1 Monash University, Clayton, Victoria, Australia
2 Health Flow Solutions, Victoria, Australia
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-Commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
The notion of trade-offs has long been recognized by operations management scholars as a necessary constraint to operations strategy. The increasing importance of this concept is reflected in numerous scholarly works, all seeking an understanding on how firms compete with their limited set of resources. A large majority of the past studies have primarily focused on the empirical validation of trade-offs mainly in manufacturing, with few that have visualized trade-offs as a result of performance frontiers in service sectors. In this article, using longitudinal data, we test and validate trade-offs in a public healthcare service-based setting through a performance frontier lens. Our analyses show that better performing hospitals on the basis of quality and cost-efficiency are those that are closer to their performance frontiers and exhibit a cost trade-off. Those that are situated further away demonstrate a trend for quality and cost improvements. However, despite the positions on the frontier, quality always seemed to be the prerequisite dimension for all hospitals. We believe this reaffirms the logic surrounding the sand cone model, albeit in old industry not known for quality.
Improvements, hospitals, longitudinal data, trade-offs, performance frontiers
Amoako-Gyampah, K., & Meredith, J. R. (2007). Examining cumulative capabilities in a developing economy. International Journal of Operations and Production Management, 27(9), 928–950. https://doi.org/10.1108/01443570710775801
Ashwini Nand, A., Singh, P. J., & Power, D. (2013). Testing an integrated model of operations capabilities: An empirical study of Australian Airlines. International Journal of Operations and Production Management, 33(7), 887–911. https://doi.org/10.1108/IJOPM-12-2011-0484
Avella, L., Vazquez-Bustelo, D., & Fernandez, E. (2011). Cumulative manufacturing capabilities: An extended model and new empirical evidence. International Journal of Production Research, 49(3), 707–729. https://doi.org/10.1080/00207540903460224
Banks, R. L., & Wheelwright, S. C. (1979). Operations VS strategy-trading tomorrow for today. Harvard Business Review, 57(3), 112–120.
Boon-Itt, S., & Wong, C. Y. (2016). Empirical investigation of alternate cumulative capability models: A multi-method approach. Production Planning and Control, 27(4), 299–311. https://doi.org/10.1080/09537287.2015.1124299
Bortolotti, T., Danese, P., Flynn, B. B., & Romano, P. (2015). Leveraging fitness and lean bundles to build the cumulative performance sand cone model. International Journal of Production Economics, 162, 227–241. https://doi.org/10.1016/j.ijpe.2014.09.014
Boyer, K. K., & Lewis, M. W. (2002). Competitive priorities: Investigating the need for trade-offs in operations strategy. Production and Operations Management, 11(1), 9–20. https://doi.org/10.1111/j.1937-5956.2002.tb00181.x
Butler, T. W., Leong, G. K., & Everett, L. N. (1996). The operations management role in hospital strategic planning. Journal of Operations Management, 14(2), 137–156. https://doi.org/10.1016/0272-6963(95)00041-0
Cai, S., & Yang, Z. (2014). On the relationship between business environment and competitive priorities: The role of performance frontiers. International Journal of Production Economics, 151, 131–145. https://doi.org/10.1016/j.ijpe.2014.02.005
Chang, S. J., Hsiao, H. C., Huang, L. H., & Chang, H. (2011). Taiwan quality indicator project and hospital productivity growth. Omega, 39(1), 14–22. https://doi.org/10.1016/j.omega.2010.01.006
Chen, Y., & Iqbal Ali, A. I. (2002). Output–input ratio analysis and DEA frontier. European Journal of Operational Research, 142(3), 476–479. https://doi.org/10.1016/S0377-2217(01)00318-6
Clark, K. B. (1996). Competing through manufacturing and the new manufacturing paradigm: Is manufacturing strategy passé? Production and Operations Management, 5(1), 42–58. https://doi.org/10.1111/j.1937-5956.1996.tb00384.x
Collins, R. S., & Schmenner, R. (1993). Achieving rigid flexibility: Factory Focus for the 1990s. European Management Journal, 11(4), 443–447.
