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PubMed2001

Influences on the implementation of TQM in health care organizations: professional bureaucracies, ownership and complexity.

TQM is introduced into many organisations in an attempt to improve productivity and quality. There are a number of organisational variables that have been recognised as influencing the success of TQM implementation including leadership, teamwork, and suppliers. This paper presents findings of a study of the implementation of TQM in Australian health care organisations. Structural factors were observed to affect the progress of TQM. Professional bureaucracies were less successful than machine bureaucracies. Private organisations were more successful than their public counterparts.

Australia↗
PubMed1994

Strategic options for hospitals based on ownership type.

Strategic planning for hospitals is difficult in this era of healthcare reform. This article offers strategy options based on an analysis of the strengths, weaknesses, opportunities, and threats of three types of hospitals.

Cost-Benefit Analysis↗
PubMedDate not supplied

From taxol to Taxol: the changing identities and ownership of an anti-cancer drug.

This paper analyzes the emergence and evolution of taxol, the world's bestselling anti-cancer drug. Over the years taxol has changed its identity, its status as property, and its association with different places (from the old-growth forests of Washington State to the government agencies of Washington, D.C., to laboratories in France). Taxol is not only a profitable pharmaceutical commodity and a substance injected into women with breast and/or ovarian cancer; it is also a natural product found in the bark of Taxus brevifolia (the Pacific yew, which is native to the North American Pacific Northwest) and a chemical substance that was discovered and brought to the point of commercial production in the public sector. We explore its role in several controversies: the destruction of old-growth forests, public participation in policy making, and the privatization of intellectual property and its effect on the price of drugs.

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

Hospital service offerings: does Catholic ownership matter?

Controlling for market and organizational characteristics, Catholic hospitals in 2001 offered more stigmatized and compassionate care services than investor-owned hospitals, and more stigmatized services than public hospitals. There were no differences between Catholic hospitals and other nonprofit hospitals, however, in the number of compassionate, stigmatized, and access services offered. This may reflect growing isomorphism in the nonprofit hospital sector.

Catholicism↗
PubMed2004

Nurse staffing and hospital ownership in California.

OBJECTIVE: The purpose of this study is to describe the relationship between nurse staffing and owner type or specific corporate owner in California acute care hospitals. BACKGROUND: Little empirical data exist regarding nurse staffing as it relates to owner type or specific corporate owner. With minimum staffing ratios scheduled to be implemented in January 2004, this study provides baseline data for evaluating the impact of minimum staffing ratios in California. METHODS: The study design is descriptive and cross-sectional. Data used in this study are for short-term general hospitals that reported to the California Office of Statewide Health Planning and Development database for fiscal years ending in 1997 through 1999. Six regression models were estimated using pooled data from the 3 years of data. RESULTS: The most consistent significant findings are: increased patient days or patient discharges predict increased registered nurse (RN) hours; lower RN wages predict increased RN hours; higher technology scores predict increased RN hours; and in 1998 there was an across-the-board decrease in RN hours. Other significant findings include that for-profit hospitals and for-profit systems had fewer RN productive hours for medical-surgical nursing, and select corporate owners, unrelated to profit status, had consistently fewer RN productive hours for medical-surgical nursing. CONCLUSIONS/IMPLICATIONS: For-profit hospitals and systems behaved differently in the healthcare market environment of the late 1990s. Select nonprofit systems were also using significantly less RN staffing. Other findings support the implication that as technology sophistication increases, there will be a need for increased RN hours to manage the advanced technology. This runs counter to the argument that increasing technology will decrease the need for RN hours. Finally, as discharges go up, the need for RN hours increases.

California↗
PubMed1990

Ownership and technical efficiency of hospitals.

The findings in this paper revealed the sample public hospitals to be more efficient relative to the sample NFP hospitals. Tight governmental control over the resources allocated to public hospitals may be one reason why these hospitals appear more efficient. Conversely, NFP hospitals appear less efficient but, in general, offer more diversified and sophisticated medical services. Therefore, even in the absence of the profit motive, the nonprofit and public sector are different enough to result in different productivity levels. This paper illustrates the applicability of the nonparametric technique in the measurement of relative technical (overall and pure) productive performance between NFP and public hospitals. The measures of inputs and outputs were relatively rough, and measures of scope of services were also crude. However, as data collection techniques improve and more precise information becomes available, this methodological approach can prove useful in the analysis of hospital efficiency and, in turn, the shaping of hospital policy.

Efficiency↗