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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.

In the face of growing demand for care and tightening resource constraints, hospitals need to ensure access to care that is affordable and effective. Yet, the multiplicity of objectives is a key challenge in this industry. An understanding of the interrelationships (tradeoffs) between the multiple outcome objectives of care (throughput, experiential and financial performance) and returns to operational inputs (diversification of care) is fundamental to improving access to care that is effective and affordable. This study serves to address this need.

The empirical analysis in the study builds on an output-oriented distance function model and uses a longitudinal panel dataset from 153 hospitals in California.

This study results point to key insights related to output–output tradeoffs along the production frontier. Specifically, the authors find that higher throughput rates may lead to significantly lower levels of experiential quality, and net revenue from operations, accounting for the clinical quality of care. Similarly, the authors’ findings highlight the resource intensity and operational challenges of improving experiential quality of care. In regards to input–output relationships, this study finds diversification of care is associated with increased throughput, improvements in service satisfaction and a corresponding increase in the net revenue from operations.

Highlighting the tradeoffs along the production frontier among the various outcomes of interest (throughput, experiential quality and net revenue from operations), and highlighting the link between diversification of care and care delivery outcomes at the hospital level are key contributions of this study. An understanding of the tradeoffs and returns in healthcare delivery serves to inform policy-making with key managerial implications in the delivery of care.

The purpose of this paper is to investigate how operations strategy and Lean concepts can be applied within a healthcare organisation and the degree to which both Lean and operations strategy are understood by senior-level National Health Service (NHS) personnel, based on the process of ongoing longitudinal cases studies. Further interviews and data analysis will examine actual performance of Lean capabilities within the NHS.

For this explanatory multiple-case study project the authors collected data through semi-structured interviews with executives in the NHS to understand how operations strategies are developed in the NHS and implemented in NHS hospitals. The unit of analysis is the hospital. Multiple (22) interviews took place over 12 months with senior-level personnel responsible for implementing change via operations strategy goals, and incorporating Lean initiatives. In addition, to triangulate data, the authors examined healthcare reports and strategy policy documents from each case hospital. This forms stage 1 of a longitudinal study which will examine the actual performance of Lean within the NHS hospitals across a range of operations parameters and explore links between such capabilities and the role and importance of operations strategy in more detail.

The findings lead to the conclusion that operations strategies were not fully developed within the hospitals. In addition, the ongoing data capture shows that “Best practice” was not being disseminated across the NHS, for either patient experience or organisational effectiveness and the role of operations strategy was not fully clear other than as a rather vague “umbrella” term. Despite Lean’s attraction for healthcare at a micro-level, significant operational and cultural hurdles must be overcome for the full strategic benefits of Lean to be realised. A much more holistic approach in providing a full service for the whole of the patient journey is needed.

The sample provides an initial snapshot. A larger number of hospitals and/or further longitudinal research will be needed to deepen understanding of embedding strategic change to improve overall performance.

Tackling cultural performance and operational issues at a macro-level could help healthcare providers reconcile the perceived conflicting goals of improving patient care (i.e. service delivery) whilst simultaneously reducing costs. The role of explicit operations strategies could be pivotal in designing and implementing such change.

This research builds on and extends the work of Toussaint and Berry (2013), Seddon and O’Donovan (2010) and Carlborg and Kowalkowski (2013). The authors highlight how some of the apparent contradictions in the requirements of the various stakeholders create operational and strategic tensions. The authors highlight the multi-faceted nature of design and delivery of a multi-touchpoint service within the complexity of a large healthcare provider.

The drug logistics play a crucial role in the hospital service performance. It has been proved that modern logistics concept is a valid access to competitiveness. In order to enhance the comprehensive capability and core competence of hospitals, including the internal support system, there is a great need to have an in-depth and systematic study on the drug logistics system in hospitals. The purpose of this paper is to explore the current situation of the drug logistics and the drug centres operations in public hospitals in China; specifically how the organizational partnerships with the supply chain partners can affect the operational performance.

In this study, the possibility of correlations between schedule instability, partnerships with supply chain partners, and internal drug logistics operation is investigated by modelling, with reference to the previous work of Law et al. (2009), in which collective efficacy of the performance is incorporated into the model.

The findings of this study show that the drug logistics working teams in public hospitals in China have a high level of efficacy and self-confidence, while they perceive they provide good operations even at a low level of schedule nervousness. The study also reinforces the significant correlation between internal operation and partnership with customers. This is definitely useful for the development of an appropriate framework for drug logistics operation improvement in the long run.

