Charles R. Gowen

Enhancing supply chain practices through human resource management

This study examines the critical impact of human resource factors on the competitive advantage of supply chain management (SCM) practices. The human resource management (HRM) literature suggests that there are effects of HRM factors on SCM success, but neglects the relative importance among various factors regarding organizational performance. Survey responses from executives in 358 of the largest US manufacturing and service corporations are analyzed to test the relationships among selected HRM factors and SCM practice success. The results suggest an interactive role of managerial and employee support to enhance the effectiveness of employee training and to mitigate the adverse effect of implementation barriers on the success of SCM practices. The corresponding implications for managerial practice are also discussed in terms of the use of HRM program implementation to create a sustainable competitive advantage even when competitors adopt similar SCM “best practices”.

Implementation of patient safety initiatives in US hospitals

Purpose – The purpose of this study is to explore the use of patient safety initiatives (PSIs) at the US hospitals. These PSIs include such approaches as open discussion of errors, education and training, and system redesign. In particular, the paper seeks to examine factors that influence the implementation of PSIs as well as the benefits realized from their implementation.Design/methodology/approach – The paper draws on the TQM and medical safety literatures to develop a conceptual framework for improving patient safety. Extensive survey data were gathered from 252 hospitals throughout the US to test McFadden et al.s model of the factors influencing successful implementation of PSIs.Findings – Certain barriers (lack of top management support, lack of resources, lack of incentives and lack of knowledge) significantly impeded implementation while other factors (perceived importance of PSIs) facilitated implementation. It was also found that implementation of PSIs was associated with benefits to the hospi...

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety.

Background: Successful amelioration of medical errors represents a significant problem in the health care industry. There is a need for greater understanding of the factors that lead to improved process quality and patient safety outcomes in hospitals. Purpose: We present a research model that shows how transformational leadership, safety climate, and continuous quality improvement (CQI) initiatives are related to objective quality and patient safety outcome measures. Methodology/Approach: The proposed framework is tested using structural equation modeling, based on data collected for 204 hospitals, and supplemented with objective outcome data from the Centers for Medicare and Medicaid Services. Findings: The results provide empirical evidence that a safety climate, which is connected to the chief executive officer’s transformational leadership style, is related to CQI initiatives, which are linked to improved process quality. A unique finding of this study is that, although CQI initiatives are positively associated with improved process quality, they are also associated with higher hospital-acquired condition rates, a measure of patient safety. Likewise, safety climate is directly related to improved patient safety outcomes. Practical Implications: The notion that patient safety climate and CQI initiatives are not interchangeable or universally beneficial is an important contribution to the literature. The results confirm the importance of using CQI to effectively enhance process quality in hospitals, and patient safety climate to improve patient safety outcomes. The overall pattern of findings suggests that simultaneous implementation of CQI initiatives and patient safety climate produces greater combined benefits.

Knowledge management as a mediator for the efficacy of transformational leadership and quality management initiatives in U.S. health care

Background: The health care industry has become one of the largest sectors of the U.S. economy and provides the greatest job growth of any industry. With such growth, effective leadership, knowledge management, and quality programs can ameliorate patient safety outcomes and improve organizational performance. Purposes: This exploratory study examines the efficacy of transformational leadership, knowledge management, and quality initiatives, each of which has been proven effective in health care organizations. The literature has neglected the relationships among these three types of programs, although they are increasingly implemented simultaneously now. This research tests the degree to which knowledge management could act as a mediator of the effects transformational leadership and quality management have on organizational performance for hospitals. Methodology: Our survey of U.S. hospitals utilizes validated scales from the literature. By calling and e-mailing quality and other department directors, the data set includes responses from all 50 states in our sample of 370 U.S. hospitals. Statistical tests confirmed acceptable regional distribution, interrater reliability, and control variable characteristics for our sample. Structural equation modeling is used to test the research hypotheses. Findings: These preliminary results reveal that transformational leadership and quality management improve knowledge management. In addition, transformational leadership is fully mediated by knowledge responsiveness and quality management is partially mediated by knowledge responsiveness for their effects on organizational performance. Practice Implications: The unique contribution of this study includes the suggestion that greater transformational leadership skills are important for health care executives to motivate successful knowledge management initiatives. Secondly, continuous improvements in quality management programs have significant positive impacts on knowledge management and organizational outcomes in hospitals. Finally, successful knowledge management initiatives are more closely tied to patient and organizational outcomes through the enhancement of knowledge responsiveness than by knowledge acquisition and dissemination alone.

Simultaneous implementation of Six Sigma and knowledge management in hospitals

Six Sigma programmes aspire to reduce variation in organizational processes and achieve clear financial results. Six Sigma initiatives have proven to be an effective technique for improving quality in manufacturing. Similarly, the importance of knowledge management has grown considerably in recent years and has emerged as a major source of competitive advantage for manufacturing firms. From the perspective of a decision support system, knowledge management is concerned with information acquisition, dissemination, and responsiveness. Little research has examined simultaneous applications of Six Sigma and knowledge management. The purpose of this paper is to explore the usefulness of knowledge management for the implementation of Six Sigma in hospitals. We hypothesize that knowledge management will enhance the implementation of Six Sigma by leading to improvements of quality programme results and sustainable competitive advantage. The results of hierarchical regression analysis demonstrate that knowledge management does ameliorate the success of Six Sigma initiatives, specifically for knowledge dissemination and responsiveness. These results are discussed in terms of the contributions to existing theory and for managers of Six Sigma and knowledge management initiatives.

