Lecture 1: Introduction & Fundamentals of
HSOM
Health service Operation management (HSOM):
The analysis, design, planning an control of all the steps necessary to deliver services to clients in
healthcare.
Has its roots in service managements + operation management.
From 1800 moving from agriculture towards manufacturing towards sercvie economy. More time to
enjoy services (restaurants, entertainment).
Operation mangement: from 1970-1980 (more focus on manufacturing)
Service management: after 1980 (more focus on services)
Operation management
Transformation from input to output in which we use resources and apply regulations (or guidelines).
E.g. making of a table: wood to table, usage of tools and the carpenter as resources and manual as
regulations. The wood (input) is something we can only use once, however the resources we can use
multiple times.
There are different types of operations
Alteration (changing things: input to output)
Transportation (input: things being on one place, output: at the other place)
Inspection (input: not expected good, output: quality improvements)
Storage (In operations seen as an operation, but in services more seen as a delay
between operations)
Hierarchy form operations management perspective:
An operation (transformation) can be seen as different activities, in between those activities there
can be watining times.
,On the level of the operation it leeds to difference in input and output.
On the level of the activity this doesn't have to be, activity can be divided into tasks
Unit- process- network in operation management
Unit: a department in a health organization that performs operations of the same operation type
MRI department (unit), performing MRI's (operation type)
Process: series of operations that need to be performed to produce a particular service
In most casus the unit is part of a process: delivers the service for the patients. Patient
undergoes different types of examinations (different units), to get to a diagnosis.
Network: combination of units and chains performing operations for services for several groups of
clients.
Service management
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.
Characteristics of services:
Customer participation (interaction e.g. between doctor and patients)
Simultaneous creation and use (service takes place within the consultation room!)
Heterogeneity (service differs between patients, even when patient comes with same
complaints!)
, Perishable (you cannot keep the service, after consultation patients go home and you
cannot keep the service and goes away when the time is over)
Intangible (you can not grab it)
Non-transferrable ownership (you cannot transfer it to someone else)
A service does not stand on its own: a service is part of a package (service package).
The service itself is at the center and are surrounded by explicit and implicit services:
Explicit: Hair is looking good, another colour, had a cup of coffee
Implicit: Friendly interaction with the hairdresser
However there is also an outer circle
Suporting facility: surroundings, chair/mirror
Information: about waiting times, about the options you can choose from
Facilitating goods: the gel the hairdresser is using, the quality of the coffee
Part 2: Service value & quality
Classical value chain (Porter)
Applicable for manufacturing industry.
Starts with purchasing the goods and ends with services such as handling guarantee issues.
From an operation management perspective we see this whole process as an operation (input to
output = primary process).
There are some supporting functions: firms infrastructure (buildings), human resources,
technological infrastructure (machines and ICT) and procurement (activiteiten gericht op het
beheersen en sturen van de inkomende goederenstroom tot aan het moment dat de goederen in
productie worden genomen. Procurement is een ruimer begrip dan purchasing en omvat tevens
materiaalbehoefteplanning, voorraadbeheer en transport)
From an operation management perspective: all of these supporting functions can be seen as the
resources we need to perform the operation in the primary process.
, The value is the comparison between the quality and service that is delivered versus the costs.
If there is good quality and service for the costs, the customer is willing to pay.
In health service value we look at value as perceived quality / sacrifices.
Clinical outcomes: healing of broken leg
Functional outcome: can I now go back to work or do some sports with my healed leg
Experience: did I feel safe, are the care professionals friendly, were there no long
waiting times, was the care how I expected
Costs: money to pay for the care
Effort: go to the hospital/fysiotherapist, arrange transport etc.
Health services Quality
The 5 dimensions of general service quality (servqual)
1. Reliability: delivering service on time and without errors
2. Responsiveness: giving attention to the customer, provide the service as soon as
possible
3. Empathy: understanding the needs of the customer without him explicitly demanding
for it
