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The purpose of this paper is to present the contemporary understanding and emerging structural models of organisational governance of public hospitals in order to provide evidence-based guidance to countries that are reforming their public hospital governance structures in line with best practice.

The paper uses the structural dimension of Cooper, Fusarelli and Randall’s policy model and institutional theory to review the legislative frameworks of four model countries supported by extant literature.

The paper conceptually distinguishes health system governance and organisational governance in the health system. It further visualises the emerging alternative legislative models of organisational governance and a hierarchy of governors applicable to public hospitals.

The paper provides critical knowledge for understanding organisational governance within health system governance framework and develops tools that can be used in reforming institutional mechanism of organisational governance of public hospitals.

This paper develops and tests a descriptive model of management accounting system choice through an empirical analysis of the adoption of innovative cost accounting systems in not-for-profit hospitals. The logistic regression analysis indicates that management accounting system design is impacted by organi zational objectives, technological complexity, and other features of the organizational control system. Descriptive statistics indicate limited use of management accounting techniques common in manufacturing firms, such as standard costing and variance analysis. A cross-lagged model suggests that implementation of an innovative management accounting system may be causally linked to decreasing operating costs.

Health-care delivery organizations (hospitals) constitute a complex adaptive system; hence, a contingency perspective is imperative to guide the design of customized approaches to quality management in different health-care settings. Accordingly, this paper aims to propose a contingency framework to advance the understanding of the relationship between situational factors and effectiveness of quality approaches in health-care organizations (HCOs), such as hospitals in India.

Related literature was reviewed to identify existing research and theories related to quality and quality approaches, situational factors of the HCOs (hospitals) and some existing logical evidence on public and private hospitals in India. Then a contingencies framework for quality and quality approaches was conceptualized.

This paper proposes contingent determinants arise out of conceptualization of the HCOs (hospitals) from different system perspective such as rational system, natural system, open system and integrative system; uncertainty because of physicians’ behaviour, nurses’ approach and a dual line of authority; and the task environment such as patients, competition and economic pressure. These determinants represent situational constructs to the quality enhancement of any attempt at quality approaches. While these determinants have an influence on the quality and quality approaches of the HCOs (hospital), it is imperative to build any quality improvement strategy to work effectively, i.e., quality approach is dependent on determinants of the contingencies of the hospital’s environment, be it external or internal. Propositions for future research are also incorporated.

This paper proposes a conceptual model as well as research propositions that need to be validated and confirmed empirically. It advances the research and theory related to quality and quality approaches in a health-care setting. It can enable policymakers, hospital managers to analyze and gauge the appropriateness of quality approaches in a given context before implementing them and could help to improve the introverted quality approaches and quality dimensions currently followed in HCOs (hospitals).

Contingency framework is a new approach for research on the effectiveness of quality approaches in hospitals. The fundamental idea behind this framework is that effectiveness of quality approaches can be understood best by examining its contingent determinants. Thus, it has the capacity to contribute to the efforts of government and policymakers to make the quality of care affordable to all in India. Essentially, we examine the contexts and variables that determine the effectiveness of quality approaches.

This special “Anbar Abstracts” issue of Journal of Management in Medicine is split into 6 sections covering abstracts under the following headings: General Management; Personnel and Training; Quality in Health Care; Health Care Marketing; Financial Management; and Information Technology.

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.

A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.

Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.

Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.

Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.

For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.

This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.

Medical errors cause a significant number of deaths. Providing training to medical staff can improve the quality of medical care. Hospitals have traditionally used face‐to‐face modality to train staff but they are beginning to adopt e‐learning systems that can easily deliver training at work or to other convenient locations. The purpose of this paper is to investigate factors leading to e‐learning adoption in hospitals.

A framework of factors leading to the adoption decision of e‐learning systems is first proposed. Survey data are collected to empirically test the proposed framework. The samples consist of senior executives and managers in hospitals.

It is found that three factors including managerial, organizational, and technological exhibit significant influences on the adoption decision. One novel result is that the organizational variable of hospital specialization significantly influences the decision to adopt e‐learning systems.

This study is one of the first to propose a model of adoption of e‐learning specifically in the context of hospitals. Limitations and strengths of the study and possible future research direction are also discussed.

From a practitioner's standpoint, the results of this study can help hospital administrators to accelerate the adoption of e‐learning systems.

This study is one of the first to propose a model of adoption of e‐learning specifically in the context of hospitals. It is expected that the model developed can assist to further understand the e‐learning adoption in hospitals.

Delay in the clinical information system (CIS) restoration overseeing critical health-care operations after an unexpected data loss can be fatal for patients under care. Investment in information technology (IT) capabilities and synergy between various computerized systems has been argued as the resilient information system's enablers. The purpose of this study is to empirically quantify the influence of IT investment, integration and interoperability in recovering the CIS from a data disaster.

