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Summary Lectures Health Service Operations Management HCM
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Summary Lectures 1 to 7 Health Service Operations Management
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Health Service Operations ManagementLecture 1: Research field & concepts
Health Service Operations Management (HSOM): the analysis, design, planning and control
Input: patient
Resources:
- Shared resources (different departments)
- Dedicated resources (specialized department)
- Staff, healthcare professionals input operation output
Regulations: guidelines with added value
(Vissers & Beech, 2008)
When a surgeon has a high volume, the surgeon has a lot of
experience. These people don’t need manuals or guidelines
anymore. High volumes contribute to trust.
Types of operations: components Assemble a
materials table
- Alteration
carpenter
- Transportation
- Inspection
- Storage
o We don’t use this concept in healthcare, you can’t store a patient. This leads to
waiting. When there is a low demand, professionals are waiting. Either the patient is
waiting or the professional is waiting.
o Storage vs. waiting
Two buffers to cope with variability:
- Time buffer: we can have patients or professionals waiting
- Capacity buffer: when there is peak demand, we can bring in new capacity
Everyone is focused on short length of stay. Is this because of variation (complex patients that need
to stay 25 days) or is this the effect of poor organisation? If you don’t arrange follow up care, there
will be patients unnecessary in the hospital. The same will happen when there is no capacity.
Hierarchy from Operations Management perspective
A process resembles
the patient journey.
Short process with high predictability: knee operation, getting a flu shot (standardized care)
Long process with low predictability: organ transplantation, chemotherapy, mental health treatment
,Unit: a department in a health organisation that performs operations of the same operation type.
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.
Chain logistics approach: on a service level what is the quality delivered?
Service Management
From 1800: moving from agriculture towards manufacturing towards service economy.
Industrial revolution Production management Operations management Service Operations
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)
Characteristics of services:
- Customer participation:
o Shared decision-making, patient centred care
o The patient knows the whole patient journey
- Simultaneous creation and use of services
o While the service is created, it is used by customers
- Perishable
- Intangible
- Heterogeneity
- Non-transferrable ownership
o Transferrable ownership: it is not ownership anymore, it is a service. You use the
service and it is transferrable.
On demand services e.g. Netflix.
, (Van der Burg, Ahaus et al., 2019)
The service package
(Fitzsimmons et al., 2014)
Service experience: you have expectations and you
experience the service. You have perceptions on the
experience.
Explicit services: e.g. pain control
Implicit services: e.g. the trust you have in the
doctor
Supporting facility: the building (e.g. hospital), the
equipment
Information: important in order to have the service
experience (e.g. electronic health record)
Facilitating goods: the supplies that you need
If something is wrong in the supporting facility, the
service experience will be influenced. If the information is not up-to-date, the service experience will
be affected.
Service Value & Quality
Classic Value Chain (Porter)
Value is delivered by units. Goods are purchased, there are operations, the product is distributed, it
is sold. Value is outcomes vs. costs.
Health Services Value
Clinical outcomes e.g. no rejecting of the transplant
Functional outcome e.g. is the patient fatigue? Is the patient suffering from itching?
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