HPI4010: Organizing and Managing Patient Flows
Summary of the module
Maastricht University
Faculty of Health, Medicine and Life Sciences (FHML)
MSc Healthcare Policy, Innovation and Management
,Table of contents
1. Integrated care ecosystems ................................................................................................................................ 3
1.1 Banathy’s system .......................................................................................................................................... 7
1.2 Flow ............................................................................................................................................................ 10
1.3 Digital transformation ................................................................................................................................ 15
2. CPI (managerial) thinking .................................................................................................................................. 18
2.1 Essence and relevance of lean .................................................................................................................... 22
2.2 Other approaches for process management .............................................................................................. 39
2.2.1 Total Quality Management (TQM) ...................................................................................................... 39
2.2.2 Six sigma ............................................................................................................................................. 39
2.2.3 Business Process Re-engineering (BPR) .............................................................................................. 41
2.2.4 Kaizen .................................................................................................................................................. 42
2.2.5 Agile management .............................................................................................................................. 42
2.3 Differences and similarities of the approaches .......................................................................................... 43
2.4 Applicability of lean to care delivery processed across organizations........................................................ 44
2.5 Lean in healthcare ...................................................................................................................................... 46
3. Socio-Technical (organizational) thinking.......................................................................................................... 50
3.1 Principles of STS thinking ............................................................................................................................ 54
3.2 Organizational stress loop .......................................................................................................................... 57
3.3 Organizational sustainability loop .............................................................................................................. 63
3.4 Dutch/ Lowlands socio-technical design .................................................................................................... 67
3.5 Concepts connecting both loops ................................................................................................................ 70
2
,1. Integrated care ecosystems
Characteristics of the system
Ecosystems can be understood as dynamic and co-evolving communities. An eco-system is:
- Purposeful
- Collection of entities
- Relationships between entities (structure)
- Behaviour: dynamic interaction (system as a negotiated order)
- External environment (open systems)
- Input-transformation-output-feedback
- Process, flow
An eco-system is the network of organizations—incl. suppliers, distributors, customers (patients),
competitors, government agencies, etc.—involved in the delivery of a product or service through
both competition and cooperation.
3
, Origin: business ecosystems
(Moore, J. F., 1993 Predators and Prey: A new Ecology of Competition)
Systems vs. networks
Ecosystems differ from networks because of the following reasons:
Types of systems
- Sub system
A number of parts with all the relations (e.g., department).
- Aspect system
A specific set of relations of a system (e.g., arrows from a quality perspective or a finance
perspective).
4
Summary of the module
Maastricht University
Faculty of Health, Medicine and Life Sciences (FHML)
MSc Healthcare Policy, Innovation and Management
,Table of contents
1. Integrated care ecosystems ................................................................................................................................ 3
1.1 Banathy’s system .......................................................................................................................................... 7
1.2 Flow ............................................................................................................................................................ 10
1.3 Digital transformation ................................................................................................................................ 15
2. CPI (managerial) thinking .................................................................................................................................. 18
2.1 Essence and relevance of lean .................................................................................................................... 22
2.2 Other approaches for process management .............................................................................................. 39
2.2.1 Total Quality Management (TQM) ...................................................................................................... 39
2.2.2 Six sigma ............................................................................................................................................. 39
2.2.3 Business Process Re-engineering (BPR) .............................................................................................. 41
2.2.4 Kaizen .................................................................................................................................................. 42
2.2.5 Agile management .............................................................................................................................. 42
2.3 Differences and similarities of the approaches .......................................................................................... 43
2.4 Applicability of lean to care delivery processed across organizations........................................................ 44
2.5 Lean in healthcare ...................................................................................................................................... 46
3. Socio-Technical (organizational) thinking.......................................................................................................... 50
3.1 Principles of STS thinking ............................................................................................................................ 54
3.2 Organizational stress loop .......................................................................................................................... 57
3.3 Organizational sustainability loop .............................................................................................................. 63
3.4 Dutch/ Lowlands socio-technical design .................................................................................................... 67
3.5 Concepts connecting both loops ................................................................................................................ 70
2
,1. Integrated care ecosystems
Characteristics of the system
Ecosystems can be understood as dynamic and co-evolving communities. An eco-system is:
- Purposeful
- Collection of entities
- Relationships between entities (structure)
- Behaviour: dynamic interaction (system as a negotiated order)
- External environment (open systems)
- Input-transformation-output-feedback
- Process, flow
An eco-system is the network of organizations—incl. suppliers, distributors, customers (patients),
competitors, government agencies, etc.—involved in the delivery of a product or service through
both competition and cooperation.
3
, Origin: business ecosystems
(Moore, J. F., 1993 Predators and Prey: A new Ecology of Competition)
Systems vs. networks
Ecosystems differ from networks because of the following reasons:
Types of systems
- Sub system
A number of parts with all the relations (e.g., department).
- Aspect system
A specific set of relations of a system (e.g., arrows from a quality perspective or a finance
perspective).
4
