Date of Award

2025

Degree Type

Dissertation

Degree Name

Doctor of Business Administration (DBA)

Specialization

Business Administration

Department

Business Administration

First Advisor

Dara Schniederjans

Abstract

Healthcare spending in the United States (US) is increasing at a rate higher than the US gross domestic product while the demand for healthcare services is simultaneously increasing. With supply costs posing as the second highest cost in hospital expenditures, reducing supply expenses by means of eliminating supply management waste could potentially reduce overall healthcare costs. Supported by evidence found through three manuscript studies, this study expounds upon the findings from previous studies to better understand the relationship between medical supply inefficiency due to the influence of stakeholders’ misaligned decision-making in efforts to achieve performance goals. This exploratory, mixed-methods study applied both Agency Theory and Transaction Cost Economics Theory to answer the overarching research question: What is the relationship among job performance measurements, medical device purchase order decisions, and waste in the form of oversupply and expired medical supplies? Results indicate stakeholders have an agency in how they perceive and act upon their respective job performance goals. Stakeholders’ decision-making priorities are more in line with each other than the stakeholders recognize. This implies that better understanding the emotional relationship decision makers have with their respective job performance goals along with focused collaboration among the stakeholders could enable more efficient medical supply management, leading to reduced supply expenses.

To assess the overarching research, each manuscript study focused on one area of the overarching research question and suspected behavior. The first manuscript studied how decision making, driven by job performance measurement goals, can inadvertently create inefficiencies, specifically examining the relationship between physician and nurse incentives and the corresponding supply management decisions. The second manuscript examines hospital stakeholders’ reaction to outside pressure through examining the establishment of job performance goals in response to outside pressure. The third manuscript focuses on the decision-making process of hospital stakeholders and how they weigh options to make supply management-related decisions.

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