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Article
Publication date: 1 February 1997

Martin Kitchener and Richard Whipp

Examines the process of change in hospitals that has emerged following the introduction of the health quasi‐market in 1991. Blends empirical evidence with Greenwood and Hinings’…

599

Abstract

Examines the process of change in hospitals that has emerged following the introduction of the health quasi‐market in 1991. Blends empirical evidence with Greenwood and Hinings’ archetype and tracks of change concepts to analyse the process which is labelled quasi‐market transformation (QMT). Argues that, before 1991, hospitals tended to operate within structures and systems underpinned by an interpretive scheme. Represents these similarities of configuration as the directly‐managed (DM) hospital archetype. When change initiatives challenged this configuration, the outcomes were negotiated and resulted in “adjustmental” change. In contrast, shows the introduction of the quasi‐market to have involved the first transformation of the DM archetype’s interpretive scheme, systems and structures. Analyses four years of transition to reveal that QMT has been interpreted differently within hospitals. However, presents data to suggest that many hospitals now display significant similarities in terms of configuration. Represents these similarities within the emerging Trust hospital archetype.

Details

International Journal of Public Sector Management, vol. 10 no. 1/2
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 7 October 2014

Danielle A. Tucker, Jane Hendy and James Barlow

As management innovations become more complex, infrastructure needs to change in order to accommodate new work practices. Different challenges are associated with work practice…

1017

Abstract

Purpose

As management innovations become more complex, infrastructure needs to change in order to accommodate new work practices. Different challenges are associated with work practice redesign and infrastructure change however; combining these presents a dual challenge and additional challenges associated with this interaction. The purpose of this paper is to ask: what are the challenges which arise from work practice redesign, infrastructure change and simultaneously attempting both in a single transformation?

Design/methodology/approach

The authors present a longitudinal study of three hospitals in three different countries (UK, USA and Canada) transforming both their infrastructure and work practices. Data consists of 155 ethnographic interviews complemented by 205 documents and 36 hours of observations collected over two phases for each case study.

Findings

This paper identifies that work practice redesign challenges the cognitive load of organizational members whilst infrastructure change challenges the project management and structure of the organization. Simultaneous transformation represents a disconnect between the two aspects of change resulting in a failure to understand the relationship between work and design.

Practical implications

These challenges suggest that organizations need to make a distinction between the two aspects of transformation and understand the unique tensions of simultaneously tackling these dual challenges. They must ensure that they have adequate skills and resources with which to build this distinction into their change planning.

Originality/value

This paper unpacks two different aspects of complex change and considers the neglected challenges associated with modern change management objectives.

Details

Journal of Organizational Change Management, vol. 27 no. 6
Type: Research Article
ISSN: 0953-4814

Keywords

Article
Publication date: 6 June 2016

Heru Fahlevi

This paper aims to understand why an expected enhanced role of accounting in Indonesian public hospitals has not occurred, although serial organizational changes and reform of…

Abstract

Purpose

This paper aims to understand why an expected enhanced role of accounting in Indonesian public hospitals has not occurred, although serial organizational changes and reform of hospital payment systems have taken place.

Design/methodology/approach

This study adopts a multiple case study research approach. It was carried out in two Indonesian public hospitals. Interviews were the main tool used for collecting data. The primary interviewees were the top managers, accountants and senior physicians in the hospitals surveyed.

Findings

Insights from the interviews revealed that the owners’ traditional role of funding deficits plus the conventional mindsets of managements and physicians who are only interested in health outcomes have hindered the infiltration of economic and accounting logic into the management of these two public hospitals. Consequently, the expected accounting innovations, i.e. an enhanced role of accounting in the hospitals’ daily activities did not emerge.

Research limitations/implications

This case study is not a longitudinal study and the interviewees, particularly senior physicians, were selected based on their availability and willingness to participate in the interviews. Thus, the findings should be treated with caution.

Practical implications

An enhanced role of accounting and other accounting innovations would indicate that the hospitals are responding as expected to the institutional and financial reforms.

Originality/value

Contingency theory and institutional theory have been used together in this study which aims to not only discuss the reasons for accounting changes occurring or not occurring, but also to understand the motivations behind the accounting changes or lack of change. Thus, a more comprehensive understanding of accounting innovations is expected.

Article
Publication date: 1 April 2004

Ronald J. Burke

This study examined employee reactions to a process reengineering initiative in a large financial services organization. Data were obtained from 2,514 employees, using…

2630

Abstract

This study examined employee reactions to a process reengineering initiative in a large financial services organization. Data were obtained from 2,514 employees, using questionnaires completed anonymously. Employees having longer company tenure, those at higher levels, and men held more favorable attitudes toward the reengineering initiative. Employees indicating greater understanding of the reengineering effort had more favorable attitudes toward it. Employees holding more favorable attitudes toward the process reengineering initiative also reported more positive work experiences and outcomes and described the organization in more favorable ways. Implications for managing large‐scale change efforts are proposed.

