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An Exploratory Study of Dynamic Capabilities and Performance Improvement in Hospitals
Mona Al-Amin, Erin Sullivan1, Nicole E Szalay2
1Department of Public Service and Healthcare Administration, Sawyer Business School, Suffolk University, Boston, Massachusetts.
Summary
Hospitals need dynamic capabilities for sustained performance improvement. Developing these dynamic capabilities, which involve identifying, seizing, and learning from opportunities, is crucial for optimizing hospital performance beyond ad hoc projects.
Area of Science:
- Healthcare Management
- Organizational Capabilities
- Performance Improvement
Background:
- Hospitals face pressure to provide high-value care, often relying on payment incentives.
- A significant percentage (70-90%) of performance improvement projects fail to meet goals.
- Operational capabilities alone are insufficient for sustained superior performance; dynamic capabilities are needed.
Purpose of the Study:
- To propose the dynamic-capabilities framework as a model for developing and managing hospital performance improvement (PI) capabilities.
- To explore the implications of a strategy driven by dynamic-capabilities PI in healthcare settings.
- To assess if hospitals engage in activities aligned with the dynamic-capabilities framework.
Main Methods:
- A semi-structured interview guide was developed based on a literature review of the dynamic-capabilities framework.
- Nine participants from hospital PI departments in Massachusetts and New Hampshire were recruited.
- Qualitative data analysis involved thematic indexing and coding of de-identified interview transcripts using NVivo12.
Main Results:
- Hospitals showed no significant variation in PI structures, methodologies, or weaknesses.
- Most hospitals had PI departments and favored top-management-initiated projects, but lacked programs for general staff PI training.
- Common weaknesses included PI project selection, communication, coordination, learning from past projects, and sustaining improvements.
Conclusions:
- Dynamic PI capabilities enable systematic identification, exploitation, and learning from improvement opportunities, alongside resource reconfiguration for optimal performance.
- Ad hoc PI projects are inadequate for achieving sustained superior performance in hospitals.
- Developing dynamic PI capabilities is essential for hospitals to systematically and effectively address pressures for high-value care and achieve superior performance.
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