Transition to hospital process orientation: The case of regional hospitals in Latvia

Abstract

Management of processes instead of functions has growing importance into the health care. Transition to hospital process orientation (HPO) changes the way physicians and other health professionals have used to practice before. Study was performed to explore factors affecting introduction of HPO in Latvian hospitals responding to significant external pressures during the years of economic crisis to detect the best practices used for process management implementation in clinical setting. To reach the research goal dissimilarities between current performance and management of hospitals were explored. As changes in hospital reimbursement system demand improved efficiency, hospital's performance was measured by decrease in avoidable hospitalisations, and increase in usage of more cost effective alternatives to a full hospitalisation. A regression analysis was performed to evaluate correlations of hospitalisation rates in Latvian hospitals to various outpatient health services utilisation indicators. This was done to exclude influence of external factors on hospital performance and to prove the positive impact of HPO initiatives on hospitalisation rate. Afterward the performance of all regional hospitals was compared and the two most distinct hospitals were selected for further in depth analysis. Operational data of the selected hospitals and a set of structured interviews outlined the differences between both hospital's managerial practices and factors affecting the introduction of process oriented initiatives. The theoretical research together with comparative analysis of approaches used in both hospitals served as a basis for elaboration of recommendations towards development of HPO and facilitation of the development of self-management competence of health professionals.

International Health Care Regulation at National and Institutional Levels in Latvia

“…There have been several studies carried out confirming need for health care quality improvement in Latvian regional hospitals (Barzdins, 2016), lack of health care quality system in Latvia along with general problems related to strategic-level planning in health care sector of Latvia (Rutitis, 2013;Mitenbergs, 2012). Such findings have been confirmed also by the official country report and research carried out by OECD (2016) implying topicality of the problem being researched within this study.…”

Developing a Comprehensive Model for Forthcoming Reforms of University Hospitals

“…Latvian state-owned enterprises (SOEs) are subjects of scientific research in terms of legal framework and organization of public entity (Saulitis, 2013) or in the field of governance issues (Jevcuka and Ketners, 2011) in general. Healthcare SOEs are subjects of research in very few specific cases such as application of process management to hospitals (Barzdins et. al., 2015) or management of corporate identity for healthcare providers (Rutitis et.…”