Hospital-supplier integration and hospital performance: evidence from Saudi Arabia

The direct effect of institutional factors on healthcare information systems (HIS) organisational interoperability in Malaysian public hospitals

Background: Organisational interoperability (OIoP) of the Healthcare Information System (HIS) is crucial for the success of HIS, however little is known about the impact of institutional factors. Objective: This cross-sectional study aimed to investigate the direct effect of institutional factors on OIoP for HIS in public sector hospitals in Malaysia. Methods: A conceptual OIoP framework was developed using the Personal Health Systems Interoperability and Refined eHealth European Interoperability frameworks. A self-administered questionnaire survey was used to solicit data from 300 healthcare professionals. Data were assessed through an Exploratory Factor Analysis followed by a Confirmatory Factor Analysis. Results: Structured equation modelling revealed Security and Privacy Compliance, and Stakeholder Engagement and Awareness to significantly and positively affect OIoP (R2 = 0.380). Conclusion: Healthcare organisations should prioritise clear and effective policies and regulations and enough budget and resources for the suggested framework.

Applying frontier approach to measure the financial efficiency of hospitals

Objectives

The growth in global healthcare capacity has led to increased healthcare costs and a deterioration in the finances of universal health insurance. Hospitals must consider how to improve financial efficiency and service quality in order to survive and operate sustainably.

Methods

This study applies data envelopment analysis (DEA) and stochastic frontier analysis (SFA) to measure the financial efficiency of hospitals and to identify the factors and business strategies to improve profitability.

Results

The findings and recommendations show that (1) the DEA and SFA methods are similar and have reference values; (2) financial efficiency should be improved by reducing medical costs; (3) the quality of medical staff should be improved and manpower reduced; and (4) information, computerisation, and human intelligence in healthcare and management should be enhanced.

Conclusions

In terms of practical applications, this study recommends the promotion of smart healthcare to improve the efficiency and quality of healthcare services, as well as the introduction of artificial intelligence and big data analysis to optimise the use of healthcare manpower. Electronic medical records can be used to reduce the wastage of resources and labour costs, a medication management system can be established, and changes to the procurement system can be made to reduce inventory and improve the efficiency of medical equipment use. It is hoped that this study will provide reference materials and applications for healthcare organisations to improve their operational efficiency and strategies.

Classifying healthcare warehouses according to their performance. A Cluster Analysis-based approach

Purpose

The objective of this paper is to propose an approach to comparatively analyze the performance of drugs and consumable products warehouses belonging to different healthcare institutions.

Design/methodology/approach

A Cluster Analysis is completed in order to classify warehouses and identify common patterns based on similar organizational characteristics. The variables taken into account are associated with inventory levels, the number of SKUs, and incoming and outgoing flows.

Findings

The outcomes of the empirical analysis are confirmed by additional indicators reflecting the demand level and the associated logistics flows faced by the warehouses at issue. Also, the warehouses belonging to the same cluster show similar behaviors for all the indicators considered, meaning that the performed Cluster Analysis can be considered as coherent.

Research limitations/implications

The study proposes an approach aimed at grouping healthcare warehouses based on relevant logistics aspects. Thus, it can foster the application of statistical analysis in the healthcare Supply Chain Management. The present work is associated with only one regional healthcare system.

Practical implications

The approach might support healthcare agencies in comparing the performance of their warehouses more accurately. Consequently, it could facilitate comprehensive investigations of the managerial similarities and differences that could be a first step toward warehouse aggregation in homogeneous logistics units.

Originality/value

This analysis puts forward an approach based on a consolidated statistical tool, to assess the logistics performances in a set of warehouses and, in turn to deepen the related understanding as well as the factors determining them.

An integrated quality and resilience engineering framework in healthcare with Z-number data envelopment analysis

Supplier selection for medical equipment is a major challenge for hospitals in healthcare supply chains. The primary reason for measuring medical equipment supplier efficiency is to achieve the highest level of overall performance and productivity in healthcare supply chains. This study presents an integrated quality and resilience engineering (QRE) framework for evaluating medical equipment suppliers' performance using structural equation modeling and Z-number data envelopment analysis (Z-DEA). Noise analysis is used to select the best α-cut for the Z-DEA model, and fuzzy data are used to handle uncertainties. We show that flexibility, conformance to standards, redundancy, cost, quality certifications, and delivery time significantly affect the medical equipment suppliers' performance. In addition, we demonstrate that the proposed integrated QRE framework is more efficient and informative than stand-alone quality engineering or resiliency engineering. We present a case study in a cardiovascular hospital to illustrate the applicability of the proposed framework for medical equipment supplier evaluation and selection. To the best of our knowledge, this is the first study to integrate QRE and Z-DEA for supplier performance evaluation in healthcare.

