Peter Rohner

Despite growing project management maturity, the failure rate of IT-related projects remains high. We investigated four large IT-related projects within the Swiss Federal Administration that were well-managed but still failed. We found that these projects failed because of poor project governance, in particular inadequate handling of project context by the project sponsor and steering committee. We identify five contextual factors that steering committees should focus on and provide recommendations for strengthening context-aware project governance, illustrated by their implementation in the Swiss Federal Administration.

As a primary factor of technological innovation, process orientation contributes significantly to an organization's overall productivity and quality improvement. While this proposition has been confirmed for profit-oriented or- ganizations of various industries, little research exists that validates the same statement in the healthcare sector. This paper proposes and evaluates a theoretical model that investigates the effect of process orientation on hos- pitals' competitiveness and performance. The concept of the balanced scorecard is applied to comprehensively cover all facets that constitute healthcare quality innovation. A set of hypotheses is proposed conceptualizing the direct and indirect effects of process orientation on hospitals' performance (identified as patient satisfaction and financial performance) through an increase of integral competitiveness (identified as workforce conditions, operational performance and clinical quality). The model is empirically tested by means of a questionnaire-based survey among clinical and administrative management of hospitals in Switzerland. 145 complete questionnaires from 129 hospitals are analyzed. Statistical results affirm that process orientation significantly enhances hospital performance. Workforce conditions and clinical quality prove to have a significant positive effect on patient sat- isfaction, whereas the hypothesized positive effect of operational efficiency on patient satisfaction is not support- ed. Moreover, results attest the positive effect of workforce conditions and operational efficiency on financial performance, while rejecting the effect of clinical quality on financial performance.

Hospitals as the main entities of healthcare need to respond to policy initiatives affecting in particular the quality, efficiency and costs of health service delivery as well as cope with continuous technological advancements. Considering the information intensive character of healthcare, a shift in a hospital's business policy also induces potentials and pitfalls to the management of health informa- tion technology. In this sense, this paper strives to find an answer to the problem how to reduce misalignment of the business and IT architecture in hospitals. Following the design science research methodology, this paper emphasises the description of a method named H-BIT, which may support decision-makers in overcoming this alignment problem. Implications for healthcare practice are reported based on the experiences that were gained from the exemplary application of the method at a larger hospital.

The vision of the Competence Center Health Network Engineering is to support the public and private stakeholders of healthcare by means of practical and forward-looking artifacts. Transdisciplinary research approaches, such as the innovative inclusion of very diverse individuals and groups of this domain, helps us to innovate our environment.

In the OECD countries, hospitals face increased financial restrictions and competition. Process orientation is an essential means of remaining competitive. A wide range of theories and concepts relating to clinical process management already exists. When it comes to practical implementation, however, a comprehensive approach for the target-oriented and consistent introduction of clinical process management throughout an entire hospital is missing. This article documents the case of a German hospital that has realised a project of this kind and demonstrates the impacts on cooperation and on operational efficiency, which is understood as the degree to which a hospital is capable of steadily realising short lengths of stay.