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The purpose of this paper is to refine and expand technology adoption theory for a healthcare logistics setting by combining the technology–organization–environment framework with a business process management (BPM) perspective. The paper identifies and ranks factors impacting the decision to implement instances of technologies in healthcare logistics processes.

A multiple case study is carried out at five Danish hospitals to investigate the bed logistics process. A combined technology adoption and BPM lens is applied to gain an understanding of the reasoning behind technology adoption.

A set of 17 factors impacting the adoption of technologies within healthcare logistics was identified. The impact factors perceived as most important to the adoption of technologies in healthcare logistics processes relate to quality, employee work conditions and employee engagement.

This paper seeks to understand how managers can use knowledge about impact factors to improve processes through technology adoption. The findings of this study provide insights about the factors impacting the adoption of technologies in healthcare logistics processes. Differences in perceived importance of factors enable ranking of impact factors, and prioritization of changes to be implemented. The study is limited to five hospitals, but is expected to be representative of public hospitals in developed countries and applicable to similar processes.

The study contributes to the empirical research within the field of BPM and technology adoption in healthcare. Furthermore, the findings of this study enable managers to make an informed decision about technology adoption within a healthcare logistics setting.

Business process redesign (BPR) is used to implement organizational transformations towards more customer‐focused and cost‐effective care. Ideally, these innovations should be carefully described and evaluated so that “best practices” can be re‐applied. To investigate this, available evidence was collected on patient care redesign projects.

The Ebsco Business Source Premier, Embase and Medline databases were searched. Studies on innovations related to re‐engineering patient care that used before‐after design as minimum prerequisites were selected. General characteristics, logistic parameters and other outcome measures to determine the objectives and results and interventions used were looked at.

A total of 86 studies that conformed to the criteria were found: a minority mentioned measurable parameters in their objectives. In the majority of studies, multiple interventions were combined within single studies, making it impossible to compare the effects of individual interventions. Only three randomized controlled trials were found. Furthermore, inconsistencies were noted between the study objectives and the reported results. Many more issues were reported in the results than were mentioned in the study aims. It would appear that publications were hard to find owing to a lack of specific MeSH headings. Nearly 7,500 abstracts were scanned and from these it was concluded that clear and univocal research methods, terms and reporting guidelines are advisable and must be developed in order to learn and benefit from BPR innovations in health care organizations.

This appears to be the first time available evidence about redesign projects in hospitals has been systematically collected and assessed.

This paper aims to set out the relationship between business process reengineering (BPR) and data warehouse (DW) and identify the advantages brought by the integration of DW technology in BPR projects.

This paper is primarily based on a case study which was conducted in a Tunisian hospital and allowed some lessons to be learned.

Introducing changes in the field of healthcare services has become a necessity to provide better satisfaction to patients and to offer faster services and of better quality. So, the BPR approach can be applied to introduce these changes and provide better satisfaction to recipients of services, i.e. the hospital patients. This study is based on a case study based on the BPR application for healthcare process in some services of Farhat Hached Hospital in Sousse, Tunisia. This case study has mainly contributed to a proposed DW for healthcare services.

The proposed DW and the new corresponding process have not yet been implemented in the real life of the considered services. The research work in this project allowed the provision of detailed and rational justifications for the information technology introduction in BPR applied in healthcare services and in particular to the implementation of the DW concept. In addition to the detailed justifications, the research paper provided the prerequisite for the success of the project as well as its technical specifications and appropriateness to the specifity to the local setting.

The lessons learned were related in one hand to the particularities of BPR projects using the DW technology and on the other hand to the advantages brought by the DW technologies in the BPR projects. The following questions are considered in this paper: what are the particularities of the BPR projects using the DW technology? What are the main contributions of the DW technology to BPR projects?

Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care.

A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010. Non-probability sampling identified interview subjects who, through their participation in the redesign initiative, had a detailed understanding of the implementation and outcomes of the initiative. Between April 2012 and January 2013 26 in-depth semi-structured interviews were conducted and analysed with thematic content analysis.

