A problem-solving routine for improving hospital operations

Purpose – The purpose of this paper is to examine empirically why a systematic problem-solving routine can play an important role in the process improvement efforts of hospitals. Design/methodology/approach – Data on 18 process improvement cases were collected through semi-structured interviews, reports and other documents, and artifacts associated with the cases. The data were analyzed using a grounded theory approach. Findings – Adherence to all the steps of the problem-solving routine correlated to greater degrees of improvement across the sample. Analysis resulted in two models. The first partially explains why hospital workers tended to enact short-term solutions when faced with process-related problems; and tended not seek longer-term solutions that prevent problems from recurring. The second model highlights a set of self-reinforcing behaviors that are more likely to address problem recurrence and result in sustained process improvement. Research limitations/implications – The study was conducted in one hospital setting. Practical implications – Hospital managers can improve patient care and increase operational efficiency by adopting and diffusing problem-solving routines that embody three key characteristics. Originality/value – This paper offers new insights on why caregivers adopt short-term approaches to problem solving. Three characteristics of an effective problem-solving routine in a healthcare setting are proposed.