An archival dataset sourced from a European Commission-sponsored survey of 773 hospitals across 30 countries in Europe is utilized to study the relationships. The study adopts a quasi-experimental research design approach where sample observations are weighted based on their propensity to be selected in treatment groups. The artificial weighing allows attaining a pseudo-random sample to counter the effects of selection bias.

The study finds that hospitals with more than 5% of the budget dedicated to IT have 100% higher odds of recovering immediately from a critical data loss in comparison to those that have less than 1% investment in IT. The greater extent of IT integration significantly reduces the time to recover the CIS, while interoperability problems at the organizational level lessen the odds of immediate recovery by 19%. Interoperability problems at the technical and semantic levels do not significantly impact recovery times of the CIS.

The study proposes several empirically quantified and scientifically tested recommendations for health-care providers for faster restoration of critical CIS operations post data loss. The differential impact of the interoperability problems at the technical, semantic and organizational levels has also been highlighted.

Healthcare services in the USA have been described as being fragmented and uncoordinated. Integrated delivery systems are frequently promoted as being instrumental in efforts to improve the coordination of care and, thus, enhancing the quality of clinical care and patient services while ensuring optimum cost‐efficiencies. This study seeks to analyze and compare the performance of hospitals participating in highly integrated systems with non‐integrated hospitals based on outcome measures involving hospital performance.

The study compares the performance of 50 flagship hospitals participating in the most highly integrated delivery systems in the USA with a representative sample of non‐system hospitals utilizing one‐way analysis of variance. The comparative analysis was based on three key performance measures; clinical quality of medical care, patient satisfaction, and cost‐efficiency considerations.

The results of the review demonstrate that there is a statistically significant positive difference between the clinical quality performance of the highly integrated hospitals compared with the quality performance of non‐highly integrated facilities. No difference was identified between the two sample groups of hospitals for the performance measures related to patient satisfaction or cost‐efficiencies.

The study is an attempt to evaluate the implications and effectiveness of integration within the health care delivery system. It suggests that integrated delivery systems may provide the organization structure appropriate to help support and enhance the quality of clinical care for patients.

Expert knowledge is an important organisational resource, and organisations need to retain the knowledge learned by experience, which can be shared as part of inter-professional learning. In a healthcare context, radio-frequency identification (RFID) and ZigBee technologies can be used together, to provide real-time information for decision support and to create a secure and reliable smart hospital management information system (SHMIS) that allows the dynamic control of objects and transforms operational processes, while minimising any potential risks to patients and staff. Currently, the RFID technology in Saudi Arabia is being solely used for the monitoring of newborn infants, and some difficulties have been encountered during the different stages of tagging and monitoring. The current system in Medina Maternity and Children’s Hospital (MMCH) uses battery-powered active RFID tags, which are expensive and require routine maintenance. This study aims to discuss the way in which the MMCH in Medina, Saudi Arabia, could be transformed into an SHMIS.

The extraordinary growth of RFID and ZigBee technologies has made it possible to identify, locate and track objects in various environments in real time. The RFID technology is a non-contact identification technology that is cheap and reliable but has limited range in the case of passive tags. ZigBee has greater range and lower power consumption, giving more precise location of the object’s movements (0.6 m). Passive RFID when combined with ZigBee technology can be used to improve services provided by healthcare organisations through continuous data collection and supporting real-time decision-making, by applying expert knowledge of domain experts to data produced by communication from electronic and sensor technologies.

A prototype object-tracking system using RFID and ZigBee was developed to support the knowledge transformation for knowledge reasoning for decision support (KRDS), and the outcome of this research was validated with domain experts in hospitals in Saudi Arabia. Two feasibility case studies were conducted at MMCH in Saudi Arabia, to evaluate the proposed system. A survey was also conducted to address the requirements at MMCH, and the researcher adopted a range of strategy techniques, including interviews and meetings with staff, and the setting up of communities of practise (CoPs) at the target hospital.

This paper has investigated the transformation process of an automatic healthcare tracking and monitoring systems for the purpose of developing a smart system in Saudi hospitals. For the scope of the project, the prototype implementation was restricted to a laboratory environment, to demonstrate the proposed proof of concept. The next phase will include conducting a scale up of the system, with implementation and testing done in a real hospital environment.

This paper proposes a prototype application of an (SHMIS that allows the dynamic control of objects and transforms operational processes, while minimising any potential risks to patients and staff.

The use of clinical performance data is increasing rapidly. Yet, substantial variation exists across indicators designed to measure the same clinical event. We compared indicators from several indicator measurement systems to determine the consistency of results. Five measurement systems with well‐defined indicators were selected. They were applied to 24 hospitals. Indicators for mortality from coronary artery bypass graft surgery and mortality in the perioperative period were chosen from these measurement systems. Analyses results and concludes that it is faulty to assume that clinical indicators derived from different measurement systems will give the same rank order. Widespread demand for external release of outcome data from hospitals must be balanced by an educational effort about the factors that influence and potentially confound reported rates.