title: The impact of stakeholder involvement in hospital policy decision-making: a study of the hospital's business processes.
abstract: BACKGROUND
  In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital's board of directors on themes of strategic importance.
  
  
  OBJECTIVE
  To study the internal hospital's decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes.
  
  
  METHODS
  A retrospective analysis of the decision processes was conducted in three hospitals that implemented a stakeholder committee. The analysis consisted of process and outcome evaluation.
  
  
  RESULTS
  Fifteen themes were discussed in the stakeholder committees, whereof 11 resulted in a considerable change. None of these were on a strategic level. The theoretical model was not applied as initially developed, but was altered by each hospital. Consequentially, the decision processes differed between the hospitals. Despite alternation of the model, the stakeholder committee showed a meaningful impact in all hospitals on the operational level. As a result of the differences in decision processes, three factors could be identified as facilitators for success: (1) a close interaction with the board of executives, (2) the inclusion of themes with a more practical and patient-oriented nature, and (3) the elaboration of decisions on lower echelons of the organization.
  
  
  CONCLUSIONS
  To effectively influence the organization's public accountability, hospitals should involve stakeholders in the decision-making process of the organization. The model of a stakeholder committee was not applied as initially developed and did not affect the strategic decision-making processes in the involved hospitals. Results show only impact at the operational level in the participating hospitals. More research is needed connecting stakeholder involvement with hospital governance.
authors.affiliation: a Ghent University Hospital , Ghent , Belgium.|d Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery , Ghent University , Ghent , Belgium.
authors.forename: Simon
authors.initials: S
authors.lastname: Malfait
authors.affiliation: a Ghent University Hospital , Ghent , Belgium.|d Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery , Ghent University , Ghent , Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Van Hecke
authors.affiliation: c Faculty of Medicine and Life Sciences , Hasselt University , Roeselare , Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Hellings
authors.affiliation: a Ghent University Hospital , Ghent , Belgium.
authors.forename: Griet
authors.initials: G
authors.lastname: De Bodt
authors.affiliation: a Ghent University Hospital , Ghent , Belgium.|b Faculty of Medicine and Life Sciences, Department of Public Health , Ghent University , Ghent , Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Eeckloo
mesh_terms: D003657:Decision Making; D006739:Hospital Administration; D016134:Organizational Policy
keywords: Business process; Hospital governance; Patient involvement; Stakeholder involvement; Strategic policy