Is Management Essential to Improving the Performance and Sustainability of Health Care Systems and Organizations? A Systematic Review and a Roadmap for Future Studies

Lega, Federico; Prenestini, Anna; Spurgeon, Peter

doi:10.1016/j.jval.2012.10.004

Cited by 146 publications

(131 citation statements)

References 46 publications

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“…This finding is in line with the emerging body of literature on the role of management practices in health care. 8,26 Second, we demonstrated the relationship among specific aspects of management-operations, monitoring, targets, and human resources-and board practices to suggest how incentives for hospital management and governance may be aligned. What remains unanswered in our analyses is the potential direction of influence-whether boards influence management or vice versa.…”

Section: Exhibitmentioning

confidence: 95%

“…Adopting the framework proposed by Federico Lega and colleagues, our study addressed two of the three proposed questions on the relationship between management and hospital quality. 26 First, we showed that management plays a substantial role in overall hospital performance. Hospitals with high performance across a broad array of process and outcomes-based health care quality metrics are associated with better management practices.…”

Section: Exhibitmentioning

confidence: 98%

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Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Jha²,

et al. 2015

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National policies to improve health care quality have largely focused on clinical provider outcomes and, more recently, payment reform. Yet the association between hospital leadership and quality, although crucial to driving quality improvement, has not been explored in depth. We collected data from surveys of nationally representative groups of hospitals in the United States and England to examine the relationships among hospital boards, management practices of front-line managers, and the quality of care delivered. First, we found that hospitals with more effective management practices provided higher-quality care. Second, higher-rated hospital boards had superior performance by hospital management staff. Finally, we identified two signatures of highperforming hospital boards and management practice. Hospitals with boards that paid greater attention to clinical quality had management that better monitored quality performance. Similarly, we found that hospitals with boards that used clinical quality metrics more effectively had higher performance by hospital management staff on target setting and operations. These findings help increase understanding of the dynamics among boards, front-line management, and quality of care and could provide new targets for improving care delivery.H ospitals increasingly face financial pressure to improve quality through national programs such as Hospital Value-Based Purchasing, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program. Despite the recently increased emphasis by policy makers on linking payment and quality, quality improvement efforts have traditionally focused on the processes and outcomes of clinical providers. Less is known about how two critical elements, leadership and management, influence the delivery of high-quality care and how those effects might be empirically verified. 1 Several previous studies have shown an association between hospital board practices and quality of care. 2-5 Although these studies have been helpful, they have not been able to clearly delineate which specific activities of the boards affect quality of care and how they relate to hospital managers' activities. Furthermore, it is unclear whether board activities and management activities are independently important in driving quality performance. It is known that there are large variations in both how hospital boards engage with clinical quality as well as managerial practices across institutions. 2,5-8 Understanding how hospital boards and management interact with each other, and the way in which they might drive gains in quality, is critically important. The lack of empirical data in this area, however, has

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Section: Exhibitmentioning

confidence: 95%

Section: Exhibitmentioning

confidence: 98%

Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Jha²,

et al. 2015

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“…The sustainability challenge for hospitals is said to encompass three key factors that need to be balanced: the needs of patients, economic issues, and environmental issues [49]. However, when talking about sustainability, the focus in the healthcare sector has long been on financial issues [50][51][52], with environmental influences and responsibilities of hospitals given a lower priority [53]. As the literature demonstrates, hospitals consume materials, energy, and water and release various forms of waste and emissions into the water, soil, and air through their clinical activities [54][55][56][57][58][59][60].…”

Section: Introductionmentioning

confidence: 99%

The Barriers for Voluntary Environmental Management Systems—The Case of EMAS in Hospitals

Seifert

2018

Sustainability

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Abstract:The adoption of formal environmental management systems (EMS) according to EMAS (Eco-Management and Audit Scheme) represents a voluntary approach that aims to increase corporate environmental performance. Though EMAS can offer several advantages for organizations, registration numbers are falling. In the hospital sector, the dissemination of EMAS is low. The question arises as to what hinders hospitals when planning, implementing, and maintaining such voluntary environmental management initiatives. The results from interviews with environmental managers in EMAS registered hospitals reveal problems such as high initial effort for creation of the required documents, or lacking knowledge and staff awareness. The barriers are presented in a model synthesizing the problems chronologically on the organizational, group, and individual level. The challenges for the adoption of EMAS as a voluntary environmental management approach in hospitals are discussed. This paper contributes by creating an understanding of the barriers organizations might face when implementing an EMS. Thus, measures to actively manage and overcome barriers can be developed by organizations, consultants, reviewers, policy makers, and researchers.

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“…Thus, although such relationship between management practice and quality of care may be true, it has always been an international argument. [11] To be able to quantify the hospital management practice is the precondition for conducting quantitative research on hospital management and its relationship with quality of care and other clinical outcomes. The World Management Survey (WMS) first developed a management survey instrument (the WMS method) to measure the management practice in manufacturing firms.…”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of a hospital management practice rating scale

Zhu

Guo

Dou

et al. 2018

JHA

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Background: Lacking methods to quantify the inter-hospital variance in hospital management practice (HMP) is a bottle neck for research on HMP and quality of care. This study aims to quantify the inter-hospital variance in HMP by developing a novel rating scale of HMP and evaluating its feasibility, reliability and validity. Methods: Based on the theory of hospital management, we developed a HMP rating scale with 4 dimensions: Target, operations, performance and talent management. We used questionnaires to collect relevant information from the hospital director, the medical affairs director, the head of the department of cardiology, and a cardiologist. And we also requested a list of administration documents. For validation of the scale, we applied it to 101 hospitals that had participated in the Third Phase of the Clinical Pathways in Acute Coronary Syndromes Study (CPACS-3) in 2013 and repeated it in 2014. Results: The HMP rating scale includes 17 indicators and 47 sub-indicators in the four dimensions; 85% and 97% of hospitals responded to the first and second survey respectively. A high degree of the test-retest reliability for the overall score (ICC = 0.8) was found between the two time points. Both split-half and Cronbach'α coefficient of the overall score exceeded 0.85. Cumulative percentage of variance in all dimensions was above 60%, and factors extracted in each dimension were highly consistent with the designed indicators and sub-indicators. The overall HMP score was different between hospital groups with different revenues, patients' hospital stays, and number of clinical pathways (All p values < .01). Conclusions:The HMP rating scale was demonstrated reliable, valid, and responsive, but future studies with larger sample size in different settings are needed to confirm the study findings.

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Is Management Essential to Improving the Performance and Sustainability of Health Care Systems and Organizations? A Systematic Review and a Roadmap for Future Studies

Cited by 146 publications

References 46 publications

Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

Hospital Board And Management Practices Are Strongly Related To Hospital Performance On Clinical Quality Metrics

The Barriers for Voluntary Environmental Management Systems—The Case of EMAS in Hospitals

Development and evaluation of a hospital management practice rating scale

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