Journal of Healthcare Management - November/December 2013 - (Page 446)
Implementing High-Performance
Work Practices in Healthcare
Organizations: Qualitative and
Conceptual Evidence
Ann Scheck McAlearney, ScD, professor and vice chair, Department of Family Medicine,
The Ohio State University, Columbus; Julie Robbins, PhD, post-doctoral researcher,
Department of Family Medicine, The Ohio State University; Andrew N. Garman, PsyD,
professor, Department of Health Systems Management, Rush University, and CEO,
National Center for Healthcare Leadership, Chicago, Illinois; and Paula H. Song, PhD,
associate professor, Health Services Management and Policy, College of Public Health,
The Ohio State University
E x E C U t i V E S U M M a r Y
Studies across industries suggest that the systematic use of high-performance work
practices (HPWPs) may be an effective but underused strategy to improve quality of
care in healthcare organizations. Optimal use of HPWPs depends on how they are
implemented, yet we know little about their implementation in healthcare.
We conducted 67 key informant interviews in five healthcare organizations, each
considered to have exemplary work practices in place and to deliver high-quality care,
as part of an extensive study of HPWP use in healthcare. We analyzed interview transcripts inductively and deductively to examine why and how organizations implement HPWPs. We used an evidence-based model of complex innovation adoption to
guide our exploration of factors that facilitate HPWP implementation.
We found considerable variability in interviewees' reasons for implementing
HPWPs, including macro-organizational (strategic level) and micro-organizational
(individual level) reasons. This variability highlighted the complex context for
HPWP implementation in many organizations. We also found that our application
of an innovation implementation model helped clarify and categorize facilitators of
HPWP implementation, thus providing insight on how these factors can contribute
to implementation effectiveness. Focusing efforts on clarifying definitions, building
commitment, and ensuring consistency in the application of work practices may be
particularly important elements of successful implementation.
For more information about the concepts in this article, please contact
Dr. McAlearney at ann.mcalearney@osumc.edu.
446
Table of Contents for the Digital Edition of Journal of Healthcare Management - November/December 2013
Journal of Healthcare Management - November/December 2013
Interview With John W. Bluford III, FACHE, President and Chief Executive Officer, Truman Medical Centers
REAL Data Collection Essential for Care of Vulnerable Populations
Fewer, but Tighter, Payer Relationships Expected to Underpin Integrated Health System Strategies in the Future
Healthcare Employers’ Policies on Nurse Education
Reducing Preventable Emergency Department Utilization and Costs by Using Community Health Workers as Patient Navigators
Engaging Primary Care Physicians in Quality Improvement: Lessons From a Payer–Provider Partnership
Implementing High-Performance Work Practices in Healthcare Organizations: Qualitative and Conceptual Evidence
Journal of Healthcare Management - November/December 2013
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