Healthcare Succession and Competitive Advantage: Simulating a Randomized Control Trial

2.50
Hdl Handle:
http://hdl.handle.net/10755/306556
Category:
Abstract
Type:
Poster
Title:
Healthcare Succession and Competitive Advantage: Simulating a Randomized Control Trial
Author(s):
Oglesby, Ryan
Lead Author STTI Affiliation:
Non-member
Author Details:
Ryan Oglesby, PhD, MHA, RN, CEN, NEA-BC, rloglesby@triad.rr.com
Abstract:

Research Abstract

Purpose: The purpose of this study was to describe and demonstrate an improved sampling design and analysis to explore executive succession–organizational performance relationships addressing limitations in the literature to date. Significant concerns exist about the methods used to explore this phenomenon. First, improved designs are needed for more robust causal inferences about succession’s competitive impact. Second, disagreements about competitive advantage’s measurement have contributed to inconsistent results. This study suggests design improvements for succession–performance studies with an empirical example using U.S. hospitals.

Design: This quasi-experimental study of existing data employed a panel analysis of repeated cross-sectional observations. Aggregating several years of data provided more robust, longitudinal representation of phenomena occurring. The combination of time series with cross-sections enhanced the data in ways not be possible using only one of these dimensions. Transformational leadership was used conceptually to guide this research.

Setting: The AHA Annual Survey for fiscal years (FYs) 2003 through 2007 provided the panel data for this study to describe characteristics of operations and leadership among member hospitals. Over 6,000 AHA member organizations were surveyed each year during the five-year study period. The AHA (2008) reports an 85 percent response rate to its survey.

Participants/Subjects: This study simulated a random sampling of the target population, all acute-care hospitals in the U.S. An accessible population of this target was AHA member organizations. From this accessible population, organizations who responded to the 2003 through 2007 AHA Annual Surveys were chosen as the selected study sample. The actual sample studied resulted from the PSM simulation process described in the Methods Section.

Methods: Propensity score matching (PSM) was used to simulate a randomized control trial. Stochastic frontier estimation (SFE) was used to measure organizations’ competitive performances before and after executive succession. This frontier provided insights into how executive succession–organizational performance impacts U.S. hospitals over time. Pre- and post-succession measurement using a panel design provided competitive capabilities measurement for comparison.

Results: Change in executive leadership and specifically outside succession led to increased competitive capabilities. Outsiders were able to close the performance gap faster in the sampled hospitals. Insiders performed no better than the control group. U.S. hospitals, in general, are improving efficiency and overall healthcare organizations are pushing the market performance frontier. Frontier estimation techniques can be a powerful direct measurement tool for relative inefficiency in U.S. hospitals and PSM can assist researchers in simulating random assignment based on pre-intervention characteristics.

Implications: Limited empirical evidence is available in the healthcare literature related to the influence executive succession has on performance in U.S. hospitals. Several empirical knowledge gaps in the healthcare literature were overcome related to the influence CEO succession and CEO origin have on performance outcomes of healthcare organizations. Strong empirical evidence provides support for the cause and effect associations of executive impact. The need for a renewed focus on leadership succession in healthcare is paramount. Internal leadership development efforts and investments made thus far may not be providing the returns desired.

Keywords:
Randomized Control Trial
Repository Posting Date:
9-Dec-2013
Date of Publication:
9-Dec-2013
Conference Date:
2013
Conference Name:
2013 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Ft. Lauderdale, Florida, USA
Description:
2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleHealthcare Succession and Competitive Advantage: Simulating a Randomized Control Trialen_GB
dc.contributor.authorOglesby, Ryanen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsRyan Oglesby, PhD, MHA, RN, CEN, NEA-BC, rloglesby@triad.rr.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/306556-
dc.description.abstract<p>Research Abstract</p><p>Purpose: The purpose of this study was to describe and demonstrate an improved sampling design and analysis to explore executive succession–organizational performance relationships addressing limitations in the literature to date. Significant concerns exist about the methods used to explore this phenomenon. First, improved designs are needed for more robust causal inferences about succession’s competitive impact. Second, disagreements about competitive advantage’s measurement have contributed to inconsistent results. This study suggests design improvements for succession–performance studies with an empirical example using U.S. hospitals.</p><p>Design: This quasi-experimental study of existing data employed a panel analysis of repeated cross-sectional observations. Aggregating several years of data provided more robust, longitudinal representation of phenomena occurring. The combination of time series with cross-sections enhanced the data in ways not be possible using only one of these dimensions. Transformational leadership was used conceptually to guide this research.</p><p>Setting: The AHA Annual Survey for fiscal years (FYs) 2003 through 2007 provided the panel data for this study to describe characteristics of operations and leadership among member hospitals. Over 6,000 AHA member organizations were surveyed each year during the five-year study period. The AHA (2008) reports an 85 percent response rate to its survey.</p><p>Participants/Subjects: This study simulated a random sampling of the target population, all acute-care hospitals in the U.S. An accessible population of this target was AHA member organizations. From this accessible population, organizations who responded to the 2003 through 2007 AHA Annual Surveys were chosen as the selected study sample. The actual sample studied resulted from the PSM simulation process described in the Methods Section.</p><p>Methods: Propensity score matching (PSM) was used to simulate a randomized control trial. Stochastic frontier estimation (SFE) was used to measure organizations’ competitive performances before and after executive succession. This frontier provided insights into how executive succession–organizational performance impacts U.S. hospitals over time. Pre- and post-succession measurement using a panel design provided competitive capabilities measurement for comparison.</p><p>Results: Change in executive leadership and specifically outside succession led to increased competitive capabilities. Outsiders were able to close the performance gap faster in the sampled hospitals. Insiders performed no better than the control group. U.S. hospitals, in general, are improving efficiency and overall healthcare organizations are pushing the market performance frontier. Frontier estimation techniques can be a powerful direct measurement tool for relative inefficiency in U.S. hospitals and PSM can assist researchers in simulating random assignment based on pre-intervention characteristics.</p><p>Implications: Limited empirical evidence is available in the healthcare literature related to the influence executive succession has on performance in U.S. hospitals. Several empirical knowledge gaps in the healthcare literature were overcome related to the influence CEO succession and CEO origin have on performance outcomes of healthcare organizations. Strong empirical evidence provides support for the cause and effect associations of executive impact. The need for a renewed focus on leadership succession in healthcare is paramount. Internal leadership development efforts and investments made thus far may not be providing the returns desired.</p>en_GB
dc.subjectRandomized Control Trialen_GB
dc.date.available2013-12-09T16:59:43Z-
dc.date.issued2013-12-09-
dc.date.accessioned2013-12-09T16:59:43Z-
dc.conference.date2013en_GB
dc.conference.name2013 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationFt. Lauderdale, Florida, USAen_GB
dc.description2013 ENA Leadership Conference Theme: Shape the Future. Held at the Greater Fort Lauderdale Broward County Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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