Defining excellence in health service management: evidence from an international study

Health service executives are striving to implement the best managerial practices amid the major turbulence and restructuring which is prevalent in many health care systems today. All too often, guidance about what the best practices are needs to be sought from studies contained within the general management literature. It is problematical whether this literature is applicable to health service organizations. This article reports the results of a study which examined the views of 93 executives in 14 hospitals in Britain, Canada and the United States about what constitutes managerial excellence. The hospitals were selected on the basis of their reputed success in health service management. Using grounded theory methodology, eight factors of excellence were derived from the interview data which were supplemented by data made available from hospital documentation supplied by participants. The results of this study are compared with those of Peters and Waterman (1982). This is the most frequently cited study of managerial excellence in the general management literature. The main conclusions drawn are that a current definition of health service management excellence has been identified; there was a high degree of unanimity among participant executives about the constituents of success and excellence in health service management; and, that there are some marked differences between this definition of excellence and that propounded by Peters and Waterman (1982). The implications of this definition of excellence for health service executives are discussed.