Contrasting continuous quality improvement, Six Sigma, and lean management for enhanced outcomes in US hospitals

Purpose - Rapidly rising healthcare costs, partially due to preventable medical errors, have led hospitals to redouble their process improvement (PI) efforts. The purpose of this paper is to examine how PI initiatives mediate the effect of medical error sources to enhance three hospital outcomes (patient safety, operational effectiveness, and competitiveness). Design/methodology/approach - Drawing from Dynamic Capabilities Theory, the authors develop a framework to explore three PI initiatives: Continuous Quality Improvement (CQI), Six Sigma Initiatives (SSI), and Lean Management Initiatives (LMI). Hierarchical regression analysis is employed to test the proposed model, using data from a nationwide survey of 210 US hospitals. Findings - For enhancing patient safety outcomes, it was found that CQI and LMI were significant in mediating hospital error sources; however, SSI was not significant after accounting for the other two PI types. For improving organizational effectiveness, CQI and SSI were significant; whereas LMI was not significant over and above the other two PI types. Finally, only SSI was significant for superior sustainable competitive advantage. Research limitations/implications - The paper provides insight into which PI initiatives were most effective for various hospital outcomes. The findings can benefit healthcare practitioners as they select among different PI programs for enhancing healthcare results. Limitations of the study include the use of perceptual measures, relatively small sample size, and potential alternate relationships relevant to the outcome variables. Originality/value - This is the first study to explore the mediating effects of three PI programs for the impact of medical errors on each of three hospital outcomes.

On the centrality of strategic human resource management for healthcare quality results and competitive advantage

Purpose – Healthcare organizations have addressed current error issues by adopting quality programs, which usually include strategic human resource management (HRM). However, little research has focused on the determinants of successful quality programs at healthcare organizations. The purpose of this paper is to examine the centrality of strategic HRM for addressing healthcare errors, error reduction barriers, quality management processes and practices, quality program results, and competitive advantage.Design/methodology/approach – The methodology of this study involves the analysis of questionnaire data from the quality and/or risk directors of 587 US hospitals by factor analysis and regression analysis.Findings – The findings focus on highly statistically significant relationships of strategic HRM with antecedent healthcare error sources, error reduction barriers, and quality management processes and practices, as well as the strategic HRM consequences of perceived quality program results and sustaina...

Organizational Culture, Knowledge Management, and Patient Safety in U.S. Hospitals

Research in healthcare operations has grown in interest and importance over the last decade, as the healthcare environment continues to become more complex and challenging. This study investigates the relationships among organizational culture, knowledge management, and patient safety performance. Drawing on existing literature, the authors develop and test a model for patient safety performance using data from a nationwide survey of more than 200 hospitals. Structural equation modeling is used to provide empirical support for the model. In particular, they find that different dimensions of organizational culture are related to more effective knowledge management, which in turn is associated with better patient safety performance. The authors conclude by discussing the major implications of their study for operations managers and healthcare practitioners and then provide directions for future research.

Integrating business ethics into a graduate program

Five faculty members in the College of Business at Northern Illinois University received a grant from the James S. Kemper Foundation to integrate ethics into the graduate business curriculum. This was the second phase of a comprehensive program to integrate ethics into the business curriculum. Each faculty member taught a required course in the MBA program. The faculty members represented each of the five functional departments in the College of Business.This paper describes the ethics content, materials, and approaches that were used to cover ethics by each of the five faculty members. Hopefully, this description will help other faculty and universities integrate ethics more effectively into the business curriculum.

Turnaround strategies of American and Japanese electronics corporations: How do they differ in formulating plans and achieving results?

Abstract Greater competitive and economic pressures have made corporate turnaround strategies critical to the survival of many high-technology international business organizations. The traditional differences between American and Japanese firms in the areas of human resources, production, finance, and marketing have recently appeared to converge on some common strategies employed to reverse an adverse corporate situation. American and Japanese high-technology firms are examined in terms of the antecedents, actions, and results of varying levels of turnaround strategy implementation. Survey responses from American and US subsidiaries of Japanese electronics firms illustrate that significant differences exist among levels of strategy implementation in assessing the need for a turnaround strategy, the actions taken to reverse an adverse situation, and the relative success of the actions. In addition to greater capacity utilization, low turnaround plans are generally enacted by redesigning the product or process, but successful high turnaround plans are implemented most often by gain sharing or profit sharing, as well as by eliminating unprofitable products. American firms achieve greater return on investment, operating profit margin, and cash flow, but lower sales growth and less unit labor cost improvement than Japanese corporations. These results are discussed for managerial insights into the strategy formulation process of international high-technology firms for successful competitive advantage.