The influence of HIM implementations on hospital organisation and how this affected hospital healthcare performances
This research examines hospital organisational changes that are associated with the implementation of healthcare interaction models (HIMs) and how such changes affect hospital healthcare performance. It also explore the implementation of HIMs in the current patient journey. Four different HIMs are assessed based on two dimensions, namely localisation and synchronousness as well as the three dimensions of healthcare performance, namely quality, accessibility and affordability. Hospital organisation covers both hospital structure and hospital process parameters. This study is conducted in six different Dutch hospitals across the country, including three academic and three regional hospitals. It aims to answer the following main research question: As a result of the implementation of different healthcare interaction models, which hospital organisational changes are associated with HIMs and how do such changes affect hospital healthcare performance? To address this research question, a qualitive multiple-case study (six cases) is performed and 12 qualitive semi-structured interviews are conducted. The respondents are selected based on their availability and personal interest in this topic. The respondents include medical staff members, an insurance company employee and patients whose diverse perspectives are relevant to the trias in healthcare. The results indicate that most of the cases remain preoccupied with the implementation of one or more HIMs. Furthermore, several categories of issues slow down the implementation. However, academic and regional hospitals lack any differences. Hospital structural changes are mainly associated with HIMs, including the characteristics of different locations; meanwhile, the implementation of HIMs such as medical records triggers hospital process changes. Changes in hospital processes primarily affect the healthcare performance dimensions of quality and accessibility. By contrast, hospital structural changes apparently exert a larger impact on the affordability of the Dutch healthcare system. Therefore, the implementation of HIMs can help to achieve a quality, accessible and affordable Dutch healthcare system in the long term.
Faculteit der Managementwetenschappen