تاثیر اندازه گیری عملکرد بر پویایی گروه خرید: تجربه کانادایی  The impact of performance measurement on purchasing group dynamics: The Canadian experience

1. Introduction Since around the early 1990s, numerous reports have indicated that in industrialized countries, healthcare managers must control cost increases much better, without sacrificing quality and service (Naylor, 1999; Ford and Scanlon, 2007; Roehrig, 2011; Hadad et al., 2013). According to many authors, supply chain management presents interesting opportunities to achieve significant savings (CSC Consulting, 1996; Ebel et al., 2013) without impacting service delivery, and, actually, even by improving it (Agwunobi and London, 2009; Narayana et al., 2014). When considering only the last provider in the supply chain –the healthcare center (HC)–, purchasing and inventory represent between 30% and 45% of expenses, while purchasing can correspond to half of that amount (Landry and Beaulieu, 2013). In many industrialized countries, healthcare supply chains include purchasing groups, which act as intermediaries between HCs and suppliers (McKone-Sweet et al., 2005). Created over 100 years ago in healthcare and now known under different names, a purchasing group is a service provider to other organizations and is mostly used for bids and contract negotiation (Nollet and Beaulieu, 2005). As suggested by Adobor and McMullen (2014), a purchasing group can be viewed as a third party facilitating the relationship between buyers and suppliers. Purchasing groups often promise, implicitly or explicitly, a lower price through the consolidation of purchases from many HCs, while reducing administrative costs normally resulting from the duplication of activities such as supplier search and supplier selection in individual HCs. However, Hu and Schwarz (2011, p. 1) mention that “… GPOs play a very significant –and very controversial– role in the supply chains for healthcare products”. Their idea is supported by the fact that over the last 30 years there has been criticism voiced by members of many purchasing groups (Housley, 1982; Johnson, 1999; Nollet and Beaulieu, 2003; GAO, 2010), or, inversely, by the groups who complain that their members do not abide the decisions made on their behalf by the group (Schneller, 2009). At the core of the tensions between a purchasing group and its members lies purchasing group’s performance assessment, including for the computation of total savings. The concept of savings can be quite complex in the supply field (Nollet et al., 2008). However, a purchasing group’s performance often depends upon the members’ commitment to the group, as well as on the relationships between the group and its members.