities in the firm's strategic directions. As firms decide how they choose to strategically position their operating systems, they in turn need to decide how to best focus their resources on operational elements that support these goals.

From the authors' best knowledge, this is the first study which examines the link between operations strategies and operations activities in service firms.

The purpose of this paper is to examine the relationship between exploration and exploitation innovation, and business performance in small and medium enterprise (SME) service firms. Furthermore, the paper also examines the interaction between the two innovation orientations in predicting business performance, and the influence of size in the effectiveness of each of them in enhancing business performance.

Using empirical data drawn from 180 managers in Australian service organisations, this study also compares the effect of ambidextrous innovation on business performance within these SMEs.

The findings show that, controlled for size, neither of the innovation orientations show significant, direct relationships with firms' performance. However, ambidextrous innovation was positively associated with business performance, indicating a synergy between exploration and exploitation. Further examination indicates the relationship between exploration/exploitation innovation and performance is moderated by size within the authors' sample of small firms.

Taken together, the results point to an interesting and complex relationship within SMEs relating to innovation orientation, size, and performance. This relationship suggests that service SMEs are best served by the simultaneous pursuit of both exploitive and exploratory innovation.

This research is original in that it deliberately focuses on innovation in service SMEs, an area that has not seen significant research previously. As such, the authors' insights into the relationship between ambidextrous innovation and performance suggest the need for creating balance and synergy between the two innovation types.

The purpose of this paper is to examine empirically how operational performance and contextual factors contribute to differences in overall patient care costs across different hospitals.

Administrative data are employed from a sample of hospitals in New York State to construct measures of contextual factors, operational performance, and cost per patient. Operational performance and cost variables are adjusted to account for case mix differences across hospitals. Hierarchical regression is used to analyze the effects of contextual and operational variables on cost performance.

Increased length of stay, increased patient volume, and educational mission were associated with higher cost per patient. Mortality performance was associated with lower cost per patient. However, it was not found that location, size, or ownership status had a significant relationship with cost performance.

This paper identifies several significant relationships between contextual and operational variables and hospital costs. From a managerial perspective, these findings highlight the fact that some drivers of cost in hospitals are under the control of managers. One of the primary cost drivers in the study is length of stay, which implies that there is significant room for improvement in healthcare performance through a focus on operational excellence.

For researchers, the present study highlights the relative importance of operational versus contextual factors, with respect to cost performance in hospitals. The results of this study also provide direction for additional research into the role operational performance might play in determining the overall organizational performance in a hospital.

As hospital costs continue to rise, increasing attention is being paid to the way these organizations are and should be managed. This attention typically comes in the form of focus on costs of services, quality (often measured through mortality rates) and length of stay. Hospital management has a broad array of choices at their disposal to address these challenges. As service operations, hospitals present a significant opportunity to apply the many tools and techniques from the field of operations strategy to this important industry. The objective of this paper is to use the operations strategy framework to assess the relationship between a set of operational elements and hospital performance in terms of average length of stay (ALOS), so that hospital managers improve the effectiveness and efficiency of patient care of their hospitals.

Using the structural and infrastructural operations strategy framework, this study examines the relationship between several strategic variables and hospital performance. To analyze these relationships the paper employs data from the population of hospitals in New York State. The performance measure is the ALOS for patients, adjusted for the mix and severity of cases in each hospital.

The paper finds that a direct relationship exists between the dependent variable and location, capacity, and teaching status, and failed to find a direct relationship for capital expenditures, salary, and staffing levels. However, the paper did find significant interaction effects between capital expenses and both salary and staffing levels.

There appear to be trade‐offs between capital expenditures and workforce decisions that have significant implications in light of current and expected hospital staffing shortages. The findings indicate that reductions in staff may not be perfectly replaced by corresponding increases in capital expenditures.

This paper further expands the body of research that addresses the important challenges hospitals face from an operations management perspective.

Advanced processing technologies, managerial practices, and information systems have merged as vital elements of modern day production. It has been argued that these changes in practice and technology have yielded a strategic manufacturing environ‐ment in the 1990s which is very different from that which existed in the 1970s and 1980s. Examines and documents these changes through the findings of a study in the US power tool industry of the effectiveness of the product‐process matrix in explaining the operations strategies of firms over the period 1970‐1990. Utilizes data from a detailed literature‐based survey, from on‐site interviews with executives and tours of manufacturing plants in the industry to explore the strategies followed over time by main and niche power tool firms competing in the US market. Shows that, while the Hayes and Wheelwright product‐process model captures many aspects of strategic operations decisions through 1980, changes have dramatically altered the competitive landscape and that many of the trade‐offs central to the model are no longer central to the articulation and formulation of operations strategy.