تاثیر تصمیمات مدیریت عملیات استراتژیک بر عملکرد بیمارستان جامعه

Over the past decade, 10% of community hospitals have closed. In this challenging time, our study presents hospital administrators with some valuable information that can help improve community hospitals’ performance. The purpose of this paper is to develop a strategic operations management model that links long-term service choices, intermediate operations decisions, and hospital performance given the structural constraints of location, size, and medical teaching status. Data collected from 151 community hospitals are used to test the model. The research identifies strategic operations management decisions in the US community hospitals, shows their causal relationships, and identifies their effects on hospital performance. Specifically, we find that intermediate infrastructural operations decisions affect a community hospital’s cost, quality, and financial performance after the structural decisions of location and size have set the stage. Our study also reveals that community hospitals have adopted new staff and demand management decisions in response to the market needs.

Service is positioned at the center of economic activities in any society. As a matter of fact, no economy can function without the infrastructure that service organizations provide in the form of transportation, education, and health care (Fitzsimmons and Fitzsimmons, 2000). In recent years, we have witnessed a major evolution in the industrial nations, from being primarily manufacturing-based to primarily service-based. Therefore, knowing how to effectively manage a service organization has become a priority. Due to the increasing needs for better direction and management of service organizations, operations management researchers and practitioners have started to apply operations management concepts and techniques developed in manufacturing sectors to service industries (Heineke, 1995, Buler et al., 1996 and Fitzsimmons and Fitzsimmons, 2000).

There are several ways in which this study can be extended. An extensive field study could be conducted to investigate the best practices for the various regions of the US hospitals could then determine how they measure up against the best practices in their region. Additionally, the study suggests that skill enhancement activities such as staff training, job enlargement, and staff competence are the most important staff management variables. Future research could consider developing a more generalizable workforce measurement scale. This scale could then be used to screen current and prospective employees. Additional areas for study include staff development plans that incorporate the concept of life-long learning to better facilitate the need of becoming a learning organization (Squires, 2001). Another important workforce management issue is the continuing nursing shortage (Johnson, 2001). An integrated solution should be sought from educators, practitioners, policymakers, payers, and hospitals administrators to recruit and retain nurses. Finally, the optimal mix of outpatient services versus inpatient services for a large urban hospital should be investigated.