At the Epicenter of COVID-19-the Tragic Failure of the Global Supply Chain for Medical Supplies

The tragic failure of the global supply chain in the face of the current coronavirus outbreak has caused acute shortages of essential frontline medical devices and personal protective equipment, crushing fear among frontline health workers and causing fundamental concerns about the sustainability of the health system. Much more coordination, integration, and management of global supply chains will be needed to mitigate the impact of the pandemics. This article describes the pressing need to revisit the governance and resilience of the supply chains that amplified the crisis at pandemic scale. We propose a model that profiles critical stockpiles and improves production efficiency through new technologies such as advanced analytics and blockchain. A new governance system that supports intervention by public-health authorities during critical emergencies is central to our recommendation, both in the face of the current crisis and to be better prepared for potential future crises. These reinforcements offer the potential to minimize the compromise of our healthcare workers and health systems due to infection exposure and build capacity toward preparedness and action for a future outbreak.

Contingency framework for understanding quality in public and private hospitals of India

Purpose

Health-care delivery organizations (hospitals) constitute a complex adaptive system; hence, a contingency perspective is imperative to guide the design of customized approaches to quality management in different health-care settings. Accordingly, this paper aims to propose a contingency framework to advance the understanding of the relationship between situational factors and effectiveness of quality approaches in health-care organizations (HCOs), such as hospitals in India.

Design/methodology/approach

Related literature was reviewed to identify existing research and theories related to quality and quality approaches, situational factors of the HCOs (hospitals) and some existing logical evidence on public and private hospitals in India. Then a contingencies framework for quality and quality approaches was conceptualized.

Findings

This paper proposes contingent determinants arise out of conceptualization of the HCOs (hospitals) from different system perspective such as rational system, natural system, open system and integrative system; uncertainty because of physicians’ behaviour, nurses’ approach and a dual line of authority; and the task environment such as patients, competition and economic pressure. These determinants represent situational constructs to the quality enhancement of any attempt at quality approaches. While these determinants have an influence on the quality and quality approaches of the HCOs (hospital), it is imperative to build any quality improvement strategy to work effectively, i.e., quality approach is dependent on determinants of the contingencies of the hospital’s environment, be it external or internal. Propositions for future research are also incorporated.

Research limitations/implications

This paper proposes a conceptual model as well as research propositions that need to be validated and confirmed empirically. It advances the research and theory related to quality and quality approaches in a health-care setting. It can enable policymakers, hospital managers to analyze and gauge the appropriateness of quality approaches in a given context before implementing them and could help to improve the introverted quality approaches and quality dimensions currently followed in HCOs (hospitals).

Originality/value

Contingency framework is a new approach for research on the effectiveness of quality approaches in hospitals. The fundamental idea behind this framework is that effectiveness of quality approaches can be understood best by examining its contingent determinants. Thus, it has the capacity to contribute to the efforts of government and policymakers to make the quality of care affordable to all in India. Essentially, we examine the contexts and variables that determine the effectiveness of quality approaches.

Evaluation of lean practices in warehouses: an analysis of Brazilian reality

Purpose

This article aims to investigate the most applied lean warehouse practices in Brazilian warehouses.

Design/methodology/approach

To perform this research, three phases were conducted: a literature review, a multiple case study, and an analysis of lean warehouses practices implementation by an engineering committee. Thus, both qualitative and quantitative approaches were used. Additionally, the study has an applied nature, with an exploratory and descriptive character.

Findings

Results showed that regardless of the type of criterion used, the most implanted practices are those that do not involve investments in technology. On the other hand, practices like RFID and Cross Docking systems were not found in any of the operations, which shows numerous possibilities for improvement.

Originality/value

The main contribution of this article is to initiate a debate about the management and productivity of Brazilian warehouses, a theme still little explored by the academic community despite the importance that the logistic scenario represents for Brazil as an emerging country and leader in Latin America, participating actively in several global supply chains.

Designing a hybrid cloud for a supply chain network of Industry 4.0: a theoretical framework

Purpose

Supply chain is the area that requires effective and integrated means of communication, shared risk, collaboration and orchestration in order to work successfully and the cloud computing has lot to offer to this domain. Cloud computing has appeared as a modern paradigm in supply chain networks for creating intelligent industries of future. The purpose of this paper is to propose a framework that can transform supply chain stakeholders toward Industry 4.0.

Design/methodology/approach

Cloud computing is attributed with increasing competitiveness by focusing on cost reduction, greater elasticity, flexibility and maximum utilization of resources which results in successfully achieving business goals. This paper proposes a Hybrid Supply Chain Cloud model, which integrates the infrastructure, the resources and the configurations of platforms.

Findings

This research paper is aimed at proposing a hybrid cloud that essentially helps in integrating the supply chain network with the flexibility and efficiency. It is important that a supply chain network adds value to ensure customer satisfaction and this can be best achieved by collaborating it with hybrid cloud.

Research limitations/implications

This research provides a consistent central management and comprehensive view of all computing resources, which gives organizations the knowledge they need to optimize workload placement.

Practical implications

The findings derived from this research aim to facilitate policy makers and practitioners to develop effective courses of action in current and future supply chain management. Therefore, upon implementation, this model can provide long-term benefits for the organizations by improving the overall efficiency of its supply chain network.

Originality/value

The proposed hybrid cloud will provide deep level of integration in Industry 4.0 situation and thereby brought up portable comprehensive infrastructure based on resources and required configuration in real-time environment.