Slack and performance in health care delivery

Improving quality and productivity simultaneously is vital to organizational competitiveness. Although continuous improvement is accepted as the objective for world class competition, it is not clear as to which interventions achieve the best performance, which variables intervene by enhancing or restricting the achievement of high quality and productivity, or which measures are appropriate for evaluating differences. Develops a quality evaluation tool and total factor productivity measures for health care clinics. Uses data envelopment analysis (DEA) to discriminate between high and low slack groups. Finds that hypothesized relationships and interactions between quality, productivity, and slack generally have statistically insignificant differences, exceptions being that health care consumers were able to identify characteristics of high and low quality care as well as health care professionals and that health care quality can increase with no decline in productivity when there is high‐slack. In general, high‐slack clinics could increase quality or productivity, but not both.