The healthcare goods logistics innovation evaluation: theoretical foundations and practical applications

The research presented in this thesis is focused on innovation in the health goods logistics process managed by hospital companies, with particular reference to the systems for the evaluation of its performance. It can be seen as an initial observation of the current knowledge in the context of healthcare goods logistics innovation within hospital companies (chapter 1); an initial deduction, from the literature, and explanation of a model for the healthcare goods logistics innovation performance measurement (chapter 2); an initial testing of the validity of this model and comparison with other systems of evaluation that emerge from the analysis of a case study (chapter 3). The thesis has the objective to offer a managerial support for the innovation performance evaluation of the healthcare goods logistics process managed by hospital companies. In particular, the purpose of the first article is to present a theoretical framework of the healthcare goods logistics process and its innovation within hospitals, that is, the process which includes all the activities from receiving healthcare goods until their delivery to patients. In contrast to other contexts, in healthcare the strategic importance of this process has only recently been recognised: it is essential for service differentiation and quality improvements, playing a central role in supporting the efficient operational functioning of hospitals. Although this is an important issue both theoretically and in practice, there has so far and to the best of our knowledge been no attempt to systematically review the literature examining hospital logistics process and its innovation. Therefore, in order to address this deficit, a Systematic Review of selected peer-reviewed articles is presented, providing a more complete understanding of the theme and focusing on concepts and definitions, process organisation, models, types of innovations and their conditions. The second paper aims to define a measurement system for the evaluation of innovations in the logistics process within hospitals. Driven by the need to contain costs and improve the quality of services provided to patients, hospitals are dealing with the complexities of business process reengineering of their critical processes, among which are the logistics of health goods. However, against the growing diffusion of these initiatives, there are still very limited attempts to propose and apply models to assess the performance of these innovations. The work differs from previous examinations of logistics performance measurement in that it uses a broader scope, following a Systematic Review of the literature, and its suggestion that a logistics innovation evaluation system must consider different performance dimensions, including costs, benefits, quality and safety. From a practical point of view, the work provides an important tool for the management of hospitals involved in logistics innovation evaluation, which are currently supported with inadequate systems of analysis. The objective of the third study is to identify any problems and inefficiencies in the logistics innovation evaluation system adopted by a hospital company and to define possible paths for improvement. The study is undertaken through combining a review of the literature and an empirical exploratory investigation, the latter conducted through qualitative methodology based on a case study. The focus of the case study is the Azienda Ospedaliero Universitaria Cagliari, a hospital affected by the experimentation of new organisational and technological solutions for the management of the healthcare goods logistics process. The results of the analysis document how the performance of the new method of management of healthcare goods logistics can be defined in terms of benefits to the economic, organisational, quality and process safety aspects. From the research conducted, and on the basis of a comparison with more complex approaches and measurement systems, it is clear that a logistics performance evaluation system which is based on only a limited set of indicators has evident criticalities. This study provides suggestions and guidelines for the design of a more articulated and complex tool to monitor the performance of the healthcare goods logistics process in order to improve the approach and the evaluation system currently adopted by the hospital management. It also contributes to the literature on hospital management through adopting a current research perspective.