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PurposeThis study investigates the impact of the degree of process maturity on the degree of patient orientation in the context of radical process changes. The study is based on a sample of healthcare providers in Ukraine which experiences a fundamental transformation of its healthcare system.Design/methodology/approachThe investigation was conducted among the full population of the chief physicians from 53 medical institutions (hospitals, general practitioners centers, dental clinics, and maternity clinics) in one of the largest cities in Ukraine. We investigated the maturity of the process of interaction with patients as perceived by these top managers. We applied variance-based structural equation modeling (SmartPLS3).FindingsThe study shows that each stage of process maturity predetermines the following one. With regard to the impact of each stage of process maturity on patient orientation, all stages show a positive and significant relationship toward patient orientation, i.e. even the lowest stage of maturity is critical for patient orientation. A further contradictory finding to extant literature is, that based on the set of indicators, the process appears to be in different stages at the same time. This speaks against the regular sequence-based approach toward process maturity.Originality/valueAlthough it has been assumed that higher degrees of process maturity are associated with higher customer (patient) orientation, this work shows that the relationship holds also for each stage of process maturity separately. This research is based on a very unique sample – the almost complete set of chief physicians and their deputies of practically all medical institutions of a large city.

Objectives To develop a goal-oriented indicator system based on the balanced scorecard (BSC) concept, which takes into account the perspectives of the referring physician and patient and emphasizes the focus on the internal processes of the radiology department. Methods Development of a BSC occurred in six steps: (Step 1) strengths/weaknesses and opportunities/risks (SWOT-) analysis of the radiology department, (Step 2) setting-specific objectives (model, core values, key objective) followed by the development of 4 perspectives, (Step 3) and definition of strategic issues oriented to the value-added chain of the processes of the radiology department. (Step 4) Creation of a “Strategy Map” with regard to the perspective and their cause–effect relationships. (Step 5) Development of an automated key performance indicator (KPI) cockpit for the monitoring, reporting, and management scorecard. Results A total of 10 success factors were identified using SWOT analysis. The core values include high quality in clinical, teaching, and research areas. The radiological value-added chain is composed of three processing steps. 1. registration, 2. examination, and 3. reading/X-ray demonstration. Three action programs were derived: 1. increase competency (e.g., specialist standard), 2. improve referring physician/patient satisfaction, 3. increase productivity. Daily process monitoring was added to the management cockpit as a monitoring scorecard. The scorecard comprises 18 KPIs and is automatically updated every month. The annual management scorecard comprises 10 KPIs. Conclusions The BSC makes it possible to implement a strategy for radiology that is strongly oriented toward the requirements of the referring physicians and the demands of patients.

This result is a surprise taking into consideration the development and discussion in Germany in recent years and in comparison to studies based on alternative approaches to efficiency measurement. The detailed analysis of the studies shows that because of weaknesses and a variety of differences in the methodological structure of the studies a really convincing answer regarding the first question ultimately cannot be derived from the results.

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