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Operations Management in Healthcare
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Collegeslides en aantekeningen van colleges bij het vak Operations Management in healthcare. Overzichtelijk. Zowel Nederlandse als Engelse termen.
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Operations management in healthcareCollege 1
- Operations management is the activity of managing the resources which are devoted to the
production and delivery of products and services.
- Efficiënt: zo snel
mogelijk en zo goedkoop mogelijk. Relatie tussen output
in relatie tot input en de middelen die erin worden
gestopt.
o Minimale productie kosten
o Zo snel mogelijke productie
o Minimale wachttijd
o Enz.
- Effectiviteit: of je je doelen behaald
o Customers: quality of product, quality of service
o Staff: quality of labor
o Company owners: market position, business resilience, etc
- The part of management involved with designing and organizing processes such that they are
both efficient and effective
- Without effectiveness, an organization will not survive; Without efficiency it may survive
- Verschil kwaliteit van zorg en service:
o Zorg: uitkomsten van de behandeling
o Service: beleving in het proces
- Output zegt niks over de kwaliteit van de geleverde zorg, outcome wel
- Voorbeeld supermarkt:
o Aldi: bulk, goedkoop
o Jumbo: duurder, fijnere winkelbeleving, luxe
- Als zorginstelling moet je een waarde propositie kiezen:
o Je waarde propositie moet je vertrekpunt zijn, wat willen ze bereiken, kiezen tussen
“aldi of jumbo”
o Hebben zorgverleners een keuze, als ze “een aldi” willen zijn, dan komt niemand
meer bij ons en krijgen we geen contracten bij verzekeraars
- Voor ziekenhuizen is het van belang dat ze effectief en efficiënt zijn om contracten te
behouden met verzekeraars
o Geen lange wachtrijen en goede kwaliteit zorg leveren
- Economie: gaat over schaarste
o Zorg: personeel, geld
- Vraag en aanbod in de zorg
, o Vraag: wat willen patiënten krijgen voor soort zorg
o Aanbod: wat je levert qua zorg
- Operations management is overal, in alle producten en service die je koopt
- Operations management is nodig in de zorg:
o Advance of new technologies
o Rising costs
o Poor quality
Tremendous foxus on quality of care. However less on processes surrounding
delivery of this care. Makes sense, as health care practitioners not trained for
this. Who gets planning job? Newbie physician or secretary
o Aging populations in developed countries
There are certain health conditions that are expected to be a challenge to
our health care system with the increasing aging population. Comorbidity
increases, more diseases.
o Empowered healthcare consumer
Due to: media attention for waiting lists, bad practices, internet,
benchmarking, market mechanisms; overall patients more demanding
o Medical and life sciences knowledge explosion
We kunnen steeds meer vervangen, nieuwe ingrepen, vragen weer meer van
de zorg.
- Operations management wordt al gebruikt sinds 1700, in bijvoorbeeld de industrie
- Operations management in de zorg is iets van de laatste tijd
- De zorgvragers zijn meer gaan vragen in de loop van der tijd
- Verschillen tussen manufacturers en services:
- Manufacturers:
Services
o Tangible product Intangible products
o Product can be inventoried Product cannot be inventoried
o Low customer contact High customer contact
o Longer response time Short response time
o Capital intensive Labor intensive
- Similarities service / manufacturers
o All use technology
o Both have quality, productivity, & response issues
o All must forecast demand
o Each will have capacity, layout, and location issues
, o All have customers and suppliers
o All have scheduling and staffing issues
- Operations management skills are not only good to have in today’s competitive environment.
If you don’t have them, you’re missing out because your competitors have those skills.
o To stay competitive, you need to make most of the resources and opportunities you
have, and you need OM.
- Healthcare: a business unlike all others
o Financial model does not reward efficiency
o Patients are customer and product at the same time
Patients cannot be refused
Interventions cannot be preempted
o More variability than in any other industry
o Many different types of care providers
Different types of hospitals, different strategies
Academic hospitals do almost everything
Specialized clinics are often seen as “cream skimmers”
o Multiple decision makers (doctors managers)
Doctors are private entrepreneurs within hospital
o Stakeholders often have conflicting goals
- Waardestroomanalyse / value stream map: techniek uit Lean Manufacturing om de stroom
(flow) van goederen/producten in kaart te brengen, te analyseren en te optimaliseren.
- Logistieke paradigma’s: Total access, klinisch pad, benchmarking, TQM, continuous
improvement, ConWip, JIT, BPR, TOC, sixsigma, ERP, Lean, APS
o Voordelen: focus op prestatiemeting, eenvoudige principes, bewezen succes,
organisatie brede betrokkenheid en culturele verandering
o Nadelen: paradigma keuze gebaseerd op consultant, niet op bewezen effectiviteit.
, - Paradigma = filosofie/streven, hoe doelen te bereiken? Focus op operationeel niveau, “het
laaghangende fruit”
College 3 OM in healthcare 10-05
- Ellectieve vraag: planbare zorg, niet met spoed
- Snijdende keten: alle patiënten die geopereerd moeten worden
- Beschouwende keten: interne geneeskunde, vage klachten en veel pijn, opgenomen worden
voor diagnose
- Medical planning: beslissing gemaakt door clinici (protocollen, behandelingen, diagnoses
etc). Ook omvat het nieuwe medische behandelingen door clinici.
- Resource capacity planning betreft de dimensionering, planning, planning, monitoring en
controle van hernieuwbare middelen. Hiertoe behoren apparatuur en faciliteiten (bv. MRI's,
fysiotherapieapparatuur, beddengoed, steriele instrumenten, operatiekamers,
revalidatiekamers), alsmede personeel. door staff management, staff, equipment, facilities
o Herbruikbare artikelen
- Materiaal planning: warehousing (opslag), voorraad, inkoop
o Niet herbruikbare artikelen
- Financial Planning: Kosten en opbrengsten, vergoedingen
- Why important?
o Forecasts serve as a basis for planning
o Enable health care managers to anticipate the future to plan the system and plan the
use of that system
o It is not an exact science; one must blend experience, judgment, and technical
expertise
- RVE- structuren: resultaat verantwoordelijke eenheden
- Common elements
o Assumption that past continues into future
o Errors occur
Actual differs from predicted
Presence of randomness
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