Corbett, L. M., & Claridge, G. S. (2002). Key manufacturing capability elements and business performance. International Journal of Production Research, 40(1), 109–131. https://doi.org/10.1080/00207540110073091
Corbett, L. M., & Clay Whybark, D. C. (2001). Searching for the sandcone in the GMRG data. International Journal of Operations and Production Management, 21(7), 965–980. https://doi.org/10.1108/01443570110393441
Corbett, C., & Van Wassenhove, L. (1993). Trade-offs? What trade-offs? Competence and competitiveness in manufacturing strategy. California Management Review, 35(4), 107–122. https://doi.org/10.2307/41166757
Da Silveira, G., & Slack, N. (2001). Exploring the trade-off concept. International Journal of Operations and Production Management, 21(7), 949–964. https://doi.org/10.1108/01443570110393432
Egbunike, O., Purvis, L., & Naim, M. M. (2018). A systematic review of research into the management of manufacturing capabilities. Production Planning and Control, 29(16), 1349–1366. https://doi.org/10.1080/09537287.2018.1535147
Ehie, I. C., & Schoenherr, T. (2020). Revisiting the cumulative capability model (CCM) among manufacturing firms in developing countries. Production Planning and Control, 32(9), 715–729.
Ferdows, K., & De Meyer, A. (1990). Lasting improvements in manufacturing performance: In search of a new theory. Journal of Operations Management, 9(2), 168–184. https://doi.org/10.1016/0272-6963(90)90094-T
Filippini, R. (1997). Operations management research: Some reflections on evolution, models and empirical studies in OM. International Journal of Operations and Production Management, 17(7), 655–670. https://doi.org/10.1108/01443579710175583
Flynn, B. B., & Flynn, E. J. (2004). An exploratory study of the nature of cumulative capabilities. Journal of Operations Management, 22(5), 439–457. https://doi.org/10.1016/j.jom.2004.03.002
Fynes, B., Voss, C., & De Búrca, S. (2005). The impact of supply chain relationship dynamics on manufacturing performance. International Journal of Operations and Production Management, 25(1), 6–19. https://doi.org/10.1108/01443570510572213
Garvin, D. (1987). Competing on the eight dimensions of quality. Harvard Business Review, November-December Issue, 101–109.
Größler, A., & Grübner, A. (2006). An empirical model of the relationships between manufacturing capabilities. International Journal of Operations and Production Management, 26(5), 458–485. https://doi.org/10.1108/01443570610659865
Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., & Tatham, R. L. (1998). Multivariate data analysis. Prentice Hall.
Hall, R. W. (1987). Attaining manufacturing excellence. McGraw-Hill.
Hall, R. W., & Nakane, J. (1990). Flexibility—Manufacturing Battlefield of the 90s: A Report on Attaining Manufacturing Flexibility in Japan and the United States. Association for Manufacturing Excellence.
Hayes, R. H., & Pisano, G. P. (1994). Beyond world-class: The new manufacturing strategy. Harvard Business Review, 72(1), 77–86.
Hayes, R. H., & Pisano, G. P. (1996). Manufacturing strategy: At the intersection of two paradigm shifts. Production and Operations Management, 5(1), 25–41. https://doi.org/10.1111/j.1937-5956.1996.tb00383.x
Hayes, R. H., & Schmenner, R. W. (1978). How should you organize manufacturing. Harvard Business Review, 56(1), 105–118.
Hayes, R. H., & Wheelwright, S. C. (1984). Restoring our competitive edge: Competing through manufacturing. John Wiley & Sons.
Hill, C. W. L. (1988). Differentiation versus low cost or differentiation and low cost: A contingency framework. Academy of Management Review, 13(3), 401–412. https://doi.org/10.5465/amr.1988.4306957
Ho, F. N., & Huang, C.-W. (2020). The interdependencies of marketing capabilities and operations efficiency in hospitals. Journal of Business Research, 113, 337–347. https://doi.org/10.1016/j.jbusres.2019.09.037
Hutton, S., & Eldridge, S. (2019). Improving productivity through strategic alignment of competitive capabilities. International Journal of Productivity and Performance Management, 68(3), 644–668. https://doi.org/10.1108/IJPPM-11-2017-0277
Jacobs, R. (2001). Alternative methods to examine hospital efficiency: Data envelopment analysis and stochastic frontier analysis. Health Care Management Science, 4(2), 103–115. https://doi.org/10.1023/a:1011453526849
Jaikumar, R. (1986). Postindustrial manufacturing. Harvard Business Review, 64(6), 69–76.
