Improving hospital efficiency: a process model of organizational change commitments.

Area of Science:

• Healthcare Management
• Organizational Change
• Health Services Research

Background:

• Improving hospital efficiency is a key objective for healthcare managers and policymakers.
• Change initiatives are crucial for enhancing operational performance in healthcare settings.

Purpose of the Study:

• To understand the process of defining change initiatives aimed at increasing hospital efficiency.
• To explore the role of subjective understandings and differing perspectives in shaping these initiatives.

Main Methods:

• Participant observation was conducted within a perioperative coaching program across seven Ontario hospitals.
• The study focused on the definition and framing of change initiatives by various stakeholders.

Main Results:

• Physicians, nurses, administrators, and external facilitators held diverse views on efficiency barriers and proposed solutions.
• Strategic and contested framing dynamics significantly influenced hospital commitments to change.
• Subjective understandings and the politics of meaning-making were central to defining the scope of hospital changes.

Conclusions:

• The success of hospital efficiency improvement efforts is influenced by how stakeholders subjectively understand and politically negotiate the meaning of proposed changes.
• Recognizing and managing diverse perspectives is crucial for effective implementation of efficiency initiatives.