Management control levers in hospitals: the influence of accreditation on other management control systems

Marcia-Zanievicz da Silva; Micheli-Aparecida Lunardi; Alyne-Cecilia Serpa-Ganz; Vinícius-Costa da Silva-Zonatto

doi:10.18046/j.estger.2020.155.3562

Authors

Marcia-Zanievicz da Silva Professor, Graduate Program in Accounting and Administration, Universidade Regional de Blumenau, Blumenau, Brazil https://orcid.org/0000-0003-1229-7705
Micheli-Aparecida Lunardi Graduated, Master in Accounting Sciences, Universidade Regional de Blumenau, Blumenau, Brazil https://orcid.org/0000-0003-0622-928X
Alyne-Cecilia Serpa-Ganz Graduated, Master in Accounting Sciences, Universidade Regional de Blumenau, Blumenau, Brazil https://orcid.org/0000-0002-7192-6033
Vinícius-Costa da Silva-Zonatto Professor, Graduate Program in Accounting, Universidade Federal de Santa Maria, Santa Maria, Brazil https://orcid.org/0000-0003-0823-6774

DOI:

https://doi.org/10.18046/j.estger.2020.155.3562

Keywords:

accreditation, hospitals, management control system, control levers

Abstract

The objective of this study is to identify the influence of accreditation on management control systems (MCS) before and after implementation. A survey was performed, with a sample of 92 respondents (professionals responsible for implementing accreditation) and a t-test was used to evaluate the difference between the two samples (before and after accreditation). The results show that after accreditation, management control systems (beliefs, boundary, diagnostic, and interactive control systems) had seen significant improvements, leading to better management and quality of the health services provided. In the face of growing demands from the health sector, analyzing the balanced use of management techniques that improve organizational control in companies is expected to contribute to better service delivery and maximization of generally scarce resources.

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References

Akroyd, C., Biswas, S. S. N., & Chuang, S. (2016). How management control practices enable strategic alignment during the product development process. Advances in Management Accounting, 26, 99- 138. https://doi.org/10.1108/S1474-787120150000026004

Alonso, L. B. N., Droval, C., Ferneda, E., & Emídio, L. (2014). Acreditação hospitalar e a gestão da qualidade dos processos assistenciais. Perspectivasem Gestão & Conhecimento, 4(2), 34-49.

Alkhenizan, A., & Shaw, C. (2011). Impact of accreditation on the quality of healthcare services: a systematic review of the literature. Annalsof Saudi medicine, 31(4), 407. https://doi.org/10.4103/0256-4947.83204

Anthony, R. N. (1965). Planning and control systems: a framework for analysis. Graduate School of Business Administration Harvard. University Cambridge.

Anthony, R. N, & Govidarajan, V. (2008). Sistemas de controle gerencial (12a. ed.). São Paulo: McGraw-Hill.

Agência Nacional de Vigilância Sanitária - Anvisa. (2004). Acreditação: A Busca pela Qualidade nos Serviços de Saúde. Informes Técnicos Institucionais. Revista de Saúde Pública, 38(2), 335-336. https://doi.org/10.1590/S0034-89102004000200029

Araujo, C. A. S., dos S. Figueiredo, O. H., & Figueiredo, K. (2015). O que Motiva os Hospitais Brasileiros a Buscar a Acreditação?. Revista de Gestão em Sistemas de Saúde, 4(1), 17-28. https://doi.org/10.5585/rgss.v4i1.111

Bonato, V. L. (2011). Gestão de qualidade em saúde: melhorando assistência ao cliente. Mundo Saúde, 35(5), 319-31.

