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Improving Hospital Efficiency: A Process Model of Organizational Change Commitments

Nigam, A., Huising, R. and Golden, B. R. (2014). Improving Hospital Efficiency: A Process Model of Organizational Change Commitments. Medical Care Research and Review, 71(1), pp. 21-42. doi: 10.1177/1077558713504464

Abstract

Improving hospital efficiency is a critical goal for managers and policy makers. We draw on participant observation of the perioperative coaching program in seven Ontario hospitals to develop knowledge of the process by which the content of change initiatives to increase hospital efficiency is defined. The coaching program was a change initiative involving the use of external facilitators with the goal of increasing perioperative efficiency. Focusing on the role of subjective understandings in shaping initiatives to improve efficiency, we show that physicians, nurses, administrators, and external facilitators all have differing frames of the problems that limit efficiency, and propose different changes that could enhance efficiency. Dynamics of strategic and contested framing ultimately shaped hospital change commitments. We build on work identifying factors that enhance the success of change efforts to improve hospital efficiency, highlighting the importance of subjective understandings and the politics of meaning-making in defining what hospitals change.

Publication Type: Article
Additional Information: Copyright Sage 2014
Publisher Keywords: Hospital Efficiency, Framing, Professions, Organizational Change
Subjects: H Social Sciences > HD Industries. Land use. Labor
R Medicine > RA Public aspects of medicine
Departments: Cass Business School > Management
URI: http://openaccess.city.ac.uk/id/eprint/14009
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