Details

The TQM Magazine, vol. 16 no. 2
Type: Research Article
ISSN: 0954-478X

Keywords

Article
Publication date: 30 September 2013

Mariado Carmo Caccia-Bava, Valerie C.K. Guimaraes and Tor Guimaraes

Business process reengineering (BPR) is touted in the literature as the dramatic improvements necessary for competitiveness, but in practice there are many unsuccessful cases. A…

1580

Abstract

Purpose

Business process reengineering (BPR) is touted in the literature as the dramatic improvements necessary for competitiveness, but in practice there are many unsuccessful cases. A more systematic and rigorous factor-assessment deemed important to each BPR phase and overall project success is needed. This paper aims to assess the extent to which proposed success factors in a hospital contribute to each BPR phase's success.

Design/methodology/approach

Based on the relevant literature, desirable results from each project phase were defined. Overall project success was defined as the benefits hospital managers derive from BPR according to manager opinions. A total of 192 hospital administrators shared their last BPR experience, where changes were operational for at least one year.

Findings

Recommendations are made for hospital managers to focus attention and resources on factors important to BPR success. Hospital managers are not emphasizing the most important activities and tasks recommended in the BPR literature, such as changes to customer/market related business processes, every business activity's value-added element and applying the right innovative technology. Based on the whole findings, top managers should not engage BPR before ensuring that important success factors are present.

Originality/value

While many researchers identified and/or tested factors important to BPR success, this is the first study to explore BPR success factors' importance to each project phase, from inception to overall project success assessment phase.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 8
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 December 2005

Maria do Carmo Caccia‐Bava, Valerie C.K. Guimaraes and Tor Guimaraes

Business process reengineering has been touted in the literature as a dramatic improvement necessary for organization competitiveness, but in practice there are many unsuccessful…

1434

Abstract

Purpose

Business process reengineering has been touted in the literature as a dramatic improvement necessary for organization competitiveness, but in practice there are many unsuccessful cases. Thus, there is need for a more systematic and rigorous assessment of the factors deemed important to project success. The main objective of this study is to examine this issue.

Design/methodology/approach

For this research, success has been defined as the benefits the hospital has derived from the BPR project, according to top managers' opinions. A sample of 192 hospital administrators shared their organizations' experience with their last BPR project implementation, where the changes have been operational for at least one year.

Findings

Based on the results, recommendations are made for hospital managers to focus attention and resources on factors important to BPR project success. In general, hospitals are not emphasizing some of the most important activities and tasks recommended in the BPR literature, such as changes to customer/market‐related business processes, the value‐added element of every business activity, and applying the right innovative technology.

Originality/value

Based on the findings as a whole, it behoves top managers not to engage in BPR before ensuring the presence of the success factors found to be important.

Details

International Journal of Health Care Quality Assurance, vol. 18 no. 7
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 April 1996

Stuart D. Francis and Patrick G. Alley

Describes a business process re‐engineering project in the department of surgery of a publicly‐funded hospital in Auckland, New Zealand. Through the creation of an internal…

1284

Abstract

Describes a business process re‐engineering project in the department of surgery of a publicly‐funded hospital in Auckland, New Zealand. Through the creation of an internal marketing approach, by splitting the health system into purchaser and provider elements, the need to refocus on service provision became very apparent. Patient focus review teams were put together to analyse internal processes. Discusses in detail the outcomes of the review, highlighting the need for further changes and setting the direction for a re‐engineering programme.

Details

Business Process Re-engineering & Management Journal, vol. 2 no. 1
Type: Research Article
ISSN: 1355-2503

Keywords

Article
Publication date: 8 August 2023

Yasmine YahiaMarzouk and Jiafei Jin

Based on the dynamic capabilities view, the current study aims to empirically investigate the effects of organizational learning culture (OLC), strategic reconfiguration (SREC…

Abstract

Purpose

Based on the dynamic capabilities view, the current study aims to empirically investigate the effects of organizational learning culture (OLC), strategic reconfiguration (SREC) and digital transformation (DT), altogether, on Egyptian private hospitals' strategic renewal in the face of the COVID-19 pandemic.

Design/methodology/approach

This study adopted a cross-sectional design to collect the data used to carry out mediation analysis. A self-administered questionnaire was used to collect data from a sample consisted of 264 Egyptian private hospitals. The smart partial least square structural equation modeling technique (PLS-SEM) was adopted to test the hypotheses.

Findings

The results demonstrate that OLC directly and positively affects SR. Besides, SREC and DT partially and serially mediate the OLC-SR relationship.

