Processus de reapprovisionnement dans le secteur hospitalier: Collaboration et performance

Health care systems are confronted with critical issues mainly due to rising costs and demand for better quality of services. Collaboration between health care organizations and professional groups has been identified as a potential solution to deal with these issues. Historically, health care organizations have been implementing several reforms, but these organizations are facing major difficulties mainly due to the organizational context. In fact, health care organizations, more specifically hospitals, are considered as complex systems. These systems can be viewed as professional bureaucracies, which is characterized by the existence of different professional groups coming from multi-hierarchical levels and multi-services. The management of such systems is not a homogeneous undertaking because it is composed of divergent processes running simultaneously. These professional groups maintain cooperative relationships between themselves but are working towards a goal which is specific to their profession. Hospitals operate in a complex, dynamic and institutionalized environment. Implementation of collaborative environment is perceived by various professionals like a strategy carrying solutions for health care systems challenges, but implies that the practices of these professional groups and their relational activities change as well.; Several empirical studies related to health care sector have demonstrated that a greater collaboration between professional groups or organizations has a positive impact on their performance but that is not always the case. However, no empirical study has yet looked into the concepts of collaboration and performance at the level of supply chain in public health care organizations. Based on a review of the literature on collaboration and organizational performance, this thesis identifies, on one hand, a list of performance indicators of restocking activities and, on the other hand, studies the relationship between collaboration dimensions and performance indicators.; The research design encompasses both a qualitative and quantitative approach, which made possible the collection of two sets of empirical evidence. The first set of data was gathered through field research in three non-profit hospitals and one health group purchasing organization. At this stage, the multiple case study allowed us: to examine the restocking activities, the main professional groups involved, their respective roles and responsibilities, and the restocking modes used by hospitals. This first phase also allowed to modelize the processes connected to SAP R/3 and finally, to refine a list of performance indicators. The second set of empirical evidence was collected within four organizations from 163 respondents that are involved in restocking activities. The results from this second set of data support the research propositions. Statistical analyses have demonstrated some convergences and divergences between professional groups and, have confirmed the relationship between collaboration dimensions and performance indicators. This thesis also suggests that the strength of the relationship between collaboration and performance differs according to the professional groups.; This thesis has theoretical and applied contributions. Conceptually, the study confirms the importance of collaboration within public health organizations. Then, this research has demonstrated, in general, that the professional groups who are sharing some performance indicators do not confer to them the same level of importance. Results have also confirmed the positive impact of cooperative relationships on the performance between professional groups. From a practical point of view, the results of this study has demonstrated what are the essential dimensions that are needed to maintain and develop collaborative agreement. This thesis contributes to the literature related to the evaluation of the restocking activities within public health organizations by propo...