Theses and Dissertations - UTB/UTPA

Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Business Administration

First Advisor

Dr. Hale Kaynak

Second Advisor

Dr. Jorge A. Gonzalez

Third Advisor

Dr. Michael A. Abebe


Improving the quality of healthcare services available to patients and increasing the efficiency of treatment processes are two pressing needs of the U.S. healthcare system. Aside from extensive research on medicine and disease-specific cures, extant literature does not offer a comprehensive framework that considers all determinants of patient care quality. The objective of this research is to offer an empirically tested framework that may be used by full-service U.S. hospitals to improve the quality of care available to their admitted patients. This framework draws in variables from both external as well as internal hospital supply chains, as recommended by many healthcare experts, and uses lean principles as the basic underlying philosophy thereby filling the aforementioned gap in the literature. To test the hypotheses a cross-sectional online survey was conducted resulting in responses from 294 senior hospital executives located all over the U.S. Structural equation modeling using LISREL 8.53 software was used to analyze the data. The results of the study demonstrate empirical support for all the suggested hypotheses. This research contributes to operations and healthcare literature. First, a unified supply chain framework is offered that integrated several constructs which have been mentioned in a piecemeal manner across several studies in healthcare, operations and medical fields. Second, the results of this study highlight the need for academicians to comprehensively measure patient care quality (PCQ). Typically, three dimensions of PCQ--interpersonal, environmental and administrative quality--are overlooked in the operations and healthcare literature. Third, hospitals need to effectively manage relationships with their suppliers because lean practices cannot be implemented without active supplier and cooperation. Finally, this research provides empirically tested measures for PCQ which are more comprehensive than those available in extant literature. The framework has implications for healthcare practice as well. Patients in hospitals would benefit from an integration of the entities of the hospital supply chains because the healthcare system would then focus on the effectiveness and efficiency of all elements and their individual processes. Full-service hospitals across the U.S. may find the framework useful in their efforts to improve the quality of admitted patient care.


Copyright 2015 Subhajit Chakraborty. All Rights Reserved.

Granting Institution

University of Texas-Pan American