Contextual factors shaping surgeons' power dynamics and influence in hospital inventory systems: an exploratory study

Abstract

Although many studies have addressed the impact of stakeholders' power dynamics on supply chain processes within the healthcare sector, a comprehensive understanding of how hospital context, specifically funding orientation and surgeons’ contract arrangements, shapes these dynamics within Inventory Management (IM) in the Operating Theatres (OTs) remains notably absent. This doctoral thesis endeavours to bridge this gap by conducting an in- depth investigation into the influence of surgeons through power dynamics in four hospitals using multiple case study methods. In doing so, the central inquiry focuses on how a hospital's funding orientation (public or private) and surgeons’ contract arrangements (hospital-based or non- hospital-based) influence the power dynamics over SCM practices, particularly in the inventory management (IM) field. The case studies reveal a close association between surgeons’ power and these organisational and environmental contextual elements. Notably, a high level of surgeons' influence in the IM process is observed in contexts characterised by private-funding orientation and non- hospital-based physician arrangements. Conversely, the hospital case with public-funding orientation and hospital-based surgeons exhibited low levels of surgeons’ influence within the IM process. Recognising these contextual distinctions is crucial for Healthcare managers, SCM professionals and policymakers. This thesis gives them valuable insights into improving and implementing hospital SCM practices, acknowledging key stakeholders' power dynamics and influence.