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The purpose of this paper is to evaluate the utility of clinical processes in healthcare institutions of different sizes. The implications of adoption rate of computerized physicians order entry (CPOE) and electronic medical/health records (EMRs/EHRs) in different sized healthcare institutions in the USA were studied in terms of understanding its impact on enhancement of quality of patient care.

This study has used secondary data to obtain insights on the processes and technologies used in hospitals of different sizes in the USA and enlighten those in the developing countries to adopt a strategy that would be most appropriate for them. The Dorenfest Institute for H.I.T. Research and Education Analytics database (The Dorenfest Institute, 2011) provided the data for 5,038 US hospitals. Logistic regression was performed to study the impact of the different types of processes and technologies on institutions of different sizes, classified based on the number of beds, physicians, and nurses.

The findings show that small sized hospitals had a positive relationship with drug dosing interactions process and nursing and clinician content process. On the contrary, medium sized hospitals had a negative relationship with the usage of CPOE for entering medical records, i.e. <25 percent (p<0.05). In order to be effective, these institutions should increase the usage of EMRs by more than 25 percent to get positive outcomes. Large hospitals showed a positive relationship with the usage of >75 percent of CPOE to enter medical records and usage of medical records >75 percent.

The authors demonstrate the need for an evaluation of utility of acute care hospitals based on hospital size in terms of number of physicians, and nurses, which have not been dealt earlier by the past studies. Moreover, there is also a need for an evaluation of utility of acute care hospitals for implementation of CPOEs and EMRs that are integrated with clinical decision support systems.

Although the data are US-centric, the insights provided by the results are very much relevant to the Indian scenario to support the improvement of the quality of care. The findings may help those implementing processes in healthcare institutions in India. No study has addressed the measurement of the positive and negative outcomes arising due to the implementation of different percentages of CPOEs and EMRs in different sized institutions. Further the number of physicians and nurses have not been considered earlier. Therefore, the authors have classified the hospitals based on physicians and nurses and studied their impact on the adoption of CPOEs, clinical decision support systems, and EMRs.

The strategic management perspective suggests that organizations structure their governing boards to complement the strategic goals of the organization. In contrast, the institutionalization perspective holds that organizations structure their governing boards to respond to institutional pressures in their task environment. Regardless of which perspective is followed, three structural dimensions of governing boards are expected to be affected: size, diversity of composition, and medical staff representation. A study was conducted to relate the institutional requirements and strategies of acute care hospitals to the structural characteristics of their boards of directors. Results indicated that, after controlling for organizational size and membership in a multihospital system, the governing board structure of 109 acute care hospitals varied significantly both as a function of their overall business strategy and as a function of institutional linkages. However, the proportion of the total variance in board structure accounted for by strategy variables was approximately twice as much as that accounted for by institutional variables.

The purpose of this research is to explore the differences across hospital characteristics (i.e. lean maturity, hospital size, hospital type and ISO 9001) on lean expectation, lean performance, service quality expectation and service quality performance.

The survey instruments were developed from an extensive literature review, validated by experts and tested by statistical techniques. Data was collected from the perspective of care providers in 220 outpatient departments of Thai hospitals with multiple respondents to improve reliability of data. Analysis of variance and independent sample t test were applied for analysis.

It was found that there are significant differences across lean maturity and hospital size on overall lean expectation and overall lean performance, and across ISO 9001 on overall service quality performance. Overall, service quality expectation and performance have higher mean scores than overall lean expectation and performance.

To the best of author’s knowledge, this is one of the first studies to present insights into the links between Thai hospital characteristics, expected lean and service quality and performance from the care provider viewpoint. Findings form this study can be used to improve individual hospitals or develop healthcare system at national level.

The goal of this study is to provide guidance to managers who must make decisions regarding the adoption of technological innovations. The study was conducted within the context of the hospital industry. Results indicate that while adoption of technological innovations may lead to increased performance for certain hospitals, for large hospitals, and those located in rich environments, medical technology may be a ‘no‐win’ situation. Failure to adopt technology may result in the loss of patients, but adoption may result in increased costs that cannot be recovered due to underutilization.

The purpose of this study is to examine the effects of health-care governance and ownership structure on the performance of hospitals in Ghana.

The study uses multiple regression models based on a sample of 132 hospitals in Ghana.

The results of the study indicate that hospitals with a governing board perform better than those without a governing board. The results of this study also suggest that board characteristics and ownership structure are important in explaining the performance of hospitals in Ghana. The results further indicate that mission-based and private hospitals with effective board governance structures exhibit better performance than public hospitals.

This study makes a number of new and meaningful contributions to the extant literature and the findings support managerialism, stakeholder and resource dependency theories. The findings also have important implications for the effective governance of hospitals.

This study examines the relationship between CEO compensation and patient satisfaction in Ontario, Canada. The purpose of this paper is to determine what impact hospital CEO compensation has on hospital patient satisfaction.

The analyses in this study were based on data of 261 CEO-hospital-year observations in a sample of 103 nonprofit hospitals. A number of linear regressions were conducted, with patient satisfaction as the dependent variable and CEO compensation as the independent variable of interest. Controlling variables included hospital size, type of hospital, and frequency of adverse clinical outcomes.

CEO compensation does not significantly influence hospital patient satisfaction. Both patient satisfaction and CEO compensation appear to be driven primarily by hospital size. Patient satisfaction decreases, while CEO compensation increases, with the number of acute care beds in a hospital. In addition, CEO compensation does not even appear to moderate the influence of hospital size on patient satisfaction.

