Dissertation/Thesis Abstract

Long-Term Sustainability of Surgical Operational Improvements Post Consultancy: A Multiple Case Study Analysis
by Evans, Angelette M., D.B.A., Northcentral University, 2017, 217; 10288881
Abstract (Summary)

United States hospitals are faced with fulfilling the triple aim, which require high quality, safe practices, and at lowered cost. The payment model for the Center of Medicaid and Medicare Services and many commercial payers has moved toward a fee-for-value based model, which was a deviation from the traditional fee-for-service system. The new models are either incentivizing healthcare providers for achieving or exceeding quality, safety, and service outcomes; or penalizing them for not adding value or achieving expected outcomes. Ultimately, hospitals are required to be efficient and bend the cost curve or suffer the consequences in their fiscal performance. Surgical services are hospital departments that have the potential to achieve the highest net revenue if efficiency is achieved and sustained. Hospital leaders often contract consultants to support business process change (BPC) efforts with the main goal of attaining long-term sustainable improvements to their operational processes through effective knowledge management. The following study was a retrospective examination of the BPC initiative through the perspectives of a cross section of two case sites surgical service members. The researcher compared and contrasted the surgical team’s perceptions of their BPC execution, their journey, and the post initiative performance. Questionnaires, interviews, and document collection were used to collect a rich overview of the BPC phenomenon. The data showed that there are multiple factors that influenced the long-term culture of change, which included transformational leadership, effective knowledge management, and the prioritization of the change initiative. In addition, the participants implied that physician leadership is required to achieve behavioral alignment to expected performance. The outcome of this research resulted in the following recommendations to direct future research. First, further investigation is needed to determine if the Lean methodology is an effective approach to business process change for healthcare organizations, or are there other methods that would prove more beneficial for the healthcare arena. Second, there needs to be more investigation on how healthcare systems can optimize knowledge management processes for retention and transition so when key leaders and knowledge experts leave organizational learning continues. Lastly, there needs to be further investigation into physician leaders’ influence on business process change, which would include a gap assessment of their current clinical competencies against the business acumen domain of healthcare administration, operational management, and business development.

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Indexing (document details)
Advisor: Luckel, Henry, Shaw, Melanie
School: Northcentral University
Department: School of Business and Technology Management
School Location: United States -- Arizona
Source: DAI-B 78/12(E), Dissertation Abstracts International
Subjects: Surgery, Organizational behavior, Health care management
Keywords: Culture of change, Hospital financial management, Knowledge management, Physician leadership and behavior, Process improvement, Surgical operations
Publication Number: 10288881
ISBN: 978-0-355-08506-8
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