Lectures Health Service Operations Management
LECTURE 1 ........................................................................................................................................................ 2
LECTURE 2 UNIT OPERATIONS MANAGEMENT............................................................................................... 14
LECTURE 3 QUANTITATIVE ANALYSES OF UNITS ............................................................................................ 20
LECTURE 4 VARIABILITY, UNCERTAINTY, AND FLEXIBILITY ............................................................................. 31
LECTURE 5 IMPROVEMENT APPROACHES ...................................................................................................... 34
LECTURE 6 VALUE-BASED HEALTH CARE AND LEAN MANAGEMENT .............................................................. 50
,Lecture 1
Part 1
Practicalities of the course
HSOM is about the analysis, design, planning and control of all the steps necessary to deliver
services to clients in healthcare. It’s about coordinating and organizing care, within different
levels.
The course, starting with the first topic in this week: fundamentals of HSOM:
From 1800: moving from agriculture towards manufacturing towards service economy.
We can see that 200 hundred years, the majority was working in agriculture like creating
food for family. Nowadays it is a service culture, so there is movement from agriculture
towards manufacturing/production, and service industry. People need less time,
effort/money to produce their food which makes that manufacturing and producing foods is
getting more important. Because more time also time left to buy services.
So, production, operations and service management developed quite recently.
Health Service Operations Management
It’s also about operations management. An operation is something which transfers input to
output. Vissers and Beech, 2008
Example: is we assemble a wood and nails to a table, resource is a carpenter. Might have a
manual for this. Manual on how, tools which all contribute to making the table. Distinction
,between materials and tools, is that you cannot use the materials next time (you use it for
the table), however tools can be used again (like a hammer).
Example of a service-operation?
Is service the input or the output? What kind of resources do we need and what kind of
regulations?
→ You could say service is more in the middle, doing the process of going from input to
output
Different types of operations
• Alteration
We change things, e.g. changing wood in a table
• Transportation
We move things, e.g. wood in a specific place and the movement to another endpoint, the
table
• Inspection
The expectation is to get a table, so this can get inspected, some kind of quality
measurement
• Storage
In production is it seen as type of operations, but in services storage is seen as a delay in
different operations
Hierarchy from Operations Management perspective
You can also look at operations from a hierarchy, it can consist of different activities. In
between those activities there can be some waiting times. Difference between both level:
on level of operation there is transformation of input to output and on the level of activity
this is not always, it can always be an activity without a transformation. It can be divided in
tasks and task can also be divided. So a hierarchy in operations – activities - tasks
Triangles is waiting time.
Health Services Operations Management: Unit – Process – Network
, o Unit
A department in a health organization that performs operations of the same operation type.
E.g. in a hospital there is a MRI department (unit), the task is to perform a MRI. They have
resources → specific staff etc.
o Process/chain
In most cases a unit is part of a process (e.g. a process in helping the patiënt with certain
health complaint). Series of diagnostic work/operations that need to be performed to
produce a particular service.
o Network
Combination of units and chains performing operations for services for several groups of
clients. It the complete image.
Differences between the unit, process and network approaches
Health Service Operations Management So, it’s also about service management
Unit OM approach: focussing on e.g. efficiency, for workers to work efficient. We see it as a
single component, so it does not have a view on the whole process.
→ In network approach we combine both approaches (process and capacity approach). This
is difficult, it’s easier to optimize a unit or process, but it’s more difficult to optimize a
combination where 1 might decrease the other.
Health Service Operations Management
Services, a definition:
‘’A service is an activity or series of activities of more or less intangible nature that normally,
but not necessarily takes place in interactions between the customer and service employees
LECTURE 1 ........................................................................................................................................................ 2
LECTURE 2 UNIT OPERATIONS MANAGEMENT............................................................................................... 14
LECTURE 3 QUANTITATIVE ANALYSES OF UNITS ............................................................................................ 20
LECTURE 4 VARIABILITY, UNCERTAINTY, AND FLEXIBILITY ............................................................................. 31
LECTURE 5 IMPROVEMENT APPROACHES ...................................................................................................... 34
LECTURE 6 VALUE-BASED HEALTH CARE AND LEAN MANAGEMENT .............................................................. 50
,Lecture 1
Part 1
Practicalities of the course
HSOM is about the analysis, design, planning and control of all the steps necessary to deliver
services to clients in healthcare. It’s about coordinating and organizing care, within different
levels.
The course, starting with the first topic in this week: fundamentals of HSOM:
From 1800: moving from agriculture towards manufacturing towards service economy.
We can see that 200 hundred years, the majority was working in agriculture like creating
food for family. Nowadays it is a service culture, so there is movement from agriculture
towards manufacturing/production, and service industry. People need less time,
effort/money to produce their food which makes that manufacturing and producing foods is
getting more important. Because more time also time left to buy services.
So, production, operations and service management developed quite recently.
Health Service Operations Management
It’s also about operations management. An operation is something which transfers input to
output. Vissers and Beech, 2008
Example: is we assemble a wood and nails to a table, resource is a carpenter. Might have a
manual for this. Manual on how, tools which all contribute to making the table. Distinction
,between materials and tools, is that you cannot use the materials next time (you use it for
the table), however tools can be used again (like a hammer).
Example of a service-operation?
Is service the input or the output? What kind of resources do we need and what kind of
regulations?
→ You could say service is more in the middle, doing the process of going from input to
output
Different types of operations
• Alteration
We change things, e.g. changing wood in a table
• Transportation
We move things, e.g. wood in a specific place and the movement to another endpoint, the
table
• Inspection
The expectation is to get a table, so this can get inspected, some kind of quality
measurement
• Storage
In production is it seen as type of operations, but in services storage is seen as a delay in
different operations
Hierarchy from Operations Management perspective
You can also look at operations from a hierarchy, it can consist of different activities. In
between those activities there can be some waiting times. Difference between both level:
on level of operation there is transformation of input to output and on the level of activity
this is not always, it can always be an activity without a transformation. It can be divided in
tasks and task can also be divided. So a hierarchy in operations – activities - tasks
Triangles is waiting time.
Health Services Operations Management: Unit – Process – Network
, o Unit
A department in a health organization that performs operations of the same operation type.
E.g. in a hospital there is a MRI department (unit), the task is to perform a MRI. They have
resources → specific staff etc.
o Process/chain
In most cases a unit is part of a process (e.g. a process in helping the patiënt with certain
health complaint). Series of diagnostic work/operations that need to be performed to
produce a particular service.
o Network
Combination of units and chains performing operations for services for several groups of
clients. It the complete image.
Differences between the unit, process and network approaches
Health Service Operations Management So, it’s also about service management
Unit OM approach: focussing on e.g. efficiency, for workers to work efficient. We see it as a
single component, so it does not have a view on the whole process.
→ In network approach we combine both approaches (process and capacity approach). This
is difficult, it’s easier to optimize a unit or process, but it’s more difficult to optimize a
combination where 1 might decrease the other.
Health Service Operations Management
Services, a definition:
‘’A service is an activity or series of activities of more or less intangible nature that normally,
but not necessarily takes place in interactions between the customer and service employees
