Process Management Impact on Clinical and Experiential Quality: Managing Tensions Between Safe and Patient-Centered Healthcare

This research investigates the effect of process management on clinical and experiential quality. Clinical quality measures hospitals' performance on patient safety, i.e., adherence to standards, whereas experiential quality relates to patient centeredness, i.e., responsiveness to the needs and preferences of the patient. Drawing from the organizational learning literature, we argue for a trade-off between clinical and experiential quality as hospitals emphasize process management. We also study how external and internal forces, i.e., state legislation and hospital leadership, influence this relationship. A combination of primary data and secondary data collected at various time intervals is employed to test our hypotheses. Four important implications emerge from this work. First, we find that hospitals' emphasis on process management is associated with an increase in clinical quality but a decrease in experiential quality. Second, we find that state legislation initially reinforces this trade-off but, overtime, facilitates a positive impact of process management on both quality outcomes. Third, a post hoc analysis suggests that a specific type of hospital leadership, namely, patient-centered leadership, helps mitigate the negative association between process management and experiential quality. Finally, our research provides preliminary evidence regarding the relationship between clinical quality and patient satisfaction contingent on experiential quality. Implications for theory and practice are discussed.