Summary
exam
Healthcare operations
,Lectures
Week 1
Tertiary care: teaching and national referral hospitals
Secondary care: specialist hospitals and referral center
Primary care: health centers, maternities, nursing homes, mobile clinics, etc.
Hospital operations systems
examples: ED,
intensive care, nursing wards, operating theatres, outpatient clinics, etc.
Outpatient clinics: provide diagnosis and treatment for patients who do
not need to stay overnight or do not need a bed in the hospital
Units, resources and operation types in a hospital setting
1
,Characteristics of processes (for key patient groups within general
surgery)
OT = operating theatre
Managing hospital operations
- Describe hospital systems
o Common elements, how to map
- Analyse processes
o What and how to consider
- Design, if change is required
o Identify and detail solution directions
Characteristics of an HC organization – managerial context
- Professional bureaucracy with a powerful position of the frontline workers,
clinicians of all professions, particularly doctors
- Powerful nature of professional status and knowledge
- Absence of clear hierarchical structures
- Things get done not through instructions and direction but by negotiation,
persuasion, peer influence, and agreement
Variety: structural differences between patients, physicians, and the routing of
patients
- When there is no difference it would be possible to achieve 100%
efficiency in healthcare delivery
2
, Variability: linked to the variation we observe over time in:
o The demand for capacity
o The available capacity
- Variability is always harmful
What causes variability:
Routing= sequence of process steps
visited by the patient
So routing variety = the extent to
which patient processes differ
within the group Homogeneity
Routing uncertainty= treatment
steps depend on outcomes
diagnostics phase, so required
capacity is difficult to predict
Natural variability: number of stroke patients per day (this number cannot be
influenced
- Cope and manage
Artificial variability: the capacity available over time and allocated to a specific
activity (these specific patterns are determined by decision-makers)
- Eliminate or reduce
- Professional variety (training, clinical pathways, standardization)
- Resource variety (standardization)
- Variability in available capacity (capacity management, stability in
allocation of capacity)
3
exam
Healthcare operations
,Lectures
Week 1
Tertiary care: teaching and national referral hospitals
Secondary care: specialist hospitals and referral center
Primary care: health centers, maternities, nursing homes, mobile clinics, etc.
Hospital operations systems
examples: ED,
intensive care, nursing wards, operating theatres, outpatient clinics, etc.
Outpatient clinics: provide diagnosis and treatment for patients who do
not need to stay overnight or do not need a bed in the hospital
Units, resources and operation types in a hospital setting
1
,Characteristics of processes (for key patient groups within general
surgery)
OT = operating theatre
Managing hospital operations
- Describe hospital systems
o Common elements, how to map
- Analyse processes
o What and how to consider
- Design, if change is required
o Identify and detail solution directions
Characteristics of an HC organization – managerial context
- Professional bureaucracy with a powerful position of the frontline workers,
clinicians of all professions, particularly doctors
- Powerful nature of professional status and knowledge
- Absence of clear hierarchical structures
- Things get done not through instructions and direction but by negotiation,
persuasion, peer influence, and agreement
Variety: structural differences between patients, physicians, and the routing of
patients
- When there is no difference it would be possible to achieve 100%
efficiency in healthcare delivery
2
, Variability: linked to the variation we observe over time in:
o The demand for capacity
o The available capacity
- Variability is always harmful
What causes variability:
Routing= sequence of process steps
visited by the patient
So routing variety = the extent to
which patient processes differ
within the group Homogeneity
Routing uncertainty= treatment
steps depend on outcomes
diagnostics phase, so required
capacity is difficult to predict
Natural variability: number of stroke patients per day (this number cannot be
influenced
- Cope and manage
Artificial variability: the capacity available over time and allocated to a specific
activity (these specific patterns are determined by decision-makers)
- Eliminate or reduce
- Professional variety (training, clinical pathways, standardization)
- Resource variety (standardization)
- Variability in available capacity (capacity management, stability in
allocation of capacity)
3
