Stakeholder identification and salience in purchasing: an empirical study from UK hospitals

Abstract

The lack of systematic processes for stakeholder identification and the omission of key stakeholders in UK hospitals cause significant delays in purchasing processes. This is reinforced by the strict tender processes that follow in making their purchases as a matter of assurance of fairness and competition. This paper presents a descriptive analysis of decision-making processes when the public hospitals purchase diagnostic equipment, and it discovers how the hospitals use stakeholder identification and salience during the purchase of diagnostic equipment. With the aid of purposeful case studies and semi-structured interviews, we explore how stakeholder salience is concentrated on the administrative personnel who had the role to implement organisational policy, and technical experts who make sure that the right equipment was bought. Last, this study provides an insight into how stakeholder groups share the premises of the public hospitals' decision-making process by considering the attributes of power, urgency, legitimacy, and proximity.

Factors influencing procurement behaviour and decision-making: an exploratory qualitative study in a UK healthcare provider

“…However, the findings could support future cross-Trust studies or surveys designed to understand patterns across Trusts. One study by Madhlambudzi and Papanagnou (2019) which also focused on describing and analysing purchasing behaviour specific to diagnostic equipment identified similar lack of stakeholder engagement as a key driver for conflicts and delays in procurement processes [ 25 ], demonstrating the potential for transferability of some of our results (at least, specifically to other NHS settings).…”

“…Lack of engagement and ‘silo working’ between different cadres of staff involved in procurement from central Trust administration to end users is a recurring theme in hospital procurement literature, with several qualitative and mixed-methods studies noting the absence of mechanisms for connecting stakeholders in procurement [ 23 , 24 ]. One study by Madhlambudzi and Papanagnou (2019) conducted in two other NHS Trusts on diagnostics purchasing noted that there was no deliberate effort to identify and engage key stakeholders when the purchasing decisions is made [ 25 ].…”

Purchasing high-cost medical equipment in hospitals: A systematic review

“…[27] Madhlambudzi & Papanagnou(2019) studied the involvement and salience of several stakeholders in purchasing of diagnostic equipment and found that hospitals fail to identify key stakeholders resulting in possible delays and conflicts. [37] Haas et al ( 2017) concluded that a hospital committee resulted in lower purchasing prices than when physicians selected vendors directly in a study of the selection of prosthetic implants. [28] However, committees are not flawless; Licona et al ( 2009) described a case study to demonstrate involvement of an interdisciplinary network of professionals in health technology management: despite the involved network several anomalies were identified such as uncertainty of who would install equipment after a bidding process.…”

“…[10] Empirical studies of purchasers in UK hospitals have shown that there are a wide range of stakeholders potentially involved in purchasing decisions (from clinicians, nurses, biomedical engineers, finance staff and/or managers), but their responsibilities and protocols are ill-defined, their skills and expertise differ, [11] they often work in silos and make decisions under high pressure conditions, [12] and that the lack of stakeholder analysis as part of purchasing planning processes resulted in conflicts and delays in decisions. [13] A more recent scoping literature review of the logistics function in hospitals demonstrated that logistics functions can be highly inefficient and fragmented. [14] Need for this review Understanding purchasing processes can help us uncover why some of these inefficiencies and tensions exist, by exploring the inner workings of the environment, protocols, behaviours and organization of purchasing staff and departments, and thereby identifying areas for improved practices.…”

“…Search methods On 13 August 2020, we searched the following from inception: Cost-Effectiveness Analysis Registry, EconLit and ProQuest Dissertations & Theses A&I via ProQuest, Embase, MEDLINE, and MEDLINE in Process via Ovid SP, Google and Google Scholar, Health Management and Policy Database via Ovid SP, IEEE Xplore Digital Library, International HTA Database, NHS EED via CRD Web, Science Citation Index-Expanded, Conference Proceedings Citation Index-Science, and Emerging Sources Citation Index via Web of Science, Scopus, and Zetoc conference search. An information scientist designed, tested, revised, and ran the searches in collaboration with the review team.…”