Negative factors affecting the efficiency of restructuration of public hospitals

Purpose: To diagnose causes of unsatisfactory (failure factors) of restructuring operations 6 undertaken in public hospitals located in the Silesian Province (Śląskie Voivodeship). A level 7 of achievement of an individual objective set for restructuring operation was a measure of their 8 effectiveness. 9 Design/methodology/approach: The present research study was conducted in three stages and 10 preceded by pilotage. In the first stage, the process of restructuration as perceived from public 11 hospitals was analysed, in the second stage from the point of view of their establishing entities. 12 Two survey questionnaires were used to accomplish these stages. The research studies were 13 conducted among the management staff of 17 public hospitals and among 14 establishing entity 14 representatives. The third step was aimed at assessing and sorting all the identified failure 15 factors. The group expert assessment method was applied for its implementation by 20 people. 16 Findings: The most common objective of public hospital restructuration was to improve the 17 quality of provided services and then to reduce debts. The average degree of achievement of 18 the first objective amounted to 75.2%, while the second 67.7%. The research studies led to 19 the identification of 30 factors which have a significant negative influence on restructuration; 20 among them 'adoption of improper assumptions on the restructuring plan in relation to financial 21 forecasting' was considered the most important. 22 Research limitations/implications: The research studies were conducted in public hospitals 23 located in the Silesian Province (Śląskie Voivodeship) and which operated as independent 24 public health-care units. 25 Practical implications: In order to conduct restructuring operations, public hospitals and their 26 establishing entities should apply project management methodologies, under which they will 27 plan and implement their restructuring operations. 28 Originality/value: Studies have shown the effectiveness of restructuring hospitals located in 29 Silesia and identified the factors that have a negative impact on hospital restructuring. 30