Healthcare quality innovation and performance through process orientation: Evidence from general hospitals in Switzerland

- Process orientation (PO) has got little attention in healthcare.
- We explore the effects of PO on hospitals' integral competitiveness and performance.
- Our results indicate that PO impacts operational efficiency and quality of care.
- We found a significant effect on patient satisfaction and financial performance.

As a primary factor of technological innovation, process orientation contributes significantly to an organization's overall productivity and quality improvement. While this proposition has been confirmed for profit-oriented organizations of various industries, little research exists that validates the same statement in the healthcare sector. This paper proposes and evaluates a theoretical model that investigates the effect of process orientation on hospitals' competitiveness and performance. The concept of the balanced scorecard is applied to comprehensively cover all facets that constitute healthcare quality innovation. A set of hypotheses is proposed conceptualizing the direct and indirect effects of process orientation on hospitals' performance (identified as patient satisfaction and financial performance) through an increase of integral competitiveness (identified as workforce conditions, operational performance and clinical quality). The model is empirically tested by means of a questionnaire-based survey among clinical and administrative management of hospitals in Switzerland. 145 complete questionnaires from 129 hospitals are analyzed. Statistical results affirm that process orientation significantly enhances hospital performance. Workforce conditions and clinical quality prove to have a significant positive effect on patient satisfaction, whereas the hypothesized positive effect of operational efficiency on patient satisfaction is not supported. Moreover, results attest the positive effect of workforce conditions and operational efficiency on financial performance, while rejecting the effect of clinical quality on financial performance.