Lecture 1 – Introduction to the course & balancing
Capacity & Demand
Part 1: Introduction to the course
Service management
Service = 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 and/or physical
resources or goods and/or systems of the service
provider, which are provided as solutions to customer problems (Gronroos, 1990). It has some
specific characteristics:
Make is distingable (onderscheidbaar)
Intangible –> You can not ‘pick it op’ and it is not transferable.
Non-transferrable ownership –>
Customer participation –> Customor needs to be constantly available, and needs to be there
simultaneous.
Simultaneous creation and use
Heterogeneity –> it is different between different patients and same
healthcare provider. Interaction is part of the service and how it is
delivered and experienced.
Perishable –> I can not use a service later on.
Service package –> core of the package of service is ‘service experience’.
Equipment is also a part of the service package.
Supporting facilities are resources and facilities that can be re-used again. For example equipment,
the building, a specific room. Facilitating goods is the (small) material that is used in the service, for
example medical single use material, information leaflets.
Operations management and health service operations management
Is about the resources, providing care. Right resources on the right place at the right moment.
Operations management = The control of the activities involved in producing goods and providing
services, and the study of the best ways to do this.
Control of activities = beheersen van activiteiten, assuring that services are available.
Health service operations management = Analysis, design, planning and control of all the steps
necessary to provide services for patients in such a way that their needs are met, that service
standards are met, and resources are used efficiently.
The complete package until planning and control is part of operational management.
Expectations of customour vs. efficient use of resources.
HSOM: Process – Unit – Network
Unit = A department in a health organization that
performs operations of the same operation type.
Specific departments and are performing a specific
kind of operation. Consultation with physician or GP,
taking a blood sample. Are needed to provide
processes. No process without units.
Process/chain = series of operations that need to be
performed to produce a particular service
,Network = combination of units and chains performing operations for services for several
groups of clients.
The whole process. This is network operation process management.
Problem solving cycle – Van Aken
–> Using models and analysis facilitate learning before doing
How to look at problems, for example capacity and process
management.
- Waiting lists: why are these that long? Always mix-method
approach.
Core of how they analyse problems, we will do this ourself in the ‘game’.
Financial management (cost, income, investment)
Resources is key concepts of capacity management. They must be
available in the right amount. Financing is necessary to buy the
resources and maintain them. So for efficient use of resources,
we need financing.
Part 2: Unit operational management: balancing capacity & demand
Levels of planning
Demand for a certain service. First we have to plan in capacity
management. All levels provide in what you need for the level
below. Tactical level influenced to operational planning.
1. Strategic choices: Availability of the right resources in
sufficient quantity
2. Tactical management: Allocation of resources to departments
and specialties
3. Operational planning: Scheduling of patients
Difference between tactical and operational planning:
Tactical decisions are made for a longer period. Within the tactical
planning, the departments can plan their own patients. This is
operational planning.
Scheduling system:
- Walk-in = patients are arriving, waiting for their turn, and after that they go away. First come, first
service. For example: pick a number at the pharmacy.
- Appointment scheduling = Most used in Healthcare. We have a agenda, allocating specific slots to
a certain patient. Beforehand we decide the slots. Problem: you can have ‘no shows’. Is some
more management necessary.
- Waiting list = waiting for a certain operation. Efficiently using your time or prioritizing decides
who can go first
Demand, capacity & Variability
Demand = Important ‘who are our patients’ ‘when do we accept them’ ‘is this plannable or is it an
emergency service’ ‘can I tread them as a homogeneus group?’ ‘different timeslots or the same
slots’?. A lot of things before we make a tactical view.
–> Patient groups with different characteristics
Capacity = access to the resource. Is a resource available. We
need an MRI, we also need a room and medical assistants.
, Also dependence between demand and planning.
–> Demand following resource <– planning leading resource.
There are also following resources that results to planning other resources. Can be a bottleneck, so
leading resource has to replan. Units can not work independently from each other.
Variability = There are changes in how many patients there are on days. Not every day we receive the
same amount of patients. Variability refers to deviation from average conditions.
Predictable = Seasonality in
arrival patterns. For example a lot of broken hips and virus in October and November. Or it is more
busy on Monday and Tuesday. We know it, it is called ‘seasonality’.
Unpredictable variation = There is variation, it is important when you plan or schedule that you take
variation into account.
Sources of predictable and unpredictable variability:
We have to adapt with some kind of buffering to adapt unpredictable.
- Predictable variability –> no uncertainty
o (Seasonal) Patterns in demand and capacity
o Supply chain variability: leading and following capacities
o Differences in complexity of patients
- Unpredictable variability –> uncertainty
o Fluctuation in demand
o Fluctuation in capacity
o Fluctuation in time needed for an activity
How to cope with variability? patient
service efficiency
balance
- Predict –> (1) Adapt the capacity to the demand, (2) Adapt the (quality)
demand to the capacity
extra
- Variation reduction: For example: Walk-in facilitating in the morning waiting time buffering (flexible)
capacity
It is also really busy. Inform the patients about when it is busy and
when not, so you can push them to come in the afternoon.
demand capacity
- Buffering (inventory) –> (1) Waiting times, (2) Extra capacity, (3) flexiblity
Flexible capacity
Inventory is not necessary in service organisations
For example: More consultations on Monday, because there is more demand.
Waiting times –> You can let patient wait for some time. This is on the demand site. We can not led
them wait to long. So on the capacity side we have to provide extra (flexible) capacity if it is really
busy.
