A maturity model for BPM capability assessment in Dutch hospitals

Background: Dutch hospitals are dealing with a variety of challenges impacting the quality of healthcare. Hospitals are under pressure to provide high-quality healthcare at an acceptable cost. The population is aging and requires care from a variety of medical specialists. Meanwhile, the government and health insurers are demanding more transparency into the quality of healthcare and are stimulating free market competition. Hospitals are dealing with complex, multidisciplinary processes and a departmentalised organisational structure which make it difficult to adapt to these changing conditions. Business Process Management (BPM) is a discipline that can be utilised by organisations desiring to improve quality. Several BPM maturity models exist that assist in the assessment and improvement of business process management capabilities. The goal of applying such a model is reaching a higher level of business process management maturity, and thereby improve the quality of the product or service that is being delivered. However, no such model exists specifically for the healthcare domain which takes into account healthcare-specific conditions. In this study, a domain-specific BPM maturity model for the Dutch hospital industry is developed. Methodology: The study was structured according to the Maturity Assessment Model Development Method. First, a literature study was conducted to identify the characteristics of general-purpose BPM maturity models and domain-specific process frameworks used in hospitals. A Delphi study was conducted among a panel of experts from Dutch hospitals and academia. A Delphi study constitutes a multi-round surveying technique for collecting rich data and reaching a consensus among a panel of experts. The selection of the capabilities identified by this panel was presented to a different, external panel of experts for validation. The model was further validated by developing a measurement instrument and applying it in one of the hospitals that was included in the Delphi study. Results: Eleven existing BPM maturity models were analysed for their structure and contents. In addition, two domain-specific process frameworks were analysed. This lead to the establishment of five healthcare-specific maturity levels in the proposed healthcare-specific BPM maturity model. After three consecutive rounds, the Delphi study yielded a total of thirty-three capabilities relevant to Dutch hospitals, spread across five different factors: People, culture, governance, strategic alignment and IT. Validation of the capabilities by an external panel supported the consensus that was reached in the Delphi study. Application of the measurement instrument showed that the model accurately reflects the practical situation and helps to identify relevant points for improvement. Conclusions: This study shows that the hospitals included in the panel are currently at a low-to-medium level of BPM maturity. They are aiming to improve their BPM maturity in the coming years and are implementing various projects to do so. The BPM maturity model developed in this study gives insight into the strong and weak points in regards to BPM capabilities, and helps to focus the efforts for future improvement. The model shows that capabilities related to people and culture are currently most influential in improving BPM maturity in hospitals. Further application of the model is needed to ensure generalisability