A Case Study Perspective toward Data-driven Process Improvement for Balanced Perioperative Workflow

Based on a 143-month longitudinal study of an academic medical center, this paper examines operations management practices of continuous improvement, workflow balancing, benchmarking, and process reengineering within a hospital’s perioperative operations. Specifically, this paper highlights data-driven efforts within perioperative sub-processes to balance overall patient workflow by eliminating bottlenecks, delays, and inefficiencies. This paper illustrates how dynamic technological activities of analysis, evaluation, and synthesis applied to internal and external organizational data can highlight complex relationships within integrated processes to identify process limitations and potential process capabilities, ultimately yielding balanced workflow and improvement. Study implications and/or limitations are also included

HR Metrics and Strategy

[Excerpt] The idea that an organization\u27s people represent a key strategic resource is widely accepted. The business press is filled with examples of top executives proclaiming how important it is to engage people\u27s minds and spirits in the quest for competitive advantage (Boudreau & Ramstad, 1997; Boudreau, 1996). There is also mounting scientific evidence that certain bundles of high-performance work practices (e.g., performance-contingent pay, team-based work structures, selective recruitment and hiring, extensive training, etc.) are associated with higher organizational financial performance (Becker & Huselid, forthcoming; Ichniowski, Arthur, MacDuffie, Welbourne & Andrews)

The Veterans Health Administration: Taking Home Telehealth Services to Scale Nationally

Since the 1990s, the Veterans Health Administration (VHA) has used information and communications technologies to provide high-quality, coordinated, and comprehensive primary and specialist care services to its veteran population. Within the VHA, the Office of Telehealth Services offers veterans a program called Care Coordination/Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care management and case management services to veterans with diabetes, congestive heart failure, hypertension, post-traumatic stress disorder, and other conditions. The program uses remote monitoring devices in veterans' homes to communicate health status and to capture and transmit biometric data that are monitored remotely by care coordinators. CCHT has shown promising results: fewer bed days of care, reduced hospital admissions, and high rates of patient satisfaction. This issue brief highlights factors critical to the VHA's success -- like the organization's leadership, culture, and existing information technology infrastructure -- as well as opportunities and challenges

Business Process Innovation using the Process Innovation Laboratory

Most organizations today are required not only to establish effective business processes but they are required to accommodate for changing business conditions at an increasing rate. Many business processes extend beyond the boundary of the enterprise into the supply chain and the information infrastructure therefore is critical. Today nearly every business relies on their Enterprise System (ES) for process integration and the future generations of enterprise systems will increasingly be driven by business process models. Consequently process modeling and improvement will become vital for business process innovation (BPI) in future organizations. There is a significant body of knowledge on various aspect of process innovation, e.g. on conceptual modeling, business processes, supply chains and enterprise systems. Still an overall comprehensive and consistent theoretical framework with guidelines for practical applications has not been identified. The aim of this paper is to establish a conceptual framework for business process innovation in the supply chain based on advanced enterprise systems. The main approach to business process innovation in this context is to create a new methodology for exploring process models and patterns of applications. The paper thus presents a new concept for business process innovation called the process innovation laboratory a.k.a. the Ð-Lab. The Ð-Lab is a comprehensive framework for BPI using advanced enterprise systems. The Ð-Lab is a collaborative workspace for experimenting with process models and an explorative approach to study integrated modeling in a controlled environment. The Ð-Lab facilitates innovation by using an integrated action learning approach to process modeling including contemporary technological, organizational and business perspectivesNo; keywords