Unit performance: utilization
Capacity & Demand
Part 1: Introduction to the course
Service management
Service = 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 and/or physical
resources or goods and/or systems of the service
provider, which are provided as solutions to customer problems (Gronroos, 1990). It has some
specific characteristics:
Make is distingable (onderscheidbaar)
Intangible –> You can not ‘pick it op’ and it is not transferable.
Non-transferrable ownership –>
Customer participation –> Customor needs to be constantly available, and needs to be there
simultaneous.
Simultaneous creation and use
Heterogeneity –> it is different between different patients and same
healthcare provider. Interaction is part of the service and how it is
delivered and experienced.
Perishable –> I can not use a service later on.
Service package –> core of the package of service is ‘service experience’.
Equipment is also a part of the service package.
Supporting facilities are resources and facilities that can be re-used again. For example equipment,
the building, a specific room. Facilitating goods is the (small) material that is used in the service, for
example medical single use material, information leaflets.
Operations management and health service operations management
Is about the resources, providing care. Right resources on the right place at the right moment.
Operations management = The control of the activities involved in producing goods and providing
services, and the study of the best ways to do this.
Control of activities = beheersen van activiteiten, assuring that services are available.
Health service operations management = Analysis, design, planning and control of all the steps
necessary to provide services for patients in such a way that their needs are met, that service
standards are met, and resources are used efficiently.
The complete package until planning and control is part of operational management.
Expectations of customour vs. efficient use of resources.
HSOM: Process – Unit – Network
Unit = A department in a health organization that
performs operations of the same operation type.
Specific departments and are performing a specific
kind of operation. Consultation with physician or GP,
taking a blood sample. Are needed to provide
processes. No process without units.
Process/chain = series of operations that need to be
performed to produce a particular service
,Network = combination of units and chains performing operations for services for several
groups of clients.
The whole process. This is network operation process management.
Problem solving cycle – Van Aken
–> Using models and analysis facilitate learning before doing
How to look at problems, for example capacity and process
management.
- Waiting lists: why are these that long? Always mix-method
approach.
Core of how they analyse problems, we will do this ourself in the ‘game’.
Financial management (cost, income, investment)
Resources is key concepts of capacity management. They must be
available in the right amount. Financing is necessary to buy the
resources and maintain them. So for efficient use of resources,
we need financing.
Part 2: Unit operational management: balancing capacity & demand
Levels of planning
Demand for a certain service. First we have to plan in capacity
management. All levels provide in what you need for the level
below. Tactical level influenced to operational planning.
1. Strategic choices: Availability of the right resources in
sufficient quantity
2. Tactical management: Allocation of resources to departments
and specialties
3. Operational planning: Scheduling of patients
Difference between tactical and operational planning:
Tactical decisions are made for a longer period. Within the tactical
planning, the departments can plan their own patients. This is
operational planning.
Scheduling system:
- Walk-in = patients are arriving, waiting for their turn, and after that they go away. First come, first
service. For example: pick a number at the pharmacy.
- Appointment scheduling = Most used in Healthcare. We have a agenda, allocating specific slots to
a certain patient. Beforehand we decide the slots. Problem: you can have ‘no shows’. Is some
more management necessary.
- Waiting list = waiting for a certain operation. Efficiently using your time or prioritizing decides
who can go first
Demand, capacity & Variability
Demand = Important ‘who are our patients’ ‘when do we accept them’ ‘is this plannable or is it an
emergency service’ ‘can I tread them as a homogeneus group?’ ‘different timeslots or the same
slots’?. A lot of things before we make a tactical view.
–> Patient groups with different characteristics
Capacity = access to the resource. Is a resource available. We
need an MRI, we also need a room and medical assistants.
, Also dependence between demand and planning.
–> Demand following resource <– planning leading resource.
There are also following resources that results to planning other resources. Can be a bottleneck, so
leading resource has to replan. Units can not work independently from each other.
Variability = There are changes in how many patients there are on days. Not every day we receive the
same amount of patients. Variability refers to deviation from average conditions.
Predictable = Seasonality in
arrival patterns. For example a lot of broken hips and virus in October and November. Or it is more
busy on Monday and Tuesday. We know it, it is called ‘seasonality’.
Unpredictable variation = There is variation, it is important when you plan or schedule that you take
variation into account.
Sources of predictable and unpredictable variability:
We have to adapt with some kind of buffering to adapt unpredictable.
- Predictable variability –> no uncertainty
o (Seasonal) Patterns in demand and capacity
o Supply chain variability: leading and following capacities
o Differences in complexity of patients
- Unpredictable variability –> uncertainty
o Fluctuation in demand
o Fluctuation in capacity
o Fluctuation in time needed for an activity
How to cope with variability? patient
service efficiency
balance
- Predict –> (1) Adapt the capacity to the demand, (2) Adapt the (quality)
demand to the capacity
extra
- Variation reduction: For example: Walk-in facilitating in the morning waiting time buffering (flexible)
capacity
It is also really busy. Inform the patients about when it is busy and
when not, so you can push them to come in the afternoon.
demand capacity
- Buffering (inventory) –> (1) Waiting times, (2) Extra capacity, (3) flexiblity
Flexible capacity
Inventory is not necessary in service organisations
For example: More consultations on Monday, because there is more demand.
Waiting times –> You can let patient wait for some time. This is on the demand site. We can not led
them wait to long. So on the capacity side we have to provide extra (flexible) capacity if it is really
busy.
Unit performance: utilization