There were four important findings. First, when asked to comment on the impact of the LSS implementation, without prompting the staff spoke of quality of care. Second, there was little agreement among the participants as to whether the project had been successful. Third, despite the recognition of the need for a coordinated effort across the hospital to improve ED access, the redesign process was not successful in reducing existing divides among clinicians and among managers and clinicians. Finally, staff expressed tension between production processes to move patients more quickly and their duty of care to their patients as individuals.

One of the first studies to explore the impact of process redesign through in-depth interviews with participating staff, this study adds further evidence that organisations implementing process redesign must ensure the supporting management practices are in place.

The purpose of this paper is to describe a case study undertaken at Al Buraimi Hospital in Oman, which used computer simulation and the Delphi approach to improve efficiency by reducing prescription dispensing waiting times.

This study’s framework was based on a discrete event simulation (DES) to identify the as-is pharmacy process and to create a to-be (future situation) to achieve an improvement in pharmacy workflow and service quality. Owing to healthcare environment complexity, and to gain a deeper understanding about Al Buraimi Hospital pharmacy problems, a Delphi technique was also used.

Based on Delphi, and according to the expert panel suggestions, two alternative scenarios were proposed to improve Al Buraimi Hospital pharmacy efficiency: fast-track and direct-dispensing, which should help to reduce the prescription dispensing waiting time process by 7.3 and 9.8 min, respectively.

The main limitation is the pharmacists’ shortage, which may affect the prescription dispensing process’s quality as insufficient manpower to check the prescriptions may increase the medication errors’ risk.

Based on this case study’s real-world data, findings can be used to improve public healthcare sector pharmacy efficiency. The DES can be used in healthcare services to describe and test actual and proposed situations.

The purpose of this paper is to present a business process reengineering (BPR) framework of process and data integration with patient journey as the basis for process evaluation and the improvement of patient-flow.

A BPR framework is developed using a mixed-method research design, which incorporated a case study to demonstrate a healthcare scenario with associated processes and data elements, using process models based on event-driven process chain methodology as well as patient and data models, based on unitary structuring technique. The framework includes key processes including patient booking and rebooking, and associated inputs, outputs, and control parameters. In this case, the framework is demonstrated through application to computed tomography (CT) services in a hospital to improve patient-flow, with numerical simulation of CT data collected over time.

The framework supports flexible patient scheduling and the associated planning of healthcare operations and logistics – this in turn helps to improve patient-flow. Furthermore, mathematical modelling and simulation precisely reveal the impact of booking and rebooking on the performance of the CT department.

This innovative framework has potential value for other services, within and beyond the hospital setting.

The proposed framework of process modelling, data, and patient journey addresses the lack of a holistic approach to monitoring and evaluating service performance in hospital settings. Patient journey modelling is an integral part of process and data models that can be implemented in an integrated system environment such as an enterprise resource planning system for real-time monitoring of patient-flow under dynamic conditions.

The purpose of this article is to find decision‐making models for the design and control of processes regarding patient flows, considering various problem types, and to find out how usable these models are for managerial decision making.

A systematic review of the literature was carried out. Relevant literature from three databases was selected based on inclusion and exclusion criteria and the results were analyzed.

A total of 68 articles were selected. Of these, 31 contained computer simulation models, ten contained descriptive models, and 27 contained analytical models. The review showed that descriptive models are only applied to process design problems, and that analytical and computer simulation models are applied to all types of problems to approximately the same extent. Only a few models have been validated in practice, and it seems that most models are not used for their intended purpose: to support management in decision making.

The comparability of the relevant databases appears to be limited and there is an insufficient number of suitable keywords and MeSH headings, which makes searching systematically within the broad field of health care management relatively hard to accomplish.

The findings give managers insight into the characteristics of various types of decision‐support models and into the kinds of situations in which they are used.

This is the first time literature on various kinds of models for supporting managerial decision making in hospitals has been systematically collected and assessed.

Benchmarking is increasingly considered a useful management instrument to improve performance in healthcare. The purpose of this paper is to assess if a nationwide long-term benchmarking collaborative between operating room (OR) departments of university medical centres in the Netherlands leads to benefits in OR management and to evaluate if the initiative meets the requirements of the 4P-model.