Kim, B., & Park, C. (2013). Firms’ integrating efforts to mitigate the tradeoff between controllability and flexibility. International Journal of Production Research, 51(4), 1258–1278. https://doi.org/10.1080/00207543.2012.698319
Lapré, M. A., & Scudder, G. D. (2004). Performance improvement paths in the US airline industry: Linking trade-offs to asset frontiers. Production and Operations Management, 13(2), 123–134.
Losa, E. T., Arjomandi, A., Hervé Dakpo, K. H., & Bloomfield, J. (2020). Efficiency comparison of airline groups in Annex 1 and non-Annex 1 countries: A dynamic network DEA approach. Transport Policy, 99, 163–174. https://doi.org/10.1016/j.tranpol.2020.08.013
Mapes, J., New, C. & Szwejczewski, M. (1997). Performance trade-offs in manufacturing plants. International Journal of Operations & Production Management, 17(10), 1020–1033.
Matthias, O., & Brown, S. (2016). Implementing operations strategy through Lean processes within health care: The example of NHS in the UK. International Journal of Operations and Production Management, 36(11), 1435–1457. https://doi.org/10.1108/IJOPM-04-2015-0194
Miller, S. S. (1983). Make your plant managers job manageable. Harvard Business Review, 61(1), 68–74.
Morita, M., & Flynn, E. J. (1997). The linkage among management systems, practices and behaviour in successful manufacturing strategy. International Journal of Operations and Production Management, 17(10), 967–993. https://doi.org/10.1108/01443579710176933
Narasimhan, R., & Schoenherr, T. (2013). Revisiting the progression of competitive capabilities: Results from a repeated cross-sectional investigation. International Journal of Production Research, 51(22), 6631–6650. https://doi.org/10.1080/00207543.2013.825739
New, C. (1992). World-class manufacturing versus strategic trade-offs. International Journal of Operations and Production Management, 12(4), 19–31. https://doi.org/10.1108/EUM0000000001298
Noble, M. A. (1995). Manufacturing strategy: Testing the cumulative model in a multiple country context. Decision Sciences, 26(5), 693–721. https://doi.org/10.1111/j.1540-5915.1995.tb01446.x
Pagell, M., Melnyk, S., & Handfield, R. (2000). Do trade-offs exist in operations strategy? Insights from the stamping die industry. Business Horizons, 43(3), 69–77. https://doi.org/10.1016/S0007-6813(00)89203-4
Porter, M. E. (1996). What is strategy. Harvard Business Review, 74(6) 61–78.
Qamar, A., Hall, M. A., Chicksand, D., & Collinson, S. (2019). Quality and flexibility performance trade-offs between lean and agile manufacturing firms in the automotive industry. Production Planning and Control, 31(9), 723–738.
Rosenzweig, E. D., & Easton, G. S. (2010). Tradeoffs in manufacturing? A meta-analysis and critique of the literature. Production and Operations Management, 19(2), 127–141. https://doi.org/10.1111/j.1937-5956.2009.01072.x
Roth, A. V., & Miller, J. G. (1992). Success factors in manufacturing. Business Horizons, 35(4), 73–81. https://doi.org/10.1016/S0007-6813(05)80165-X
Safizadeh, M. H., Ritzman, L. P., & Mallick, D. (2000). Revisiting alternative theoretical paradigms in manufacturing strategy. Production and Operations Management, 9(2), 111–126. https://doi.org/10.1111/j.1937-5956.2000.tb00328.x
Sarmiento, R., Whelan, G., & Thürer, M. (2018). A note on ‘Beyond the trade-off and cumulative capabilities models: Alternative models of operations strategy’. International Journal of Production Research, 56(12), 4368–4375. https://doi.org/10.1080/00207543.2018.1428773
Scarpin, M. R. S., & Brito, L. A. L. (2018). Operational capabilities in an emerging country: Quality and the cost trade-off effect. International Journal of Quality and Reliability Management, 35(8), 1617–1638. https://doi.org/10.1108/IJQRM-04-2017-0061
Schmenner, R. W., & Swink, M. L. (1998). On theory in operations management. Journal of Operations Management, 17(1), 97–113. https://doi.org/10.1016/S0272-6963(98)00028-X
Schonberger, R. (1986). The vital elements of world-class manufacturing. International Management, 41(5), 76–78.
