As the healthcare industry is in the midst of a shift to value-based payment models, hospitals face increasing pressure to balance strategic priorities and to improve both the effectiveness and ...efficiency of care delivery. To confront these challenges, hospitals are placing an increased emphasis on process excellence. We use process excellence to denote a hospital's ability to, on average, treat a patient in the most effective and efficient manner. We use actual improvements in cost per discharge (CPD), average length of stay (ALOS), and conformance quality (ConfQual), to assess changes in a hospital's level of process excellence. In this paper, we investigate empirically the association between process excellence and overall measures of hospital performance, including market share and profitability. To this end, we leverage secondary data sources and regression analysis to track over time the performance of 288 short-term acute care hospitals located in California. Our analysis leads to several important implications. First, we find that a hospital's focus on improving CPD and ALOS, is associated with higher inpatient market share, whereas improvements in ConfQual are negatively associated with market share. Second, improvements in CPD are associated with higher profitability while there is no direct relationship between improvements in both ALOS and ConfQual and profitability. Third, CPD is found to mediate the relationship between both ALOS and ConfQual and hospital performance. We further discuss the implications of this study for theory and practice.
•We examine the benefits of process excellence (PE) in California hospitals.•PE is measured by costs (CPD), length of stay (ALOS), conformance quality (ConfQual).•Archival data and panel data regression analysis are used to test two hypotheses.•Improvements in either CPD or ALOS are associated with higher inpatient market share.•ALOS and ConfQual are associated with higher profitability only indirectly, via CPD.
As information technology (IT) proliferates across functional units, manufacturers that lack a coherent strategy for integrating, standardizing and leveraging their IT resources and capabilities are ...more likely to end up with fragmented systems that do not properly support business processes and hinder performance. One strategic approach to facilitating standardization and integration among IT resources is enterprise architecture (EA). As the representation of an enterprise's business processes and IT systems, EA underpins decisions relating to data, applications, IT infrastructure (technical and human), and management responsibilities in order to inform business strategies that enable organizations to accomplish their business objectives. In this research, we leverage competence-based theory to introduce EA strategic orientation and EA assimilation as dynamic and operational capabilities, respectively. Data collected from 190 manufacturers and seemingly unrelated regression are used to test hypotheses related to a nomological network consisting of EA strategic orientation, EA assimilation, agility and firm performance. The findings suggest that EA-based capabilities can enhance agility, and indirectly increase firm performance. As the first study to assess the value of EA from a non-IT-centric perspective, this work serves as a pivot point for examining the reach and range of EAbased capabilities, particularly in operations management. The findings provide operations and IT managers with evidence of how enterprise IT initiatives are ultimately linked to firm performance by way of EA-based capabilities.
Analytical techniques continue to advance in efficacy, as well as complexity. However, it is sometimes unrealistic to employ complex analyses during time-constrained humanitarian disaster operations. ...We propose that simple, embedded analytics tools can provide an effective and practical means toward managing humanitarian operations. In this paper, we demonstrate a real-world application of our technique in a patient evacuation context. This paper contributes to literature and practice by showing how simple analytic methods and open-source imagery tools can offer significant value to the humanitarian operations literature. The application also highlights some challenges to drawing a clear picture from disparate data sources in the humanitarian operations domain.
The use of group purchasing organizations (GPOs) as a supply chain intermediary is a long-standing and strategic approach to enhancing supply cost efficiency in U.S. hospitals. As a consequence, a ...hospital's decision to reconfigure its GPO network can have critical ramifications for the hospital's supply cost performance. In this study, we conceptualize possible GPO changes as structural and relational and investigate the impact of GPO changes on supply cost efficiency. To this end, we employ archival, panel data from multiple sources that track the performance of 2,391 U.S. hospitals between 2009 and 2014. Our findings indicate that, whereas hospitals that make a structural GPO change experience a decrease in supply cost efficiency, hospitals that enact a relational change are shown to experience improvements in supply cost efficiency. Our findings have important theoretical and managerial implications for supply chain management and hospital administrators.
