The Diffusion of Operations Research in Management Decision Making - An Analysis of U.S. Healthcare Organisations

Jim Langabeer (2009)

The literature on operations research (OR) in the U.S. healthcare industry lacks a comprehensive empirical foundation which establishes the degree of OR diffusion. The primary objective is to determine the extent to which OR methods are being deployed in managerial, or non-clinical, decision processes and to establish opportunities for greater OR diffusion in healthcare organisations. A survey questionnaire was designed and administered to a nationwide sample of over 500 senior executives in U.S. hospitals to accomplish this objective, achieving a response rate of over 38%. These survey results are augmented by detailed case studies of four healthcare organisations, to gain greater insight and to triangulate the survey findings, as part of a mixed or multimethod strategy. Statistical and logical analyses were conducted to evaluate survey results, and triangulate cases with survey data.

Findings suggest that OR methods have not yet reached the“institutionalisation” phase of diffusion, and significantly higher utilisation and interest seems to reside with the newer, more contemporary OR methods than the traditional or classical methods, but nevertheless both have opportunities for higher utilisation given the types of problems the industry now faces. Contemporary methods with the greatest penetration included Six Sigma, balanced scorecard, and business process re-engineering. These methods suggest that the more user-friendly, less mathematically intense methods, which do not rely on dedicated OR staff forimplementation, are more common.

This research suggests that the decision making environment in healthcare is generally more “messy” than “rational”, and is characterised by consensus and collaboration, which influences OR utilisation. The quality of decisions was found to be somewhat linked with OR adoption, albeit in modest terms. Implications suggest a need to find mechanisms to diffuse management science into practice through more decentralised and adaptive tools and techniques.


Langabeer J and Worthington D, 2010, ‘Operations Research Diffusion in Healthcare Management’, Journal of Health Care Finance, vol 36(3), pp 73-87.