Revisiting redundancy in hospitals-A case-based research study

Health Care Manage Rev. 2021 Jul-Sep;46(3):185-195. doi: 10.1097/HMR.0000000000000257. Epub 2019 Jun 27.

Abstract

Background: Redundancy is mostly conceived as "waste" resulting from inefficient operations that ought to be eliminated. However, there are scholars who challenge this view and argue that redundancy is an essential element in facilitating reliable and safe operations in health care delivery processes. The ambiguity on redundancy has led to limited insights in health care settings.

Purpose: This article seeks to provide clarity by investigating the conceptualization of redundancy within and across disparate contexts within hospital operations.

Design/methodology/approach: An exploratory study using different hospital departments was conducted in two large hospitals as case studies to allow for in-depth understanding of the conceptualization of redundancy across hospital departments. Data sources included 42 semistructured interviews, surveys, field notes from site observations, and document analysis.

Results/findings: The findings revealed alternative conceptualizations of redundancy, these being safety, care, heterogeneity, sustenance, and waste, and highlight their dominance in distinct hospital departments. The first four categories are positive in connotation, whereas the last, waste, has a negative connotation. Further, the analysis revealed that the conceptualization of redundancy is context dependent.

Conclusion: Contrary to the general cognition of redundancy in the social science and management literature, our research found that redundancy might have a valuable role to play in core health care management concerns such as patient-centeredness, patient safety, and quality of care. This work is one of the first comprehensive studies on redundancy in the health care settings and is expected to steer scholarly conversations on redundancy in a more positive light.

Practical implications: Overall, this article serves as a call to health care operations decision makers and chiefs of hospitals to reexamine their current approach and management practices on redundancy.