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1 – 10 of over 38000Addresses the standardization of the measurements and the labels for concepts commonly used in the study of work organizations. As a reference handbook and research tool, seeks to…
Abstract
Addresses the standardization of the measurements and the labels for concepts commonly used in the study of work organizations. As a reference handbook and research tool, seeks to improve measurement in the study of work organizations and to facilitate the teaching of introductory courses in this subject. Focuses solely on work organizations, that is, social systems in which members work for money. Defines measurement and distinguishes four levels: nominal, ordinal, interval and ratio. Selects specific measures on the basis of quality, diversity, simplicity and availability and evaluates each measure for its validity and reliability. Employs a set of 38 concepts ‐ ranging from “absenteeism” to “turnover” as the handbook’s frame of reference. Concludes by reviewing organizational measurement over the past 30 years and recommending future measurement reseach.
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For 15 years general hospital managers faced new competition from for‐profit specialty hospitals that operate on a “focused factory” model, which threaten to siphon‐off the most…
Abstract
Purpose
For 15 years general hospital managers faced new competition from for‐profit specialty hospitals that operate on a “focused factory” model, which threaten to siphon‐off the most profitable patients. This paper aims to discuss North American specialty hospitals and to review rising costs impact on general hospital operations. The focus is to discover whether specialty hospitals are more efficient than general hospitals; if so, how significant is the difference and also what can general hospitals do in light of the rising specialty hospitals.
Design/methodology/approach
The case study involves stochastic frontier regression analysis using Cobb‐Douglas and Translog cost functions to compare Minnesota general and specialty hospital efficiency. Analysis is based on data from 117 general and 19 specialty hospitals.
Findings
The results suggest that specialty hospitals are significantly more efficient than general hospitals. Overall, general hospitals were found to be more than twice as inefficient compared with specialty hospitals in the sample. Some cost‐cutting factors highlighted can be implemented to trim rising costs.
Practical implications
The case study highlights some managerial levers that general hospital operational managers might use to control rising costs. This also helps them compete with specialty hospitals by reducing overheads and other major costs.
Originality/value
The study is based on empirical modeling for an important healthcare operational challenge and provides additional in‐depth information that has health policy implications. The analysis and findings enable healthcare managers to guide their institutions in a new direction during a time of change within the industry.
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Antonio Leotta and Daniela Ruggeri
This study aims to explore how the use of a performance measurement system (PMS) reflects the compatibility between institutional logics at different levels. It emphasises the…
Abstract
Purpose
This study aims to explore how the use of a performance measurement system (PMS) reflects the compatibility between institutional logics at different levels. It emphasises the centrality of institutional logics behind actors’ expectations.
Design/methodology/approach
Drawing on pragmatic constructivism, the study assumes that a PMS is used coherently when it realises the values and beliefs of the actors involved. This requires that actors communicate and understand one another (communication coherence) and accept the PMS in use (value coherence). The study argues that a coherent use of a PMS reflects the compatibility between the institutional logics at the same (field levels) or different levels (field and societal levels). The empirical evidence comes from a large public hospital located in the south of Italy.
Findings
The empirical results describe episodes that highlight how the coherence in the use of PMS reflects the compatibility of institutional logics at different levels and episodes where the compatibility can be hindered by problems in the coherent use of the PMS related to value and communication coherence. A lack of communication and value coherence is highlighted in the use of PMS as “compromising accounts”.
Originality/value
The study sheds light on how coherence in the use of PMS reflects the compatibility between the institutional logics involved at different levels, suggesting that a focus on one prevailing logic must be avoided. The study extends logics compatibility beyond the field level to the societal level.
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Duan Li‐zhong, Duan Gu‐na, Zhai Guang‐Qian, Zhang Ying, Xuan Chun‐Yu and Geng Hao
The purpose of this paper is to strengthen and standardize general hospital use of traditional Chinese medicine, strengthen the inner construction, highlight the characteristics…
Abstract
Purpose
The purpose of this paper is to strengthen and standardize general hospital use of traditional Chinese medicine, strengthen the inner construction, highlight the characteristics and advantages of Chinese medicine and improve Chinese medicine services' capacity and competitiveness.
