Browsing by Author "Asamoah-Barnieh, Raymond"

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    Understanding Variation in Processes and Outcomes of Operational Implementations: A Case Study from Healthcare
    (2015-01-21) Asamoah-Barnieh, Raymond; Bischak, Diane; Woiceshyn, Jaana
    Operational excellence is a dimension of performance conferring competitive advantage to those organizations that sustainably achieve it. However, Operational Implementations (OIs) that are expected to confer such operational excellence to organizations, exhibit variation in their implementation processes and outcomes. Operations Management Practice Contingency Research (OM PCR) has been established in order to understand this. Working within the field of OM PCR, my dissertation focuses on healthcare as an industry and Advanced Access (AA) as an OI for research. I conduct a multiple case study where ten implementation teams represent AA implementations in 23 clinic sites. From this study, I select five cases as my core analytic sample for rigorous investigation. My dissertation contains the results of compiling research documents, interviews with 52 individuals related to healthcare and AA, and a qualitative analysis of the data. The main factors responsible for the variation of implementation processes and outcomes are: • a phenomenon I refer to as task ambulation, which stems from complexity and occurs as a result of movement of the task domain, • lack of appropriate prior technology, • the culture of the implementing clinic prior to implementation, • a phenomenon I refer to as institutional managerial apathy, which manifests as a lack of concern and systematization of a healthcare system, • workload, and related phenomena. I interpret these factors through Contingency Theory, Institutional Theory, and a new theory I developed - the Effort Satisficing Theory (EST). I also propose and elaborate on Task Ambulation Contingency to enhance outcomes of operational implementations. Though this research contributes to a deeper understanding of both AA implementations and OIs in general for both academics and practitioners, the most important contribution of this research to new management and economic theory is the Effort Satisficing Theory, and the establishment of the foundations of this theory. Effort Satisficing Theory is a behavioral theory that can be translated into different fields of management and economics, with potential for advancing the performance of organizations and economies, thus establishing this dissertation a valuable contribution to 21st century Economics.
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    Using Operational Analysis to Improve Access to Pulmonary Function Testing
    (2016-04-07) Ip, Ada; Asamoah-Barnieh, Raymond; Bischak, Diane P.; Davidson, Warren J.; Flemons, W. Ward; Pendharkar, Sachin R.
    Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.