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Summary CPM: lectures, workgroups and literature
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Summary CPM: lectures, workgroups and literature
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Samenvatting CPMCharacteristics of services
• Intangible (ontastbaar)
• Non-transferrable ownership
• Customer participation
• Simultaneous creation and use (planning)
• Heterogeneity (consultations differ per patient, interaction makes the activity)
• Perishable (you cannot put it in stock, you cannot create a service already and wait for the
client)
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)
The service package:
Implicit: feeling safe in a hospital, comfortable temperature in a
room. Realize this when the services are missing; influencing the
experience of the service
Facilitating goods: materials that are used in doctors’ room
Supporting facility: a room that is available and resources
Operations management:
The control (beheersen) of the activities involved in producing
goods and providing services, and the study of the best ways to do
this.
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.
HSOM: Process – Unit – Network
• Unit: a department in a health organization that performs operations of the same operation
type (shared unit if units are used for different patient group/specialties)
• Process/chain: series of operations that need to be performed to produce a particular
service (there is no process without a unit)
, • Network: combination of units and chains performing operations for services for several
groups of clients
Methodology: problem solving cycle (Van Aken)
🡪 Always mixed method approach
Financial management: costs, income, investments
🡪 Financing for investments in
resources, then operations can
take place. Financing is the
linking pin in this picture.
Capacity Management – levels of planning
🡪 This can lead
to smooth unit
operations
Example: Operating Theatre
,🡪 Reservation of capacity at the end of each morning for the CAT scan for semi-urgent patients is an
example of tactical scheduling; allocating space in planning to patient group.
🡪 Example of strategic choices would be: being open at night to help more patients and have more
income f.e.
Scheduling system:
• Walk-in: coming to hospital whenever you want in certain period, like for bloedprikken
• Appointment scheduling: time slot in an agenda, risk of no shows and more management
than with walk-in
• Waiting list: based on priorities, people are allocated to a certain place in agenda
Demand: important to know how much time people need for a certain appointment in order to
anticipate on it. So, information on the patient groups with different characteristics.
Capacity: access to resources that are required for the operations of a unit, you need
accommodation, equipment, medical staff and other staff.
The demand of patient groups decides how the planning of leading resources is organized. There can
be bottlenecks here, cannot operate independently.
Demand following resource 🡪 planning leading resource
Demand and variability:
• Variability is sometimes more important to know than averages
• Variability refers to deviation from average conditions
Distinction between predictable and unpredictable variation
• Predictable variation – seasonality in arrival patterns
• In October and November many broken hips for elderly because of the weather. Also, viruses
in certain periods are predictable.
• There is variation around averages, so prediction is that Wednesday is busier than Thursday
but turns out the Thursday was busier than the Wednesday. So that is unpredictable.
Variability & Uncertainty
• Predictable variability 🡪 no uncertainty
• (Seasonal) patterns in demand and capacity
• Supply chain variability: leading and following capacities
• Differences in complexity of patients
• Unpredictable variability 🡪 uncertainty
• Fluctuation in demand
• Fluctuation in capacity
• Fluctuation in time needed for an activity
🡪 You have to adapt with buffers
, How to cope with variability?
• Predict
• Adapt the capacity to the demand (more available timeslots on a
certain day f.e.)
• Adapt the demand to the capacity
• Variation reduction (telling patients that certain days are busy with long
waiting times, hoping that patients choose less busy days so spreading
the demand/practices)
• Buffering
• (Inventory)
• Waiting times
• Extra capacity
• Flexible capacity (oproepkrachten)
• Flexibility: “ability to change easily according to the situation”
Unit performance: utilization
Potential - Available - Usable Capacity
*Non-available capacity: because timeslots are outside working hours or not usable because of f.e.
maintenance/education
*Usable capacity: useful timeslots for patients
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