Design/methodology/approach
Through data analysis and face‐to‐face interviews, the influential factors for Chinese medicine use in general hospitals are found and the extent and impact of these factors are researched. Based on survey results, grey relational analysis is used to analyze the actual factors.
Findings
Based on the results of grey relational analysis, a clear order of these factors on the degree of influence is obtained and suggestions are offered which can promote the development of traditional Chinese medicine in general hospitals.
Originality/value
The grey system theory was applied in medical management. The influential factors for Chinese medicine use in general hospitals was analyzed by using grey relational analysis, to offer the relevant departments several operational recommendations which can accelerate the development of general hospital use of traditional Chinese medicine.
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Rocío Rodríguez, Göran Svensson and Carmen Otero-Neira
The purpose of this paper is to assess the future direction of sustainable development in the healthcare industry. This study aims to reveal general similarities and specific…
Abstract
Purpose
The purpose of this paper is to assess the future direction of sustainable development in the healthcare industry. This study aims to reveal general similarities and specific differences between private hospitals and enabler or hinders of sustainable development.
Design/methodology/approach
Based on an inductive approach, judgmental sampling was applied to select relevant healthcare organizations. Informants were identified according to their knowledge of their organizations’ sustainability initiatives.
Findings
In the context the homogeneity that could be expected, the studied hospitals range from having a very strong organizational conviction as to the future direction of sustainable development to a very weak one. There are some general similarities and specific differences between them reported.
Research limitations/implications
There is no common formula applicable across private hospitals to determine the future direction of their sustainable development. Although hospitals benchmark best practices, others use them only as a general frame of reference. This scenario offers opportunities for further research.
Practical implications
The economic, social and environmental sustainable development across private hospitals may evolve from general principles or guidelines, but the specific sustainable development at each hospital may well evolve along tailored economic, social and environmental actions.
Originality/value
Developing a framework considering similarities and differences between the sustainability actions of each hospital in the healthcare industry is important for understanding future directions. This study provides insights into factors that could enable success or constitute hinders of sustainable development. They can also guide the industry toward a common objective which improves the hospitals sustainability actions in the future, also minimizing the effort required.
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The future of pathology services in the NHS is currently underconsideration. Recent developments in diagnostic technologies and theirpossible impact on pathology testing in the…
Abstract
The future of pathology services in the NHS is currently under consideration. Recent developments in diagnostic technologies and their possible impact on pathology testing in the future are discussed. Trends and patterns of demand for all three main pathology specialties are analysed over the 12‐year period, 1974‐86. The inflation‐adjusted, revenue cost of pathology testing per hospital admission (excluding capital costs) is shown to have fallen in real terms over this period, although it is uncertain whether this would still be the case were capital costs to be included. In the hospital sector, reported increases in demand can be quite simply related to increasing hospital activity by using a linear regression model. However, the very large increases in demand observed in the primary care sector cannot be related reasonably to any routinely reported practice activity indicators. The implications of this highly volatile pattern of demand in general practice are discussed, especially in relation to recent technological advances designed to produce rapid, near‐patient, surgery‐based tests. Although analysis indicates no evidence for historical technology‐induced increases in demand for laboratory services following the introduction of laboratory automation in the 1970s, the possibility of technology‐induced demand in the primary health care sector following the widespread introduction of surgery‐based tests is discussed.
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Hasan Bağcı and Seyhan Çil Koçyiğit
Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the…
Abstract
Purpose
Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the effects of the public hospital unions (PHUs), which were a result of Decree Law No. 663, on the efficiency and productivity of public hospitals.
Design/methodology/approach
Data envelopment analysis (DEA) and DEA-based Malmquist total factor productivity (TFP) index were used from 2011 to 2016. Raw materials and supply expenses, salaries and fringe benefits, other service costs, general administrative expenses, total number of beds, number of specialists, number of residents, number of general practitioners, number of nurses and midwives and other medical officials were used as input variables. Working capital turnover, number of inpatients, number of outpatients and number of surgical operations for Groups A, B and C were used as output variables.
