Organizational Factors that Contribute to Operational Failures in Hospitals – Harvard Business School – 1 October 2013

Posted on October 2, 2013. Filed under: Health Mgmt Policy Planning, Health Systems Improvement |

Organizational Factors that Contribute to Operational Failures in Hospitals – Harvard Business School – 1 October 2013

by Anita L. Tucker, W. Scott Heisler, and Laura D. Janisse

“Executive summary – Despite a pressing need to do so, hospitals are struggling to improve efficiency, quality of care, and patient experience. Operational failures—defined as instances where an employee does not have the supplies, equipment, information, or people needed to complete work tasks—contribute to hospitals’ poor performance. Such failures waste at least 10 percent of caregivers’ time, delay care, and contribute to safety lapses. This paper seeks to increase hospital productivity and quality of care by uncovering organizational factors associated with operational failures so that hospitals can reduce the frequency with which these failures occur. The authors, together with a team of 25 people, conducted direct observations of nurses on the medical/surgical wards of two hospitals, which surfaced 120 operational failures. The team also shadowed employees from the support departments that provided materials, medications, and equipment needed for patient care, tracing the flow of materials through the organizations’ internal supply chains. This approach made it possible to discover organizational factors associated with the occurrence and persistence of operational failures. Overall, the study develops propositions that low levels of internal integration among upstream supply departments contributed to operational failures experienced by downstream frontline staff, thus negatively impacting performance outcomes, such as quality, timeliness, and efficiency. Key concepts include:”

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