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.