An exploration of management practices in hospitals

• Published in: Healthcare : the journal of delivery science and innovation 2014-07, Vol.2 (2), p.121-129
• Main Authors: McConnell, K. John, Chang, Anna Marie, Maddox, Thomas M, Wholey, Douglas R, Lindrooth, Richard C
• Format: Article
• Language: English
• Subjects: Cardiac units; Hospitals; Internal Medicine; Lean; Management; Quality improvement
• ISSN: 2213-0764; 2213-0772
• DOI: 10.1016/j.hjdsi.2013.12.014

Abstract Background Management practices, including, for example, “Lean” methodologies originally developed at Toyota, may represent one mechanism for improving healthcare performance. Methods We surveyed 597 nurse managers at cardiac units to score management on the basis of poor, average, or high performance on 18 practices across 4 dimensions (Lean operations, performance measurement, targets, and employee incentives). We assessed the relationship of management scores to hospital characteristics (size, non-profit status) and market level variables. Results Our findings provide concrete examples of the high degree of management proficiency of some hospitals, as well as wide variation in management practices. Although the exact ways in which these tools have been implemented vary across hospitals, we identified multiple examples of units that use standardization in their care, track performance on a frequent basis and display data in a visual manner, and set aggressive goals and communicate them clearly to their staff. Regression models indicate that higher management scores are associated with hospitals in more competitive markets, teaching hospitals, and hospitals with a higher net income from patient services ( p