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Summary Health Service Operations Management: complete

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HSOM -
aantekeningen
Inhoudsopgave
Introduction, value-based healthcare and design studies......................................................................1
Introduction HSOM.............................................................................................................................1
Service................................................................................................................................................3
Value-based healthcare......................................................................................................................5
Design studies.....................................................................................................................................6
Improving home care: knowledge creation through engagement and design (Groop et al)...............7
Perceptions of practitioners and experts on value-based healthcare: a mixed-methods study
(Ahaus)...............................................................................................................................................9
What attributes determine quality and satisfaction with health care delivery? (Bowers et al)........10
Operations Management of Units........................................................................................................10
Benchmarking operating room departments in the Netherlands: evaluation of a benchmarking
collaborative (van Veen et al)...........................................................................................................13
Dimensioning hospital wards using the Erlang loss model (De Bruin et al).......................................14
Operations Management of pathways and chains...............................................................................15
Do pathways lead to better organized care processes? (Vanhaecht et al)........................................17
Performance analysis of a focused hospital unit: the case of an integrated trauma center (Hyer et
al).....................................................................................................................................................17
Variability, uncertainty & flexibility......................................................................................................19
The diseconomies of queue pooling: an empirical investigation of emergency department length of
stay (Song et al)................................................................................................................................21
Theory of constraints & six sigma.........................................................................................................22
The evolution of a management philosophy: the theory of constraints (Watson et al)....................26
Lean management................................................................................................................................27
Does lean cure variability in health care? (Roemeling et al).............................................................30
Role of lean leadership in the lean maturity-second-order problem solving relationship: a mixed
methods study (Bijl et al)..................................................................................................................31
Overig...................................................................................................................................................33

Introduction, value-based healthcare and design studies
Introduction HSOM
HSOM = analysis, design, planning and evaluation of all necessary steps to
deliver services to clients in health care. Planning and control the
processes, make sure adequate resources are in place to provide an
regulations




acceptable service.


input operation
1 output
resources

, Operation = what transforms input in output.
Input: pt with need/wish; output: pt with added value.
Resources: are used and can be re-used, they are not lost (staff and tools
are resource, prothese is input). Regulations: e.g. guidelines.

Activity (e.g. administering a pt) = task + task + task…
Operation = act + act + act… to create value. Types of operations:
alteration (transform pt), transportation, inspection, storage (in health
care: waiting for pt or professional).
Process (pt journey, though not organized this way!, lack of ownership,
e.g. after + iFOB) = op + op + op (to produce a service)…

The Erlang or Gamma distribution (a skew distribution characterised by an
early peak and a long tail to the right) is often used to arrive at a good fit
with service distributions in health care. Long tail: variation or bad
organizational logistics (doorstroomprobleem)?

Management is e.g. payment and
purchasing goods, ancillary is e.g.
cleaning and maintenance.
Resource performance output
measures are for monitoring
efficiency and effectiveness.
Role of OM is to achieve an
acceptable balance between
different types of output.
External factors affecting OM
decisions:
- System regulation. Incentive of
‘market’: invest in new
technologies, attract more pts,
reduce costs per case. Incentive NHS: ensure budgetary targets are not
exceeded, invest in monitoring key resource areas (OR, beds)
- Aging population, advances is technology, pt knowledge through
Internet.
Internal factors: who is actually managing the system, consensus among
different actors.

Care professionals are also client to OM processes; e.g., a doctor
requesting an X-ray for a pt. The product provided then is information.

Worklist OM:
1. Identify key operations
2. Understand how operations use resources
3. Identify the chain of operations, how are they linked
4. Establish control systems


Unit = department that performs operations of the same op-type (e.g.
lung)

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