Bomfin, D. F., Trivellato, L. P., & Hastenreiter, F. (2013). Aceitação e resistência ao processo de acreditação hospitalar sob a perspectiva dos profissionais que atuam em instituições hospitalares. Revista Pensamento Contemporâneo em Administração, 7(2), 116-133. https://doi.org/10.12712/rpca.v7i2.206

Canonico, P., & Söderlund, J. (2010). Getting control of multi-project organizations: combining contingent control mechanisms. International Journal of Project Management, 28(8), 796-806. https://doi.org/10.1016/j.ijproman.2010.05.005

Chenhall, R. H. (2003). Management control systems design within its organizational context: findings from contingency-based research and directions for the future. Accounting, organizations and society, 28(2-3), 127-168. https://doi.org/10.1016/S0361-3682(01)00027-7

Chopra, S., & Kondapalli, M. (2015). Applying Lean Principles to Mitigate the “July Effect”: Addressing Challenges Associated with Cohort Turnover in Teaching Hospitals. Journal of Technology, Management and Applied Engineering, 31(4), 1-20.

Churchill, G. A. (2003). Investigación de mercados. (4ª. ed.). México: Thompson.

Cruz, A. P. C., Frezatti, F., & Bido, D. S. (2015). Estilo de Liderança, Controle Gerencial e Inovação: Papel das Alavancas de Controle/Leadership Style, Management Controland Innovation: The Role of Control Levers. Revista de Administração Contemporânea, 19(6), 772-794. http://dx.doi.org/10.1590/1982-7849rac2015150099

Donaldson, S. I. (2007). Program theory-driven evaluation science: Strategies and applications. Londres: Routledge.

El-Jardali, F., Jamal, D., Dimassi, H., Ammar, W., & Tchaghchaghian, V. (2008). The impact of hospital accreditation on quality of care: perception of Lebanese nurses. International Journal for Quality in Health Care, 20(5), 363-371. https://doi.org/10.1093/intqhc/mzn023

Imoniana, J. O., & Nohara, J. J. (2005). Cognição da estrutura de controle interno: uma pesquisa exploratória. Revista de Administração e Contabilidade da Unisinos, 2(1), 37- 46.

Franciscatto, L., Bessow, C. K., de A. Ruzczyk, J. V., de Oliveira, M. A., & Kluck, M. M. (2011). Metas internacionais de segurança do paciente em hospital universitário. Revista HCPA, 31(4), 482-486.

François, P., & Pomey, M. P. (2005). Implantation de lagestion de la qualité dans les hôpitaux français, jeux d’acteurs et transformations induites. Revue d'épidémiologie et de santé publique, 53, 4-11. https://doi.org/10.1016/S0398-7620(05)84753-4

Jaafaripooyan, E., Agrizzi, D., & Akbari-Haghighi, F. (2011). Healthcare accreditation systems: further perspectives on performance measures. International Journal for Quality in Health Care, 23(6), 645-656. https://doi.org/10.1093/intqhc/mzr063

Jorge, M. J., de Carvalho, F. A., & Medeiros, R. O. (2013). Esforços de inovação organizacional e qualidade do serviço: um estudo empírico sobre unidades hospitalares. Revista de Administração Pública, 47(2), 327-356. https://doi.org/10.1590/S0034-76122013000200003

Kruis, A. M., Speklé, R. F., & Widener, S. K. (2016). The Levers of Control Framework: An exploratory analysis of balance. Management Accounting Research, 32, 27-44. https://doi.org/10.1016/j.mar.2015.12.002

Manzo, B. F., Brito, M. J. M., & dos Reis Corrêa, A. (2012). Implicações do processo de Acreditação Hospitalar no cotidiano de profissionais de saúde. Revista da Escola de Enfermagem da USP, 46(2), 388-394. https://doi.org/10.1590/S0080-62342012000200017

Mendes, G. H. D. S., & Mirandola, T. B. D. S. (2015). Hospital accreditation as an improvement strategy: impacts and difficulties in six accredited hospitals. Gestão & Produção, 22(3), 636-648. http://dx.doi.org/10.1590/0104-530X1226-14

Mundy, J. (2010). Creating dynamic tensions through a balanced use of management control systems. Accounting, Organizations and society, 35(5), 499-523. https://doi.org/10.1016/j.aos.2009.10.005

Oliveira, J. L. C. D., & Matsuda, L. M. (2016). Vantagens e dificuldades da acreditação hospitalar: A voz dos gestores da qualidade. Escola Anna Nery, 20(1), 63-69. https://doi.org/10.5935/1414-8145.20160009

Organização Nacional de Acreditação - ONA. (2006). Manual das organizações prestadoras de serviços hospitalares (3a ed.). Pelotas: Educat.