The study thus offers a good reference for the administrators and practitioners who are keen on improving the service operations in the healthcare sector in the region.

The purpose of this paper is to examine the relationship between patient safety culture and hospital performance using objective performance measures and secondary data on patient safety culture.

Patient safety culture is measured using data from the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture. Hospital performance is measured using objective patient safety and operational performance metrics collected by the Centers for Medicare and Medicaid Services (CMS). Control variables were obtained from the CMS Provider of Service database. The merged data included 154 US hospitals, with an average of 848 respondents per hospital providing culture data. Hierarchical linear regression analysis is used to test the proposed relationships.

The findings indicate that patient safety culture is positively associated with patient safety, process quality and patient satisfaction.

Hospital managers should focus on building a stronger patient safety culture due to its positive relationship with hospital performance.

This is the first study to test these relationships using several objective performance measures and a comprehensive patient safety culture data set that includes a substantial number of respondents per hospital. The study contributes to the literature by explicitly mapping high-reliability organization (HRO) theory to patient safety culture, thereby illustrating how HRO theory can be applied to safety culture in the hospital operations context.

Maintaining a safe and available supply of blood requires a mindfully coordinated supply chain (SC) and is fundamental to the effective operation of health systems across the world. This study investigates how blood supply chain (BSC) actors demonstrate collective mindfulness (CM) principles in their operations and how these demonstrations lead to improvements in blood safety and availability (BSA) in different operational contexts.

Six case studies drawn from two contrasting BSCs, the UK and Indonesia, which differ in structure and regulation are investigated in this research. Qualitative data are collected and analysed using template analysis.

The cases reveal how the CM principles are demonstrated in the supply chain context in a range of operational conditions and their impact on BSA. The BSC actors in the more centralised and tightly regulated cases display more behaviours consistent with more of the CM principles over a greater range of operational conditions compared to those in the more decentralised and loosely regulated cases. As such, more improvements in BSA are found in the former compared to the latter cases.

This paper is considered the first to investigate the demonstration of CM principles at the SC as opposed to the single organisational level. It proposes an alternative approach to understanding and evaluating reliability performance using behavioural rather than statistical principles.

The purpose of this paper is to identify the best practices in the green operations strategy of hospitals.

A total of 25 cases from all over the world were investigated. The source of data was the annual sustainability reports that were retrieved from Global Reporting Initiative (GRI) database. The present research adopted the benchmarking method and the quantitative content analysis of sustainability reports. Then, the indicative models of best practices were developed by using two analysis approaches; within cluster analysis and across clusters analysis.

This study found four major taxonomies of green operation strategy in hospitals. The significant strategic groups were resources/waste management; electrical power management; non-hazardous waste management; and emissions/resources management. Indicative models for the relationship between actions and key green performance indicators were developed in the two stages of the analysis.

The best practices of green operations strategies in hospitals have not so far been investigated. Countries around the world should obey the new regulations for their environmental footprint; if they do, it will exert pressure on all sectors and organizations at all levels to take immediate steps to measure and improve their environmental performance.

The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada.

In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a “double blind, double scored” methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management – operations, performance monitoring, targets and people management.

The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most.

This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services.

This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of management practices in the Australian public healthcare systems of Queensland and NSW.

The purpose of this paper is to examine the impact of lean management (LM) on operational performance (OP) in the context of health care in Jordanian private hospitals. LM is measured using four bundles: total quality management (TQM), human resource management (HRM), just-in-time system (JIT) and total productive maintenance (TPM). The study also investigates the effects of OP dimensions on hospitals’ business performance (BP).

The study is based on survey data collected from 260 respondents from 25 private hospitals in Jordan. Validity and reliability analyses were performed using SPSS and Amos, and the study hypotheses were tested using structural equation modeling.

The study found that the TQM bundle affects quality performance positively, but does not affect efficiency and accessibility performances, while the HRM bundle positively affects all OP dimensions. Furthermore, the JIT bundle positively contributes to both efficiency and accessibility performances, while the TPM bundle positively influences quality and accessibility performances. Moreover, the results have demonstrated that OP dimensions of quality and accessibility significantly and positively affect hospitals’ BP.

This study is one of the first to adapt the four lean bundles popularized in the manufacturing sector and apply them in a health-care context. It examines the effects of the four lean bundles on hospitals’ OP in terms of efficiency, quality and accessibility. In addition, the study demonstrates the role of OP dimensions in improving private hospitals’ BP.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.