•We examine how changes in hospital-GPO relationships impact hospital performance.•We posit that structural and relational GPO changes are strategic sourcing decisions.•Archival data and panel data regression analysis are used to test three hypotheses.•Structural GPO changes are more detrimental to performance than relational changes.•A decrease in the number of GPOs is associated with lower supply cost efficiency.
The relationship between product variety and sales has been extensively researched, but almost exclusively from the perspective of a new goods retail firm. Closed-loop supply chains for used goods, ...such as automobiles, offer unique challenges in terms of using reverse flows to create product variety at the retail location. Firms in used goods industries are unable to define their product mix a priori and may not even know which goods will be available to add to their sellable inventory. In this article, we use data from a used automobile retailer to explore these issues. A better understanding of the relationship between variety and sales can help used automobile retailers improve how they define and structure product variety at retail locations. Improved management of used automobile sales has obvious financial implications, but it also has important environmental implications, given the large contribution of passenger vehicles to overall emissions. This study implements a cluster analysis using consumer-facing variables to understand how customers view product variety for used automobiles. Our results show that three distinct classes of inventory exist, primarily driven by a key characteristic—body type—which differs from the traditional definition of product variety for new vehicles in the existing literature. A two-way fixed effects regression is then used to understand the relationship between product variety at the firm's retail locations and sales. The results demonstrate a nonlinear relationship between product variety and sales and, intriguingly, suggest that increasing product variety in some classes can be used to drive sales in others. Our findings yield important contributions for managers in used automobile firms and extend the broader literature on closed-loop supply chains. Specifically, our research demonstrates important differences in how product variety should be managed with used goods relative to new goods by a firm seeking to maximize sales.
Business analytics is driving the way organizations compete. However, the decisions made as a result of any analytics process are greatly dependent on the quality of the data from which they are ...based. Scholars suggest several data quality improvement methods, and commercial software is now available that can help improve data quality. Although organizations are motivated to find ways to improve analytic capabilities and using these methods has been shown to improve some measures of data quality, there is little understanding of the tangible and intangible outcomes of employing these methods. In this study, we explore outcomes that arise from a data quality improvement process implementation in an operations management environment. Over a three-year period, we conducted a longitudinal single case study at an organization that maintains a large fleet of aircraft, collecting and analyzing qualitative interviews and observations. The findings suggest outcomes (both positive and cautionary) associated with the implementation of data quality improvement processes. These include increased stakeholder commitment to data quality and business analytics, as well as an over-emphasis on program metrics to the peril of operational outcomes, among others. From the basis of our findings, we construct a research agenda, which includes testable Propositions regarding outcomes of data quality improvement.
Hospitals in the United States (U.S.), and the healthcare industry as a whole, are experiencing major transformations that will likely affect every facet of our society. One such example is a federal ...regulation known as the Value‐based Purchasing (VBP) program, which shifts hospital reimbursements for services rendered away from a fee‐for‐service model to a value‐based model. This change requires hospitals to more accurately track and document resources/assets utilized in the delivery of care, in addition to appropriate health outcomes. Hence, the focus of this study is on assessing the effect of the joint use of RFID and EDI on hospital performance, namely supply chain cost efficiency, personnel expenses, and hospital readmission rates. The findings, based on secondary, longitudinal data on more than 3300 US hospitals spanning eight years, suggest that hospitals bundling RFID and EDI experience an initial decrease in supply chain cost efficiency and increase in personnel expenses, with no immediate impact on readmission rates. However, over time, better supply chain cost efficiency, lower personnel expenses, and a consistent reduction in readmission rates accrue from the long‐term and consistent leveraging of the RFID‐EDI bundle. Thus, the overarching contribution of this study is the elucidation of how and along what measures the bundled leveraging of RFID and EDI improves hospital performance, as well as which measures of hospital performance are time (in)variant. We round out this study with a discussion of our findings, their implications, and offer directions for future research.
