Unlocking Hospital Performance

Abstract

In response to two decades of New Public Management (NPM) inspired reforms, the Moroccan public hospital sector is undergoing a profound transformation. This study analyzes the impact of NPM tool adoption on hospital performance, with a specific focus on the appropriation of these tools by local actors. Drawing on a quantitative survey of 240 hospital managers, our findings reveal that tool appropriation plays a crucial mediating role. This process, resulting in an organizational hybridization that merges managerial logics with public service values, is a critical determinant of effective performance improvement. Furthermore, the results confirm the influence of contingency factors, including hospital size, autonomy, and organizational culture. The study concludes that the simple transposition of NPM tools is insufficient. Instead, their effectiveness is contingent upon a contextual appropriation that promotes dynamics of hybridization.