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“Whether something cool is good enough”: The role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions

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  • Grundy, Quinn

Abstract

The emphasis on “value” within healthcare institutions has achieved unprecedented priority, particularly around the purchase of medical products and equipment. Health systems and institutions are implementing formal decision-making processes involving clinicians and supply chain professionals to rationalize purchasing and promote cost-effective investment. One particular form of this process is the “Value Analysis” process. Drawing from fieldwork (100 h), interviews (n = 51) and focus groups (n = 4) conducted from January 2012 to October 2014 at 4 acute care hospitals in the western United States, I analyze the ways that committee members constructed and evaluated a case for a product's value. Participants (n = 72) were a purposive sample including nurses, administrators, supply chain and industry professionals. Interpretive phenomenology served as the analytic approach to generating iterative themes. While trying to be evidence-based, Value Analysis committees lacked data related to a product's price or efficacy and relied heavily on local knowledge and expertise. Sales representatives were an integral part of the process, creating interest in the product and providing product information. As vehicles for cost-savings and quality improvement, purchasing committees need unique support that emphasizes local contexts and expertise, while maintaining rigor and minimizing bias. Drawing from participants' experiences, and principles of health technology assessment and economic evaluation, a guiding framework is proposed to support this decision-making.

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  • Grundy, Quinn, 2016. "“Whether something cool is good enough”: The role of evidence, sales representatives and nurses' expertise in hospital purchasing decisions," Social Science & Medicine, Elsevier, vol. 165(C), pages 82-91.
    • Handle: RePEc:eee:socmed:v:165:y:2016:i:c:p:82-91
    DOI: 10.1016/j.socscimed.2016.07.042
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    References listed on IDEAS

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    1. Satish Mehra & Robert W. Bretz, 1981. "Value Analysis: A Technique for Implementing Systems Thinking in the Organization," Interfaces, INFORMS, vol. 11(2), pages 48-52, April.
    2. Williams, Iestyn & Bryan, Stirling, 2007. "Understanding the limited impact of economic evaluation in health care resource allocation: A conceptual framework," Health Policy, Elsevier, vol. 80(1), pages 135-143, January.
    3. Eddama, Oya & Coast, Joanna, 2008. "A systematic review of the use of economic evaluation in local decision-making," Health Policy, Elsevier, vol. 86(2-3), pages 129-141, May.
    4. Eddama, Oya & Coast, Joanna, 2009. "Use of economic evaluation in local health care decision-making in England: A qualitative investigation," Health Policy, Elsevier, vol. 89(3), pages 261-270, March.
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    Cited by:

    1. Quinn Grundy & Cliodna Cussen & Craig Dale, 2020. "Constructing a problem and marketing solutions: A critical content analysis of the nature and function of industry‐authored oral health educational materials," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(23-24), pages 4697-4707, December.
    2. Miller, Fiona A. & Lehoux, Pascale & Rac, Valeria E. & Bytautas, Jessica P. & Krahn, Murray & Peacock, Stuart, 2020. "Modes of coordination for health technology adoption: Health Technology Assessment agencies and Group Procurement Organizations in a polycentric regulatory regime," Social Science & Medicine, Elsevier, vol. 265(C).
    3. Zohreh Schuessler & Anne Scott Stiles & Peggy Mancuso, 2020. "Perceptions and experiences of perioperative nurses and nurse anaesthetists in robotic‐assisted surgery," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(1-2), pages 60-74, January.

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