Management Control in Hospitals

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.

Roman Andrzej Lewandowski is an Assistant Professor at the University of Warmia and Mazury in Olsztyn, Faculty of Economics, Institute of Management and Quality Science and director of Voivodesship Rehabilitation Hospital for Children in Ameryka, Olsztynek, Poland. With his primary research interests in management control in healthcare, performance management systems, person-centered care implementation, trust, hybridity, and quality, Roman combines his extensive real-world management experience with academic expertise to explain fundamental management and control theories, concepts, methods, and tools, and how to apply them in healthcare organizations. Roman has published over 60 studies, including two books on management control, and is a recognized expert in his field. He has contributed to several international projects, including the COST Action IS0903: Enhancing the role of medicine in the management of European health systems - implications for control, innovation, and user voice; the COST Action TD1405: European Network for the Joint Evaluation of Connected Health Technologies (ENJECT); and the Polish National Science Centre project: The model, the typology and methods of measurement of control systems in public hospitals - where he served as the Principal Investigator. He was involved in the Artificial Intelligence, Enhanced Person Centred Care in Neurosurgery project, which was financed by the Ministry of Health of Montenegro. Roman has also served as Vice Chair for the European Network for cost containment and improved quality of health care (COST Action CA15222) and is a member of the governing council of the Polish Federation of Hospitals, which is part of the European Hospital & Healthcare Federation (HOPE). Overall, Roman is a researcher and expert in his field, with a passion for improving healthcare systems and patient outcomes through his research, teaching, and involvement in international projects and organizations.

1. THE ESSENCE AND NATURE OF HOSPITALS AND THEIR ENVIRONMENT 2. CONTROL IN MANAGEMENT SCIENCES 3. MAIN ELEMENTS OF THE MANAGEMENT CONTROL MODEL 4. RESEARCH METHODS 5. RESULTS OF QUALITATIVE RESEARCH ON MANAGEMENT CONTROL IN HOSPITALS 6. STRUCTURAL MODELING OF MANAGEMENT CONTROL IN HOSPITALS 7. DISCUSSION OF RESEARCH RESULTS