There are several limitations to this study. First, observations of CEO-hospital-years in which annual nominal CEO compensation was below $100,000 were excluded, as they were not publicly available. Second, this research was limited to a three-year range. Third, this study related the compensation of individual CEOs to a measure of performance based on a multitude of patient satisfaction surveys. Finally, this research is restricted to not-for-profit hospitals in Ontario, Canada.

The findings seem to suggest that hospital directors seeking to improve patient satisfaction may find their efforts frustrated if they focus exclusively on the hospital CEO. The findings highlight the need for further research on how CEOs may, through leading and supporting those hospital clinicians and staff that interact more closely with patients, indirectly enhance patient satisfaction.

To the best of the authors’ knowledge, no research has examined the relationship between hospital CEO compensation and patient satisfaction. This research fills the gap and provides a basis for future research.

This research examines how social media helps increase the dynamic capabilities of health organizations. Using the concepts of “technical fitness” and “evolutionary fitness,” the research focuses on changes in: (1) the number of “likes”; (2) the amount of discussions in these pages; and (3) enabling factors for (1) and (2) over time.

Missouri Hospital Association (MHA) provides a sample of 164 hospitals. The Facebook pages of these hospitals are analyzed. Specifically, the number of “likes” and the amount of discussions are readily available for analysis. Data collection was conducted at two time points.

At time 1, 39% of the hospitals had an official Facebook page, increased to 47% at time 2. On average, there was a 22.2% increase in likes and a 4.0% increase in pages of discussions. Whether measured by staffs or patients’ capacity, size is a significant factor that contributes to the increase in likes and discussions. Yet, the location of a hospital — measured by urbanity — is statistically insignificant. Qualitative analyses suggest that certain patient groups particularly welcomed social media. Beside, pictures, videos, and “happy news” tended to increase usage of social media for hospital stakeholders.

Social media can help health organizations fulfill the social needs of their patients. This research applies several useful concepts. In further study, researchers may examine how hospitals optimize staffs’ and patients’ inputs. Besides, comparing how hospitals’ social media platforms operate differently in other states or countries may yield findings with practical implications.

The purpose of this paper is to study the effect of the implementation of Lean bundles on hospital performance in private hospitals in Jordan and evaluate how much the size of organization can affect the relationship between Lean bundles implementation and hospital performance.

The research is considered as quantitative method (descriptive and hypothesis testing). Three statistical techniques were adopted to analyse the data. Structural equation modeling techniques and multi-group analysis were used to examine the research’s hypothesis, and to perform the required statistical analysis of the data from the survey. Reliability analysis and confirmatory factor analysis were used to test the construct validity, reliability and measurement loadings that were performed.

Lean bundles have been identified as an effective approach that can dramatically improve the organizational performance of private hospitals in Jordan. Main Lean bundles – just in time, human resource management, and total quality management are applicable to large, small and medium hospitals without significant differences in advantages that depend on size.

According to the researchers’ best knowledge, this is the first research that studies the impact of Lean bundles implementation in healthcare sector in Jordan. This research also makes a significant contribution for decision makers in healthcare to increase their awareness of Lean bundles.

The purpose of this paper is to investigate the determinants of best management practices in an Australian state-run healthcare system, namely New South Wales (NSW), and studies the impact of a range of hospital factors in driving best management practices as a means of enhancing healthcare delivery.

This study adapts a unique survey instrument globally tested to quantify the multi-dimensional nature of hospital management practices in 42 acute care public hospitals of NSW. The authors then analysed the role of hospital-specific characteristics in driving best management practices, namely hospital size (measured by the number of hospital beds, employees and doctors), level of skill and education, degree of hospital manager autonomy and organisational hierarchy.

The findings of this study show the areas of strength and potential areas of improvement in NSW hospitals. The authors find a positive association between the adoption of better management practices and hospital size (measured by the number of hospital beds and employees), level of skills and education, degree of hospital manager autonomy and organisational hierarchy. However, hospital size as measured by the number of doctors did not have a statistically significant relationship.

This paper is of interest to both hospital administrators, clinical doctors and healthcare policy-makers who want to improve and develop strategies for better management in the healthcare sector.

This study provides an internationally comparable robust measure of management capability in public hospitals, and contributes to the evidence-base of management practices and performance in hospitals.

The issue of gender diversity on hospital boards plays a significant role in the financial health and clinical performance of hospitals. The purpose of this paper is to examine the determinants of gender diversity of hospital boards in Ghana. Specifically, this study examined the proportion of females on hospital boards and considered how hospital-level characteristics such as hospital size, age, location and ownership structure explain the board gender diversity of hospital boards in Ghana.

A quantitative approach based on 100 hospitals was used.

The results of the study indicate that women are represented on all hospitals with governing boards but with different proportions depending on ownership form. In all, women represent less than half of board membership. Smaller and older hospitals were found to have more female representation on their board. Also, not-for-profit mission and for-profit private hospitals tend to engage more females than their counterpart public hospitals.

The study examined female representation on hospital boards depending on only hospital-level characteristics such as hospital size, age, location and ownership. Other factors could be determining the appointment of females on hospital boards other than hospital characteristics.

Efforts on improving the role of women on hospital boards need to be encouraged.

Evidence from this study clearly suggests underrepresentation of women in the top echelons of hospitals owned by government or the state, bigger and newer hospitals.