Portela, O. T., & Schmidt, A. S. (2008). Proposta de metodologia de avaliação e diagnóstico de gestão hospitalar. Acta Paul Enferm, 21(Esp), 198-202. https://doi.org/10.1590/S0103-21002008000500011

Rooney, A. L., & Van Ostenberg, P. R. (1999). Licensure, accreditation, and certification: approaches to health services quality. Center for Human Services, QualityAssurance Project.

Silva, M. Z., Dani, A. C., & Santos, C. A (2016). A Relação da Acreditação com o Isomorfismo Institucional e com os Artefatos de Contabilidade Gerencial nos Hospitais da Região Sul do Brasil. In: Associação Nacional de Programas de Pós-Graduação em Ciências Contábeis, 10. São Paulo: Anais ANPCONT.

Simons, R. (1995). Levers of Control: How Managers Use Innovative Control Systems to Drive Strategic Renewal. Boston: Harvard Business School Press.

Simons, R. (1990). The role of management control systems in creating competitive advantage: new perspectives. Accounting, organizations and society, 15(1-2), 127-143. https://doi.org/10.1016/0361-3682(90)90018-P

Simons, R. (1994). How new top managers use control systems as levers of strategic renewal. Strategic management journal, 15(3), 169-189. https://doi.org/10.1002/smj.4250150301

Smits, P. A., Champagne, F., Contandriopoulos, D., Sicotte, C., & Préval, J. (2008). Conceptualizing performance in accreditation. International Journal for Quality in Health Care, 20(1), 47-52. https://doi.org/10.1093/intqhc/mzm056

Souza, A. de, Guerra, M., Oliveira, C., Gomide, P. L. R., Pereira, C. M., & Freitas, D. A. (2009). Controle de gestão em organizações hospitalares. REGE. Revista de Gestão, 16(3), 15-29. https://doi.org/10.5700/issn.2177-8736.rege.2009.36675

Songini, L., Morelli, C., & Vola, P. (2018). Managerial Control Systems in Family Business: State of the Art, In: Epstein, M.J., Verbeeten, F.H.M. and Widener, S.K. (Ed.), Performance Measurement and Management Control: The Relevance of Performance Measurement and Management Control Research (Studies in Managerial and Financial Accounting, Vol. 33, pp. 193-220). Emerald Publishing Limited. https://doi.org/10.1108/S1479-351220180000033008

Speklé, R. F. (2001). Explaining management control structure variety: a transaction cost economics perspective. Accounting, Organizations and Society, 26(4), 419-441. https://doi.org/10.1016/S0361-3682(00)00041-6

Tuomela, T. S. (2005). The interplay of different levers of control: A case study of introducing a new performance measurement system. Management Accounting Research, 16(3), 293-320. https://doi.org/10.1016/j.mar.2005.06.003

Tessier, S., & Otley, D. (2012). A conceptual development of Simons’ Levers of Control framework. Management Accounting Research, 23(3), 171-185. https://doi.org/10.1016/j.mar.2012.04.003

Viana, A. L. D. Á., & Fonseca, A. M. M. (2016). Estado de Crise: Dimensões Política e Social da Crise Atual no Brasil e no Exterior. Bem Comum, Esfera Pública e Ética como Sentido e Nexos da Universalidade. Revista Continentes, 1(7), 106-120.

Widener, S. K. (2007). An empirical analysis of the levers of control framework. Accounting, organizations and society, 32(7), 757-788. https://doi.org/10.1016/j.aos.2007.01.001

Wijethilake, C., Munir, R., & Appuhami, R. (2017b). Proactive sustainability strategy and corporate sustainability performance: The mediating effect of sustainability control systems. Journal of Environmental Management, 196, 569 - 582. https://doi.org/10.1016/j.jenvman.2017.03.057

Yu, C. H. (2001). An introduction to computing and interpreting Cronbach Coefficient Alpha in SAS. In Proceedings of 26 th SAS User Group International Conference (pp. 22-25).