TY - JOUR

T1 - Hospitals on the road to competitive advantage?

T2 - 65th Annual Meeting of the Academy of Management, AOM 2005

AU - Ridder, Hans Gerd

AU - Doege, Vanessa

AU - Martini, Susanne

PY - 2005

Y1 - 2005

N2 - This research examines the implementation of Diagnosis Related Groups (DRGs) in German hospitals. Research concerning DRGs mostly concentrates on the system, functions, and outcomes of DRGs, especially reduction in length of stay, decrease in costs and the improvement of the patient treatment process. Based on a dynamic capability approach our study investigates the implementation process itself. Data from direct observation, documents, and interviews with the occupational professionals involved identified several influencing variables concerning successes or failures in the adoption of DRGs. In successful clinics a higher level of acceptance is observed as these clinics accept change, gain internal resources to compensate the lack of external support, and organize processes of implementation by shifting their capabilities to required changes. Unsuccessful clinics resist change due to the defense of medical and traditional values of patient treatment, and the inability to compensate lack of resources. They organize their implementation processes due to the traditional division of labor without enhancing their capabilities. The contribution to organizational theory lies in the adaptation of a dynamic capability approach to the field of health care management by augmenting the categories of this approach and by presenting empirical findings on processes of implementation regarding an administrative innovation in hospitals. The implications of our work for management practice concerns the ability of managers and chief physicians to consider resources and capabilities that address the change process itself and resources and capabilities supporting a new asset position within their field.

AB - This research examines the implementation of Diagnosis Related Groups (DRGs) in German hospitals. Research concerning DRGs mostly concentrates on the system, functions, and outcomes of DRGs, especially reduction in length of stay, decrease in costs and the improvement of the patient treatment process. Based on a dynamic capability approach our study investigates the implementation process itself. Data from direct observation, documents, and interviews with the occupational professionals involved identified several influencing variables concerning successes or failures in the adoption of DRGs. In successful clinics a higher level of acceptance is observed as these clinics accept change, gain internal resources to compensate the lack of external support, and organize processes of implementation by shifting their capabilities to required changes. Unsuccessful clinics resist change due to the defense of medical and traditional values of patient treatment, and the inability to compensate lack of resources. They organize their implementation processes due to the traditional division of labor without enhancing their capabilities. The contribution to organizational theory lies in the adaptation of a dynamic capability approach to the field of health care management by augmenting the categories of this approach and by presenting empirical findings on processes of implementation regarding an administrative innovation in hospitals. The implications of our work for management practice concerns the ability of managers and chief physicians to consider resources and capabilities that address the change process itself and resources and capabilities supporting a new asset position within their field.

KW - Diagnosis related groups

KW - Dynamic capability approach

KW - Implementation process

UR - http://www.scopus.com/inward/record.url?scp=84859070375&partnerID=8YFLogxK

U2 - 10.5465/ambpp.2005.18778674

DO - 10.5465/ambpp.2005.18778674

M3 - Conference article

VL - 2005

JO - Academy of Management Proceedings

JF - Academy of Management Proceedings

SN - 0065-0668

IS - 1

Y2 - 5 August 2005 through 10 August 2005

ER -