Previous studies surrounding the DeLone and McLean model of information systems (IS) success have called for future research and further examination of its measure in different contexts. We draw from ...the literature on strategic IS planning and organizational culture to contextualize the DeLone and McLean model. There is some evidence that a high-quality information technology (IT) plan leads to system success; therefore, we empirically examine the inclusion of the IT plan quality construct as an antecedent to IS success. We also empirically examine the relationships among constructs in the model of IS success in the context of different corporate cultural types-entrepreneurial and formal. The results provide strong support for the research model and suggest that variations in IS success are explained by the quality of the IT plan and the corporate culture exhibited by a firm. We discuss implications related to our finding that IT plan quality has a greater impact on IS success in organizations that exhibit an entrepreneurial corporate culture than in those that exhibit a formal corporate culture. Furthermore, we discuss how the relationships in the DeLone and McLean model of IS success differ in diverse corporate cultural types and the meaning of these differences.
Despite the possible benefits of implementing healthcare information technologies, successful implementation of effective healthcare information technology is constrained by cultural and regulatory ...concerns and technical obstacles encountered when establishing or upgrading an organisation's enterprise infrastructure. In this paper, we advance Ross' four‐stage model of enterprise architecture maturity as a valuable IT resource for helping healthcare organisations sustain a competitive advantage. We use partial least squares (PLS) structural equation modelling to analyse survey data from 164 US hospitals at different stages of EA maturity. Our results provide evidence that enterprise architecture maturity directly influences the effectiveness of hospitals' IT resources for achieving strategic goals. Further, enterprise architecture maturity indirectly influences the effectiveness of IT resources when IT alignment is incorporated as a mediating variable. We discuss the implications of our findings for research and practice and suggest opportunities for future research.
Current clinical nomograms such as American Urological Association/National Comprehensive Cancer Network (AUA/NCCN) risk categories or CAPRA may not always reflect prostate cancer (PCa) risk among ...African American men. We evaluated the usefulness of adding a commercially available cell cycle progression (CCP) score to improve risk stratification in a community-based African American population.
Biopsy tissues from 150 African American and 60 Caucasian men were obtained from a single community urologic oncology practice in Memphis, TN. The biopsy samples were evaluated with a commercially available CCP panel (Prolaris). Clinical variables such as Gleason score, prostate-specific antigen (PSA), age, clinical stage, and extent of disease were combined to determine a single category of low-, intermediate-, or high-risk. AUA risk stratification for cancer aggressiveness was then compared between the CCP score
the clinical parameters to determine potential risk improvement by the CCP score.
Based on the clinical parameters, of the 150 African American men evaluated, 20% were classified as low-risk, 40% were classified as intermediate-risk, and 40% were classified as high-risk. Of the 60 Caucasian men evaluated, 42% were low-risk, 42% were intermediate-risk, and 17% were high-risk. However, when re-evaluating the African American patients using the CCP score, 30% of the patients were determined to be more aggressive than the clinical low-risk category. Similarly, 21.67% of the patients were found to be more aggressive than the clinical intermediate-risk category, and 23.33% of the patients were more aggressive than the high-risk category. When compared to our Caucasian cohort, 12% of the low-risk patients, 8% of the intermediate-risk patients, and 10% of the high-risk patients were found to be more aggressive by the CCP score. Overall, 24% of African American men
10% of Caucasian men were reclassified to a higher risk by CCP score. When we compared the mean CCP score in the African American population
the Caucasian population, the mean CCP score in the AUA low-risk was 3.2
2.9; 3.4
3.2 in the AUA intermediate-risk; and 3.8
3.5 in the AUA high-risk category, respectively. Despite the higher mean CCP score in the African American population, the difference between the African American men and the Caucasian men was not significant (P=0.064 for low-risk, P=0.204 for intermediate-risk, and P=0.209 for high-risk).
Our data extends the evidence that CCP score derived from a biopsy specimen can be clinically useful. Our findings showed that the CCP score could stratify 10-year mortality risk in African American men beyond the current clinicopathologic features, which may better prepare patients for follow-up visits and discussions with their health care provider(s) and enhance their ability to select the most appropriate treatment option.
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