![Sample our Economics, Finance,Business & Industry journals, sign in here to start your access, latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5931/TOC-Subject-Sample-2021-Economics-Finance-Business-Industry.jpg"})
Abstract
Hospital operating performance relies on the proper utilization of resources and procedures. Unfortunately, the waste of over processing through unnecessary healthcare can reduce patient flow and increase costs to patients and hospitals. This article examines two commonly used mechanisms for addressing over processing in healthcare: accountability (individual and cross-functional) through utilization reviews (critical evaluations of service decisions regarding the appropriate service at the right cost), and their interactions with healthcare information technology (HIT) infrastructure. Hierarchical regression analyses reveal insights into service flow (patient length of stay) and efficiency (operating cost per bed) using independent primary and secondary data from 250 U.S. hospitals. The analyses show contrasting results and tradeoffs. For utilization reviews, accountability focused on individuals is associated with lower cost per bed but longer length of stay, while results for cross-functional accountability are not significant. The interaction between individual accountability through utilization reviews and HIT infrastructure relates to incremental reductions in patient length of stay, suggesting a complementary relationship for managing hospital operating performance and over processing.
Acknowledgments
The authors appreciate and acknowledge the Healthcare Information and Management Systems Society (HIMSS) and the Dorenfest Institute for use of their databases on hospital adoption of information technologies.
Additional information
Notes on contributors
John Wallace Gardner
John W. Gardner is an associate professor of supply chain and operations management in the Department of Marketing & Global Supply Chain Management at Brigham Young University (BYU). Gardner completed doctoral studies in management science at the Fisher College of Business at The Ohio State University. He holds an MBA from the Marriott School of Management and a master of arts in international and area studies from BYU. He also holds a bachelor of music for violin performance and pedagogy from the BYU School of Music. Gardner teaches quality management and global supply chain and operations management in the Marriott School of Business for both graduates and undergraduates. Areas of expertise include lean production, Six Sigma, and designing for quality. Gardner’s professional industry experience includes five years of work at Honeywell International where he served in both the process solutions and aerospace industries. Positions included lead information technology business systems analyst, pricing and business analyst for marketing and product management, and senior financial analyst for global financial planning and analysis. Gardner also worked as a manager of branch operations and customer service at Zions Bancorp. Gardner’s research passions focus on operational improvement through learning, innovation, and networks. His research includes the application of operations management principles such as process management and information systems to improve reliability in healthcare quality and patient satisfaction and outcomes in hospitals across various contexts. The results, which examine how practices and information technologies are utilized in various contexts, have been presented at numerous conferences and are published in the Journal of Operations Management, Organization Science, Journal of Business Logistics, and Quality Management Journal.
Sarah Childs
Sarah Childs is an MD candidate at the University of Utah School of Medicine. She is nearing the end of her medical school training and is actively pursuing a general surgery residency. She hopes to one day be a pediatric surgeon. Her interests are in bio-innovation, and she plans to use her MBA in this capacity at some point in the future.