Time-based management of patient processes (original) (raw)
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Resource allocation in health care processes: A case study
RePEc: Research Papers in Economics, 2013
This paper utilizes queuing models to analyze health care processes. We extend previous queuing models to allow for i) heterogeneous resources, ii) resource allocation to various tasks, and iii) teams (complementary resources). We model a process of one clinical unit. We use the model to analyze how resource allocation affects both process performance and utilization of resources. This approach emphasizes how allocation of resources to tasks affects process performance. We illustrate how the model can be used to analyze how variations in resources affect process performance and for example how ICT affects process performance.
Resource allocation in health care processes
This paper utilizes queuing models to analyze health care processes. We extend previous queuing models to allow for i) heterogeneous resources, ii) resource allocation to various tasks, and iii) teams (complementary resources). We model a process of one clinical unit. We use the model to analyze how resource allocation affects both process performance and utilization of resources. This approach emphasizes how allocation of resources to tasks affects process performance. We illustrate how the model can be used to analyze how variations in resources affect process performance and for example how ICT affects process performance.
Process improvement in healthcare: overall resource efficiency
Quality and Reliability Engineering International, 2011
This paper aims to develop a unifying and quantitative conceptual framework for healthcare processes from the viewpoint of process improvement. The work adapts standard models from operation management to the specifics of healthcare processes. We propose concepts for organizational modeling of healthcare processes, breaking down work into micro processes, tasks, and resources. In addition, we propose an axiological model which breaks down general performance goals into process metrics. The connexion between both types of models is made explicit as a system of metrics for process flow and resource efficiency. The conceptual models offer exemplars for practical support in process improvement efforts, suggesting to project leaders how to make a diagrammatic representation of a process, which data to gather, and how to analyze and diagnose a process's flow and resource utilization. The proposed methodology links on to process improvement methodologies such as business process reengineering, six sigma, lean thinking, theory of constraints, and total quality management. In these approaches, opportunities for process improvement are identified from a diagnosis of the process under study. By providing conceptual models and practical templates for process diagnosis, the framework relates many disconnected strands of research and application in process improvement in healthcare to the unifying pursuit of process improvement.
Process-based Management aimed at improving health care and financial results
Revista da Escola de Enfermagem da USP
The limited resources allocated to the health area and the growing demands require leaders’ qualified and committed performance in hospital management. In this perspective, the objective of this study is to reflect on the management practices that can be applied to hospital facilities to achieve better care and financial results. Among them, process-based management proposes an approach for continuous process improvement to achieve desired results; the method Lean Six Sigma allows identifying and eliminating waste in production processes; the continuous improvement model combines practical knowledge with the knowledge of how the system to be improved works, through observations and changes that allow its results measurement; and cost management and value-based healthcare provides for care mapping, from beginning to end, to assess what actually adds value to patients. The contributions of implementing these practices are recognized worldwide; using them, processes can be increased, i...
Managing patient flow using time buffers
Journal of Manufacturing Technology Management, 2010
The purpose of this paper is to determine how and why Theory of Constraints (TOC) based time buffer management has contributed to improved patient flow in health and social care applications. Methodology The focus of the research is on the application and implementation of time buffer management by QFI consulting. Four UK hospital implementations of the QFI Jonah software and methodology were investigated to establish how buffer management was being applied and why the reported benefits were being achieved. This involved collecting service delivery data together with semi-structured interviews. To support this evaluation, four control functions of time buffer management have been identified as a basis for evaluation of the application designs and their implementation. Findings Case research evidence shows significant and rapid improvement in length of stay following implementation of the approach, amounting to a reduction in length of stay of over 20% and significantly improved Accident & Emergency performance. Sustainability issues were evident however and were traced, at least in part, to lack of adherence to one or more of the functional elements of the system. Research limitations/implications This case research has considered four applications that represent some of the more successful implementations. This research is, therefore, limited by the range of applications considered and is also limited in its ability to evaluate the sustainability of the implementations in the longer term. Practical implications This paper provides clearer theoretical understanding of the improvements experienced by these hospitals, which is critical to expanding the use of traditional manufacturing approaches into complex service environments. Originality/value This research has helped conceptualise how time buffer management control functions can be structured to evaluate the design and implementation of novel applications.
Journal of Industrial Engineering and Management, 2017
Purpose: The main contribution of this paper is to generate an optimum solution for capacity planning and appointment scheduling issues, which are frequently encountered in clinical flows with various route and treatment periods at dental hospitals.Design/methodology/approach: It is essential to define the system well in order to ensure that the working staff and patients use their time very efficiently and that the process flows continuously. By having examined a sample healthcare system through the help of a study addressed in such context, studies on process improvement in line with the dissatisfactions of the working staff and patients have been carried out. Within the scope of the study, the operation of 7 Departments in a dental hospital undergoing a treatment process have been reviewed and examined. The problems encountered as result of the observations made are discussed in detail, and formerly and recently designed system performance analyses are conducted by having perform...
BMC Health Services Research
Background The number of people with chronic diseases has increased globally, as has the number of chronic diseases per person. Faced with this reality, the term “complex patient” is current and actual. The healthcare costs associated with these patients are high and are expected to increase since most healthcare systems are not yet ready to provide integrated long-term care. In Portugal, several health institutions have made efforts to provide integrated care: case management models have been implemented to complex patients follow-up. However, studies related to cost of these programs are still limited. Therefore, a qualitative investigation was conducted, approaching the design criteria of a case study research, to design a case management program for complex patients and determine its direct costs, following the Time-Driven Activity-Based Costing methodology, in Local Health Unit setting. Method The direct costs of providing care to a complex patient involved in a case management...
Improving Timeliness of Healthcare Services.pdf
Timeliness and accessibility of healthcare services reflect system's capacity to provide care quickly after a need is recognized. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on improving timeliness of diagnostic electromyography and nerve conduction study for carpel tunnel syndrome and peripheral neuropathy patients to avoid significant treatment delay and potential complications. We identified causes of delayed appointments and implemented strategies to reduce it from 12 to 2 weeks. FOCUS PDCA approach as well as Pareto analysis were used to identify and target core issues then suggest effective strategies including improving staff productivity, enhancing teamwork coordination and motivating healthcare team stakeholders. The results show that 93% of appointments were made available in less than 2 weeks, compared to only 8% pre-improvement, no show rate reduced to 2% compared to 13% and total procedure volume was increased to 99 compared to 52 per month.
Journal of clinical medicine research, 2018
Time-driven activity-based costing (TDABC) is a methodology that calculates the costs of healthcare resources consumed as a patient moves along a care process. Limited data exist on the application of TDABC from the perspective of an anesthesia provider. We describe the use of TDABC, a bottom-up costing strategy and financial outcomes for three different medical-surgical procedures. In each case, a multi-disciplinary team created process maps describing the care delivery cycle for a patient encounter using the TDABC methodology. Each step in a process map delineated an activity required for delivery of patient care. The resources (personnel, equipment and supplies) associated with each step were identified. A per minute cost for each resource expended was generated, known as the capacity cost rate, and multiplied by its time requirement. The total cost for an episode of care was obtained by adding the cost of each individual resource consumed as the patient moved along a clinical pa...