Cranfield University School of Management, Cranfield, UK.
J Health Organ Manag. 2010;24(4):343-60. doi: 10.1108/14777261011064977.
This paper aims to explore the theoretical and practical management implications of a case involving the falsification of hospital patient waiting lists for elective orthopaedic surgery.
DESIGN/METHODOLOGY/APPROACH: This case study is based on qualitative schedule-structured interviews with 20 senior hospital staff (managerial and clinical), including the head of the investigation team, downloads from the hospital website, and internal hospital documentation. Those data were used to construct an event narrative exploring the underlying causes and implications of the incident.
The blame for misconduct pointed at three surgeons, a senior manager, a general manager, an assistant general manager, one administrative staff member, and several organizational factors. In addition to censuring some of those involved, an investigation recommended changes to training and working practices, policies and procedures, governance arrangements, and organization culture, and led to an external evaluation of the hospital board. However, one year later, another similar incident occurred.
RESEARCH LIMITATIONS/IMPLICATIONS: This is a single case, and events are viewed through a management lens, the individuals concerned being protected by research ethics considerations.
By detailing the sequence of events, surrounding conditions, and the reactions of multiple players, this analysis reveals typified responses to incidents of this kind, and the limitations inherent in post-event investigations. If the benefits derived from national targets are to be realized in a manner which commands support from staff at all levels, then greater attention should be paid by managers and regulators to issues of transparency, responsiveness, and honesty. As core dimensions of good governance, managers must be accountable for helping to meet targets, and also for tracking how targets are met, ensuring that resources are made available, and that problematic issues raised are promptly and effectively addressed.
ORIGINALITY/VALUE: Studies of organizational misbehaviour are rare in healthcare where the focus often lies with patient deaths and injuries arising from system failures and gross individual misconduct. The analysis in this case explores the organizational conditions that contribute to such incidents.
本文旨在探讨一起伪造医院择期骨科手术患者等候名单案件的理论和实践管理意义。
设计/方法/途径：本案例研究基于对 20 名高级医院工作人员（管理和临床）的定性时间表结构化访谈，包括调查小组组长、从医院网站下载的内容以及内部医院文件。这些数据用于构建一个事件叙述，探讨事件的根本原因和影响。
不当行为的责任归咎于三名外科医生、一名高级经理、一名总经理、一名助理总经理、一名行政人员和几个组织因素。除了谴责一些相关人员外，调查建议改变培训和工作实践、政策和程序、治理安排和组织文化，并导致对医院董事会进行外部评估。然而，一年后，又发生了一起类似事件。
研究局限性/影响：这是一个单一案例，事件是通过管理视角来看待的，考虑到研究伦理因素，相关人员受到保护。
通过详细描述事件的顺序、周围条件和多个参与者的反应，本分析揭示了此类事件的典型反应以及事件后调查固有的局限性。如果要以赢得各级员工支持的方式实现国家目标带来的好处，那么管理者和监管者应该更加关注透明度、响应能力和诚实性等问题。作为良好治理的核心维度，管理者必须对帮助实现目标负责，还必须负责跟踪目标的实现情况，确保提供资源，并及时有效地解决出现的问题。
原创性/价值：在医疗保健领域，组织不当行为的研究很少见，因为该领域的重点通常在于因系统故障和严重的个人不当行为导致的患者死亡和伤害。本案例分析探讨了导致此类事件的组织条件。