Skinner, W. (1969). Manufacturing-missing link in corporate strategy. Harvard Business Review, 47(3), 136–145.
Skinner, W. (1974). The focused factory. Harvard Business Review, 52(3),114–121.
Skinner, W. (1992). Missing the links in manufacturing strategy. Manufacturing strategy: Process and content, 13–25. Chapman and Hall.
Slack, N. (1991). The manufacturing advantage: Achieving competitive manufacturing operations. Mercury Books.
Squire, B., Brown, S., Readman, J., & Bessant, J. (2006). The impact of mass customisation on manufacturing trade-offs. Production and Operations Management, 15(1), 10–21. https://doi.org/10.1111/j.1937-5956.2006.tb00032.x
Sum, C. C., Singh, P. J., & Heng, H. Y. (2012). An examination of the cumulative capabilities model in selected Asia-Pacific countries. Production Planning and Control, 23(10–11), 735–753. https://doi.org/10.1080/09537287.2011.642135
Swink, M., Talluri, S., & Pandejpong, T. (2006). Faster, better, cheaper: A study of NPD project efficiency and performance tradeoffs. Journal of Operations Management, 24(5), 542–562. https://doi.org/10.1016/j.jom.2005.09.004
Talluri, S., Kim, M. K., & Schoenherr, T. (2013). The relationship between operating efficiency and service quality: Are they compatible? International Journal of Production Research, 51(8), 2548–2567. https://doi.org/10.1080/00207543.2012.737946
Tamayo-Torres, J., Roehrich, J. K., & Lewis, M. A. (2017). Ambidexterity, performance and environmental dynamism. International Journal of Operations and Production Management, 37(3), 282–299. https://doi.org/10.1108/IJOPM-06-2015-0378
Thürer, M., Stevenson, M., Sarmiento, R., & Gianiodis, P. (2017). On strategic trade-offs: Does the principle of energy conservation explain the trade-offs law? Management Research Review, 40(11), 1163–1174. https://doi.org/10.1108/MRR-09-2016-0214
Van Ineveld, M., van Oostrum, J., Vermeulen, R., Steenhoek, A., & van de Klundert, J. (2016). Productivity and quality of Dutch hospitals during system reform. Health Care Management Science, 19(3), 279–290. https://doi.org/10.1007/s10729-015-9321-7
Vargas-Berrones, K. X., Sarmiento, R., & Whelan, G. (2019). Can you have your cake and eat it? Investigating trade-offs in the implementation of green initiatives. Production Planning and Control, 1–16.
Vastag, G. (2000). The theory of performance frontiers. Journal of Operations Management, 18(3), 353–360. https://doi.org/10.1016/S0272-6963(99)00024-8
Wanke, P., Azad, M. A. K., & Correa, H. (2019). Mergers and acquisitions strategic fit in Middle Eastern banking: An NDEA approach. International Journal of Services and Operations Management, 33(1), 1–25. https://doi.org/10.1504/IJSOM.2019.099652
Womack, J. P., Jones, D. T., & Roos, D. (1990). Machine that changed the world. Simon & Schuster.
Wurzer, T., & Reiner, G. (2018). Evaluating the impact of modular product design on flexibility performance and cost performance with delivery performance as a moderator. International Journal of Operations and Production Management, 38(10), 1987–2008. https://doi.org/10.1108/IJOPM-03-2017-0152