Business Administration, Management, and Operations Commons^™

Antecedents And Consequences Of Hospitals’ Responses To Institutions: Three Contemporary Essays Concerning Ontario Reforms, Gabriel J. A. Huppé

Electronic Thesis and Dissertation Repository

This dissertation contributes new insights on the antecedents and consequences of hospitals’ responses to institutions. It consists in three essays that collectively explore why and how hospitals balance their technical requirement of providing high-quality and affordable healthcare with an evolving constellation of institutional demands. The collective findings provide a contemporary perspective on the reconditioning of decoupling as a multi-form process, and a nuanced conception of factors affecting the institutionalization and deinstitutionalization of practices within hospitals.

Extending research on institutional leadership, Essay 1 examines hospitals’ approaches to an external mandate for energy conservation and climate mitigation. Through a qualitative investigation, it …

A Study Of Job Satisfaction And Turnover Intention Among Acute Care Nurses Working In Rural And Urban Settings, Yasin Yasin

Electronic Thesis and Dissertation Repository

In Canada, a close look at the nursing workforce shows a decline due to limited supply and increasing demand resulting in a looming shortage in the near future. Retaining nurses’ is a key strategy to overcome the shortage by limiting nurses’ turnover. Nurses’ job dissatisfaction is the most significant predictor of turnover intention and is associated with undesired outcomes such as nurses’ absenteeism, burnout, low service quality, and patient dissatisfaction. The differences in factors affecting job satisfaction between rural and urban nurses have not been fully studied. This study aimed to identify the differences and similarities in the extrinsic and …

Discrete Event Simulation Model For Planning Level 2 “Step-Down” Bed Needs Using Nems, Felipe F. Rodrigues, Gregory S. Zaric, David Stanford

Business Publications

In highly congested hospitals it may be common for patients to overstay at Intensive Care Units (ICU) due to blockages and imbalances in capacity. This is inadequate clinically, as patients occupy a service they no longer need; operationally, as it disrupts flow from upstream units; and financially as ICU beds are more expensive than ward beds. Step-down beds, also known as Level 2 beds, have become an increasingly popular and less expensive alternative to ICU beds to deal with this issue. We developed a discrete event simulation model that estimates Level 2 bed needs for a large university hospital. The …

Values Of Hospital Chief Executive Officers In Ontario, Alexander Smith

Electronic Thesis and Dissertation Repository

Value-based health systems, where the fundamental goal of the system is to maximize patient value, have been suggested as a means to improve health service delivery. However, our understanding of various stakeholder values in Ontario is limited. This study collected interview responses from 26 Ontario hospital Chief Executive Officers (CEOs) in an attempt to understand their personal values, alignment with health-system values, and use of values to drive decision-making. Results suggest that Ontario hospital CEOs have two value sets; a set of core values (i.e. integrity, compassion, empathy) that are established at a young age and are largely non-negotiable, and …