The evaluation was based on the 4P-model (purposes, performance indicators, participating organisations, performance management system), developed in former studies. A mixed-methods design was applied, consisting of document study, observations, interviews as well as analysing OR performance data using SPSS statistics.

Collaborative benchmarking has benefits different from mainly performance improvement and identification of performance gaps. It is interesting that, since 2004, the OR benchmarking initiative still endures after already existing for ten years. A key benefit was pointed out by all respondents as “the purpose of networking”, on top of the purposes recognised in the 4P-model. The networking events were found to make it easier for participants to contact and also visit one another. Apparently, such informal contacts were helpful in spreading knowledge, sharing policy documents and initiating improvement. This benchmark largely met all key conditions of the 4P-model.

The current study has the limitations accompanied with any qualitative research and particularly related to interviewing. Qualitative research findings must be viewed within the context of the conducted case study. The experiences in this university hospital context in the Netherlands might not be transferable to other (general) hospital settings or other countries. The number of conducted interviews is restricted; nevertheless, all other data sources are extensive.

A collaborative approach in benchmarking can be effective because participants use its knowledge-sharing infrastructure which enables operational, tactical and strategic learning. Organisational learning is to the advantage of overall OR management. Benchmarking seems a useful instrument in enabling hospitals to learn from each other, to initiate performance improvements and catalyse knowledge-sharing.

The purpose of this paper is to establish the influence and discipline of process control and systems engineering theory plus engineering practices in the chemical process industry on current operations management development. Thus, part I lays the requisite groundwork for subsequent papers, part II covering the concept of a manufacturing system and part III its expansion and exploitation into the managing‐by‐projects engineering change methodology to output an integrated whole.

Extensive literature and wide ranging project review identifying relevance, mode of transference and application of process control techniques in discrete manufacture and other enterprises.

Such “technology transfer” of the systems method has visibly improved discrete production performance, often to a state of international competitiveness. Contributions are made at many levels. These range from exploiting elements of the business process systems engineering (BPSE) toolkit is used to analyse material flow right up to examples of successfully enabling of the corporate achievement plan in large organisations.

Established systems philosophy is widely relevant. However, the point at which it transforms into systems engineering is application specific.

No constraints are evident on application, but the extent of useful application is critically dependent on competence and culture of the enterprise. BPSE cannot be regarded as a “quick fix” panacea. It requires extensive and effective investment in people. For this reason a caveat emptor warning appears that applying the systems approach will fail unless taken seriously at all levels in the business.

Originality confined to the domain of bringing existing knowledge together and exploiting it in such a way that the contribution to knowledge is greater than the sum of the constituent parts.

The purpose of this paper is to present the effect of the introduction of cross-functional team (CFT)-based organization, rather than, on planning and performance of OR teams.

In total, two surgical departments of the Radboud University Nijmegen Medical Center (RUNMC) in the Netherlands were selected to illustrate the effect on performance. Data were available for a total of seven consecutive years from 2005 until 2012 and consisted of 4,046 OR days for surgical Department A and 1,154 OR days for surgical Department B on which, respectively 8,419 and 5,295 surgical cases were performed. The performance indicator “raw utilization” of the two surgical Departments was presented as box-and-whisker plots per year (2005-2011). The relationship between raw utilization (y) and years (x) was analyzed with linear regression analysis, to observe if performance changed over time.

Based on the linear regression analysis, raw utilization of surgical Department A showed a statistically significant increase since 2006. The variation in raw utilization reduced from IQR 33 percent in 2005 to IQR 8 percent in 2011. Surgical Department B showed that raw utilization increased since 2005. The variation in raw utilization reduced from IQR 21 percent in 2005 to IQR 8 percent in 2011.

Hospitals need to improve their productivity and efficiency in response to higher societal demands and rapidly escalating costs. The RUNMC increased their OR performance significantly by introduction of CFT-based organization in the operative process and abandoning the so called functional silos.

The stepwise reduction of variation – a decrease of IQR during the years – indicates an organizational learning effect. This study demonstrates that introducing CFTs improve OR performance by working together as a team.