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Explaining Anomalous High Performance In A Health Care Supply Chain

机译：解释医疗保健供应链中的异常高性能

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An implicit assumption in distributing and coordinating work among independent organizations in a supply chain is that a focal organization can use financial or contractual mechanisms to enforce compliance among the other organizations in meeting desired performance objectives. Absent contractual agreement or financial gain, there is little incentive for independent organizations to coordinate their process improvement activities. In this study, we examine a health care supply chain in which the work is distributed among independent organizations. We use a detailed case study and an ab-ductive reasoning approach to understand how and why the independent organizations choose to coordinate and collaborate in their work. Our study makes two contributions to the literature. First, we use well-established lean principles to explain how independent organizations achieve superior performance despite highly uncertain and variable customer demand-a context considerably different from the origins of lean principles. Second, we forward relational coordination theory to explain why the organizations in this decentralized supply chain coordinate their work. Relational coordination includes the use of shared goals, shared knowledge, and mutual respect for one another's work as primary mechanisms to explain process improvement in the absence of any contractual incentives. Our study constitutes a first step in generating theory for work design and its improvement in decentralized supply chains.
机译：在供应链中独立组织之间分配和协调工作时，一个隐含的假设是，焦点组织可以使用财务或合同机制来强制其他组织遵守要求的绩效目标。没有合同协议或财务收益，独立组织几乎没有动力来协调其流程改进活动。在这项研究中，我们研究了医疗保健供应链，其中工作分散在独立的组织之间。我们使用详细的案例研究和归纳推理方法来了解独立组织如何以及为什么选择在工作中进行协调和协作。我们的研究为文献做出了两点贡献。首先，我们使用公认的精益原则来解释独立组织如何在高度不确定和可变的客户需求下实现卓越的绩效-这与精益原则的起源大相径庭。第二，我们提出了关系协调理论，以解释在这个分散的供应链中的组织为什么协调他们的工作。关系协调包括在没有任何合同激励的情况下，使用共有的目标，共有的知识以及相互尊重对方的工作作为解释流程改进的主要机制。我们的研究构成了工作设计理论及其在分散式供应链中的改进的第一步。

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