Examining pathways to safety and financial performance in hospitals: A study of lean in professional service operations
Examining pathways to safety and financial performance in hospitals: A study of lean in professional service operations
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DOI：
10.1016/j.jom.2016.03.001
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发表时间：
2016-03-01
影响因子：
7.8
通讯作者：
Vonderembse, Mark A.
中科院分区：
文献类型：
--
作者：
Dobrzykowski, David D.;McFadden, Kathleen L.;Vonderembse, Mark A.
医疗保健在一个复杂的专业服务环境中运作，在提供高质量和负担得起的护理方面面临着挑战——一些医疗保健专业人士认为这一系列目标是不一致的。为了考虑实现这些重要成果的机会，本研究考察了全面精益导向、内部整合、患者安全和财务绩效之间的关系。本研究借鉴专业服务运营 (PSO) 文献流来解释并提供解决医疗保健服务复杂性的方法。本研究以动态能力为基础，开发了一个改善医院财务绩效和患者安全的模型。使用结构方程模型，使用来自美国 211 家急症护理医院的调查数据对模型进行了测试，这些数据与其他两个来源的数据相匹配：来自医疗保险和医疗补助服务中心的客观患者安全数据以及来自美国医院名录的客观净收入数据。结果表明，虽然全面的精益导向对患者安全具有直接和积极的影响，但它通过内部整合间接影响财务绩效。研究结果对于提高医疗服务组织的患者安全和财务绩效以及更广泛地改善 PSO 的运营具有重大影响。 (C) 2016 Elsevier B.V. 保留所有权利。
Healthcare operates in a complex professional service environment that faces challenges in delivering high quality and affordable care - a set of goals that some healthcare professionals believe are incongruous. To consider opportunities to achieve these important outcomes, this study examines the relationships among comprehensive lean orientation, internal integration, patient safety, and financial performance. This study draws on the professional services operations (PSOs) literature stream to explain and offer a means of addressing the complexity of healthcare delivery. Grounded in dynamic capabilities, this study develops a model for improving financial performance and patient safety in hospitals. Using structural equation modeling, the model is tested with survey data from 211 acute care hospitals in the USA that are matched with data from two other sources objective patient safety data from the Centers for Medicare and Medicaid Services and objective net income data from the American Hospital Directory. Results indicate that although a comprehensive lean orientation has a direct and positive impact on patient safety, it impacts financial performance indirectly through internal integration. The results have major implications for enhancing patient safety and financial performance in healthcare service organizations, and improving operations in PSOs more broadly. (C) 2016 Elsevier B.V. All rights reserved.