For years, problems related to health-care efficiency have been at the top of the priorities of many hospitals systems and governments. The growing cost of health care, and particularly hospitals, is a significant factor in the increasing pressure for improvement of hospitals' efficiency while maintaining a high quality of services. Hospitals are recognized as organizations in which waste, unnecessary administrative burdens, failures of care coordination, failures in execution of care processes, and even fraud and abuse are frequently identified as causes.

Adoption of management control as a response to hospital problems is consistent with the conviction that control is a critical management function that has the greatest impact on organizational performance. Research proves that the lack of adequate control, adapted to modern organizational solutions, causes many harmful consequences, such as faulty services, dissatisfied patients and employees, inability to effectively compete on market, low flexibility and innovativeness, and, consequently, poor performance of the organization.

This book comprehensively presents issues related to management control and develops a breakthrough theory about management control in hospitals. It is the result of many years of research and outlines the concept of control and related theories, which are discussed in detail, taking into account the unique characteristics of medical services, the health-care market, and hospitals as public organizations.

Research has shown that the main elements of management control in hospitals are information systems, diagnostic control, interactive control, innovativeness, manager's trust in physicians, and perceived uncertainty. And that proper relationships between these elements positively influence the hospital's performance. This book describes how the success of the entire control process is based on the hospital's top management and its interaction with clinical managers, department heads, and directors of other medical departments as well as clinicians. After reading this book, the implementation of the solutions suggested will help hospitals improve their performance, including the quality and effectiveness of the provided medical services and patient care.

Dedication

About the Author

Introduction

1. THE ESSENCE AND NATURE OF HOSPITALS AND THEIR ENVIRONMENT

1.1. Characteristics of hospitals

1.2. Hospitals' structure and management

1.3. Medical profession and professional bureaucracy

1.4. Past efforts to improve hospital efficiency

2. CONTROL IN MANAGEMENT SCIENCES

2.1. Origins and definitions of control in the literature

2.2. Management control at the operational and strategic levels

2.3. The concept of levers of control

2.4. Levers of control in hospitals - an assessment of the results of the previous research

2.5. Management control from an institutional perspective

2.6. Operational definition of management control

3. MAIN ELEMENTS OF THE MANAGEMENT CONTROL MODEL

3.1. Information system in management control

3.2. Measurement of a hospital performance

3.3. Evaluation and reward of hospital employees

3.4. Innovations and innovativeness in hospitals

3.5. Trust between managers and physicians

3.6. Environmental uncertainty

4. RESEARCH METHODS

4.1. Mixed methods research design

4.2. Qualitative research strategy

4.3. Measurement instruments for latent variables

4.4. Selection and characteristics of the sample in quantitative research

4.5. Justification for choosing a path model estimator

5. RESULTS OF QUALITATIVE RESEARCH ON MANAGEMENT CONTROL IN HOSPITALS

5.1. Information systems

5.2. Hospital performance from the perspective of its director

5.3. Diagnostic use of information system

5.4. Rewarding employees

5.5. Interactive use of information system

5.6. The role of innovativeness in management control

5.7. Environmental uncertainty

5.8. Director's trust in physicians

5.9. Institutional logics and decoupling of formal structures from day-to-day practices

5.10. Conceptual model of management control in hospitals

6. STRUCTURAL MODELING OF MANAGEMENT CONTROL IN HOSPITALS

6.1. Operationalization of variables

6.2. Validation of the measurement model

6.3. Evaluating the structural model of management control in hospitals

6.4. Evaluation of the modified management control model in hospitals

6.5 Analysis of the predictive power of the model

6.5. Non-linear relationships between constructs and data heterogeneity

7. DISCUSSION OF RESEARCH RESULTS

7.1. Quantitative research findings in the context of qualitative research and implications for theory and practice

7.2. Conclusions

7.3. Limitations of the model and directions for further research

ENDING / SUMMARY

REFERENCES

ANNEXES