Findings
According to the DEA scores, the percentage of efficient hospitals showed a declining trend from 2011 to 2016. The TFP results also showed a decreasing trend from 2011 to 2016.
Practical implications
Providing administrative and financial autonomy to public hospital managers may cause efficiency and productivity losses, which is contrary to expectations.
Originality/value
This study is the first to reveal the impact of decentralization of public healthcare providers on their performance levels in Turkey.
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Clara M. Escolano Hortelano, Félix Gutiérrez Rodero, Javier Ena Muñoz, Concepción Benito Santaleocadia, Mar Masiá Canuto, Alberto Martín Hidalgo, Antonia Mora Rufete and Ildefonso Hernández Aguado
Aims to assess the impact of a day‐care center (DCC) on hospital bed usage by HIV‐infected patients. Reviews the medical records of 710 hospital admissions of HIV‐infected…
Abstract
Aims to assess the impact of a day‐care center (DCC) on hospital bed usage by HIV‐infected patients. Reviews the medical records of 710 hospital admissions of HIV‐infected patients admitted to two Spanish hospitals, one of them with a DCC, over a three‐year period. The proportion of unnecessary admissions was significantly higher in the hospital without a DCC. The rate of hospital admissions among patients who were admitted to hospital was also greater in the hospital without a DCC, as well as the rate of admissions among patients on antiretroviral drugs. Concludes that the availability of a DCC improves the appropriateness of hospital admissions and decreases the number of hospitalizations in HIV‐infected patients.
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This paper reports from a qualitative case study of a change initiative undertaken in a Danish public hospital setting during national healthcare reforms. The purpose of this…
Abstract
Purpose
This paper reports from a qualitative case study of a change initiative undertaken in a Danish public hospital setting during national healthcare reforms. The purpose of this paper is to challenge understandings of innovations as defined by being value-adding per se. Whether the effects of attempting to innovate are positive or negative is in this paper regarded as a matter of empirical investigation.
Design/methodology/approach
Narrative accounts of activities during the change initiative are analysed in order to elucidate the effects of framing the change initiative as innovation on which boundaries are created and crossed.
Findings
Framing change initiatives as innovation leads to intended as well as unanticipated boundary crossings where healthcare practitioners from different organizations recognize a shared problem and task. It also leads to unintended boundary reinforcements between “us and them” that may exclude the perspectives of patients or stakeholders when confronting complex problems in healthcare. This boundary reinforcement can lead to further fragmentation of healthcare despite the stated intention to create more integrated services.
Practical implications
The paper suggests that researchers as well as practitioners should not presume that intentions to innovate will by themselves enhance creativity and innovation. When analysing the intended, unintended as well as unanticipated consequences of framing change initiatives as innovation, researchers and practitioner gain nuanced knowledge about the effects of intending to innovate in complex settings such as healthcare.
Originality/value
This paper suggests the need for an analytical move from studying the effects of innovation to studying the effects of framing complex problems as a call for innovation.
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Inger Johanne Pettersen and Elsa Solstad
The hospital sector in Norway has been continuously reorganized since 2002 and the reforms have created organizations that are functionally/vertically controlled, whereas the…
Abstract
Purpose
The hospital sector in Norway has been continuously reorganized since 2002 and the reforms have created organizations that are functionally/vertically controlled, whereas the production lines are coordinated on a process or a lateral basis. The purpose of this paper is to focus on both the perceived functional vertical control and horizontal controls within and between the local hospitals and the regional administrative levels.
Design/methodology/approach
A national survey study, complemented with interviews of some key informants and document studies.
Findings
The study shows that the functional and vertical lines of management control are perceived to be operating according to the traditional views of management control. The study indicates that the horizontal tasks are not very well implemented, and we did not find interactive and lateral uses of management control systems for managerial purposes.
Practical implications
New control problems arise when services are to be coordinated between autonomous units.
Originality/value
The paper focuses on the control problems found within the horizontal, flat relationship between production units in hospitals; new organizational structures have emerged where lateral relations are important, but traditional control practices follow functional, vertical lines.
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