Ⅴ. Conclusions
This study adopts SRBV to investigate how hospital resources are
associated with their performance. In addition to the general approach
of SRBV, we focus on patient engagement as an essential resource for
improving performance. We analyzed ordered logistic regression models
with hospital-level datasets in the U.S. from 2018 to 2020. From the
analyses, we found that physical and human resources would positively
impact improving quality of care and patient satisfaction. In contrast,
a higher percentage of the non-white population in counties negatively
affects performance. Our key finding is that hospitals having
established PFAC are more likely to perform better.
This study has made significant contributions to hospital management
studies. First, it has presented a comprehensive model for examining the
influence of different sets of strategic resources on hospital
performance. This model aids in understanding the correlations between
financial and physical, human and social resources and their impact on
hospital quality of care and patient satisfaction. Second, this study
has developed an SRBV, incorporating patient and family engagement as
critical strategic resources to help organizations gain organizational
sustainability. Empirical evidence demonstrates how patient and family
engagement can be substantial resources for hospitals seeking to improve
quality and meet patient needs. Therefore, this study introduced a novel
insight into the resource-based approach to the role of patient
engagement. Third, from a practical perspective, this research offers
invaluable insights for healthcare managers and leadership to develop
patient and family engagement. The theoretical bodies of SRBV pointed
out the importance of capabilities that orchestrate and manage various
resources. While PFACs correlate positively with organizational
performance, each hospital should build up its capabilities to
appropriately use patient and family engagement as a resource to achieve
organizational sustainability. As a highly professionalized healthcare
domain, patient and family engagement may often encounter organizational
resistance, creating barriers between professionals and citizens
(Batalden et al., 2021). Devising tailored strategies, practices, and
cultural and educational efforts is imperative to facilitate effective
integration within organizational processes. For example, hospital
managers should develop training and orientation programs for
professionals and co-producers to understand each other and fill the
knowledge, expertise, and experience gap.
This study is subject to a few limitations. First, while it sheds light
on the empirical evidence regarding the influence of Patient and Family
Advisory Councils (PFACs) on organizational performance, it employs a
binary measure of whether hospitals operate such councils. Therefore, it
does not furnish detailed insights into the specific roles and
contributions of PFACs toward hospital performance improvement. Future
research could delineate each PFAC’s role, participation degree, and
decision-making authority within the analytical framework to resolve
this gap. Second, this study’s time frame spans from 2018 to 2020.
Expanding the time frame of the investigation would enable a more
comprehensive understanding of how the roles and impacts of PFACs may
evolve. Therefore, future studies should broaden their time frame to
capture the dynamic nature of PFAC engagement and its consequential
effects over a long-term period. Last, this study examined the
relationship between financial, human capital, social, and patient
engagement resources and hospital performance. Still, it did not account
for organizational capabilities to organize and manage these resources.
Future research should consider the resources and the capabilities
required to utilize them effectively.