Research limitations/implications

The sample size was small, covering only Egyptian private hospitals. The results may be different in the manufacturing sector and in other countries. The study was cross-sectional which is limited to trace long-term effects of OLC, SREC and DT on SR. Accordingly, a longitudinal study may be undertaken.

Practical implications

Private hospitals' managers must actively explore and dig out valuable resources in order to discover potential information and trends endeavor to redesign internal structures, and reconfigure their current resources, structures and strategies to achieve strategic renewal. The findings also provide new insights to mangers of private sectors' institutions and direct their attention toward adopting the strategic renewal option to survive amidst crises instead of retrenchment, persevering, or quitting business.

Social implications

The study's results imply that health care providers have sought to improve the capacities of their health care systems to address the patient-level social needs through continuous learning, internal reconfigurations and the transformation toward digitalization to renew their services.

Originality/value

This study therefore contributes to SR literature by being the first empirical study to introduce an integrative model for the antecedents of SR amidst the pandemic.

Details

Journal of Organizational Change Management, vol. 36 no. 5
Type: Research Article
ISSN: 0953-4814

Keywords

Article
Publication date: 13 July 2018

Luca Gastaldi, Francesco Paolo Appio, Mariano Corso and Andrea Pistorio

The purpose of this paper is to understand how digital technologies can help healthcare organisations and improve the exploration-exploitation paradox over time. The authors…

2221

Abstract

Purpose

The purpose of this paper is to understand how digital technologies can help healthcare organisations and improve the exploration-exploitation paradox over time. The authors explore inputs, processes and outcomes of implementing digital transformation programs and advance four testable propositions.

Design/methodology/approach

The authors conducted multiple case studies with embedded units of analysis: digital transformation processes; hospitals; and regional healthcare systems. Primary sources come from 107 semi-structured interviews with key informants within 14 Italian hospitals between 2009 through 2011.

Findings

Three complementary paths emerge as fundamental to balance exploratory and exploitatory efforts in healthcare: assets digitalisation within hospitals; digitally based process integration; and disruptive decision-making through analytics. Intra- and inter-path characteristics are discussed to show how digital transformation can both move hospital within the exploration-exploitation space.

Research limitations/implications

By its very nature, this study is exploratory. Notwithstanding the number of cases and interviews, its generalisability is limited.

Practical implications

Digital transformation programs are fundamental to resolve the tensions raised by the exploration-exploitation paradox. Their implementation leads to better performance (cost reductions, quality improvements). A framework is provided for practitioners to make better decisions.

Originality/value

This study sheds new light on how digital technologies are actually adopted and adapted in healthcare contexts. It does it by entailing a longitudinal perspective.

Details

Business Process Management Journal, vol. 24 no. 5
Type: Research Article
ISSN: 1463-7154

Keywords

Article
Publication date: 15 February 2024

Albi Thomas and M. Suresh

Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a…

Abstract

Purpose

Green transformation is more than simply a trend; it is a way of life, a set of habits, a field of knowledge and a dedication to resource conservation. Going green is surely a creative and transformative process for both individuals and organizations. This paper aims to “identify,” “analyse” and “categorise” the readiness factors for green transformation process in health care using total interpretive structural modelling (TISM) and neutrosophic-MICMAC.

Design/methodology/approach

To address the study objectives, the study used TISM and neutrosophic-MICMAC analysis. To identify the readiness factors, a literature study was conducted, and the factors were face-validated by the healthcare experts. The factors influence on one another were captured by using a scheduled interview with a closed ended questionnaire. The TISM addressed the identification and analysing of factors and the categorization and ranking the readiness factors is addressed by using neutrosophic-MICMAC analysis.

Findings

This study identified 11 green transformation process readiness factors for healthcare organizations. The study states that the key factors or driving factors are awareness of green governance principle, environment leadership and management, green gap analysis, information and communication technology and innovation dynamics.

Research limitations/implications

The factor ranking is sensitive to the respondents’ ratings. The study relied on the past literature and experts’ opinion may result in the subjective biases. The complex nature of healthcare ecosystem challenges to capture all the factors. The study focussed on Indian hospitals.

Practical implications

Study significantly impacts the healthcare practitioners, academicians and policymakers by providing critical insights into the readiness factors required for the healthcare green transformation process. The study offers a better understanding of the crucial or key or driving factors that aid in embracing green and sustainable practices.

Originality/value

Identifying a gap in conceptual and theoretical frameworks for green transformation readiness factors in healthcare organizations and in Indian context. The study addresses this gap by aiming to create a thorough theoretical framework and highlighted by its focus on Indian hospitals.

Details

Journal of Indian Business Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1755-4195

Keywords

1 – 10 of over 11000