The MTO-Framework for Implementation of E-Business Models

Venture capitalists typically require that you can explain the business model in the time it takes the lift to get to the tenth floor. Implementation typically takes years. There is a disproportionate large amount of focus on what constitutes an innovative new business model compared to implementation since most e-business failures are attributed to failures in implementation. Obviously, there is a significant lack of knowledge of factors leading to successful implementation among those responsible for practical implementation of e-business models. E-business models or IT-systems for inter-organizational purposes cannot be implemented exclusively following the traditional guidelines in the IS/IT literature. Development methods are very different from earlier, there are many more stakeholders, and the environment is much more dynamic. The paper suggests a framework highlighting important implementation factors derived from four different disciplines; venture capitalist experiences, business process reengineering, diffusion theory and system development. The contribution of the paper is a classification of implementation factors in a framework that identifies the technological, the organizational, and the market related factors relevant for implementation of e-business models

Hospital-wide Process-oriented Organization of Care: The Case of Turku University Central Hospital

In reaction to the productivity challenges that hospitals around the world have faced, some hospitals have begun to move towards a process-oriented organization of care in order to enhance productivity. Existing research on process-oriented organization emphasizes severe challenges along the implementation process. However, the literature contains only a small number of documented cases of hospital-wide process-oriented reorganization. Against this background, in this case study, we explain how hospitals can successfully implement organization-wide process orientation. To do so, we conducted an exploratory single case study with semi-structured, face-to-face interviews and document analyses as our primary data-collection methods. We developed a theoretical framework of antecedents, interventions, enablers, barriers, and consequences that explain the trajectory of this successful hospital-reorganization project. We contribute a substantive theory on which other researchers can build and can extend in future studies. Further, in analyzing our unique case, we identify factors that the extant literature has not yet discussed, such as the blackboxing of diagnosis and treatment activities as an enabler. In line with existing literature, we also found that, even in this case, inflexible healthcare IT represented a barrier that hindered the case study in implementing process orientation

Towards an organisation-wide process-oriented organisation of care: A literature review

<p>Abstract</p> <p>Background</p> <p>Many hospitals have taken actions to make care delivery for specific patient groups more process-oriented, but struggle with the question how to deal with process orientation at hospital level. The aim of this study is to report and discuss the experiences of hospitals with implementing process-oriented organisation designs in order to derive lessons for future transitions and research.</p> <p>Methods</p> <p>A literature review of English language articles on organisation-wide process-oriented redesigns, published between January 1998 and May 2009, was performed.</p> <p>Results</p> <p>Of 329 abstracts identified, 10 articles were included in the study. These articles described process-oriented redesigns of five hospitals. Four hospitals tried to become process-oriented by the implementation of coordination measures, and one by organisational restructuring. The adoption of the coordination mechanism approach was particularly constrained by the functional structure of hospitals. Other factors that hampered the redesigns in general were the limited applicability of and unfamiliarity with process improvement techniques.</p> <p>Conclusions</p> <p>Due to the limitations of the evidence, it is not known which approach, implementation of coordination measures or organisational restructuring (with additional coordination measures), produces the best results in which situation. Therefore, more research is needed. For this research, the use of qualitative methods in addition to quantitative measures is recommended to contribute to a better understanding of preconditions and contingencies for an effective application of approaches to become process-oriented. Hospitals are advised to take the factors for failure described into account and to take suitable actions to counteract these obstacles on their way to become process-oriented organisations.</p

Adoption of Vertical Standards

Over the past decade, the theories of Diffusion of Innovations and of Economics of Standards have been integrated to explain the Diffusion of Standards in Information Technologies. More recently, complex networked technologies unique to particular industries have been identified as a separate category called vertical standards, and the study of their adoption within and across industries has begun. This paper adds to the discourse by developing a theory-based model to explain variance in the adoption of vertical standards by firms. We posit that vertical standards adoption will be influenced by firm-level factors and adopter community-level factors. Key firm-level factors such as prior technology drag, knowledge barriers, and expected benefits, and adopter community-level factors such as standard legitimization and orphaning risk are identified as antecedents of vertical standards adoption. We also identify factors that impact each of these antecedents and put forth a research model interrelating these factors to vertical standards adoption. We expect to test our research model using data collected through a web-based survey of OASIS member firms