‘Putting patients first’ is a slogan that is often used in healthcare. It is also an empty slogan according to Taco van der Vaart, Professor of Supply Chain Management at the University of Groningen. In his inaugural speech on Tuesday 21 May, he argued that speed is underrated in Dutch healthcare. ‘Speed should play a much more important role in our care system. Patient waiting times are currently unnecessarily long. Healthcare should focus on patient flows rather than individual patients.’
Online retailer Bol.com is experimenting with a two-hour delivery service this year. The contrast between this and the healthcare sector is striking, according to Van der Vaart. ‘Bol.com is striving to drastically reduce delivery times that are already fast, while healthcare has resigned itself to accepting long waiting times. It may seem a big step from retail logistics to care, but the enormous difference in value attributed to speed is remarkable.’
Van der Vaart finds it interesting that online retailers are very deliberately aiming for speed, whereas waiting times seem to have no priority in healthcare. ‘In healthcare, waiting times of three to six weeks for a visit to a hospital specialist are no exception. Nor are waiting times of three to four weeks for an MRI scan or gastroenteroscopy. Add to this any surgery and treatments needed, and the total lead time ranges from 12 weeks to six months. From a supply-chain perspective, that is a terribly long time.
Decreasing waiting times is of great interest to patients: research reveals a relationship between waiting times and the quality of care that they receive. Van der Vaart: ‘In addition, longer waiting times mean more insecurity, slower recovery, a higher risk of complications or a postponed return to work for patients. Care institutions also have a financial reason to strive for shorter waiting times: the care services provided can be claimed faster.’
According to Van der Vaart, people assume all too readily that waiting times in healthcare are caused by a lack of capacity. In his inaugural speech, he mentions three other causes:
Waiting times that are triggered by the first two causes can be reduced by achieving more collaboration within specific patient flows, such as patients experiencing pain in their chests, hip-replacement patients or patients with chronic conditions such as COPD or diabetes, claims Van der Vaart.
‘In addition, it is of utmost importance to achieve a more regular availability of specialists. Of course, the number of patients who visit an outpatient clinic has a great influence on the number of follow-up examinations or surgeries throughout the chain. This is why the patient flow needs to be as regular as possible. This includes, for example, avoiding instances in which several specialists in one unit visit a conference or take holiday leave simultaneously. Less variability in care provision will lead to shorter waiting times for patients.’
This change of direction is not easy to achieve, Van der Vaart realizes. ‘Our healthcare system is fragmented not only in the actual delivery of care, but also in the steering by management, health insurers companies and government and in the funding of healthcare. The key to better waiting times in healthcare is held by the most important link in the supply chain: the specialists. They occupy a central and autonomous position, which is decisive for the performance of the entire chain. Real improvements cannot be enforced by changing the system or providing financial incentives. Instead, they require collaborations between hospitals and specialists and between insurance companies and care providers. These collaborations must focus on patient flows, clear process responsibilities and supply chain orchestration.’
Contact: Taco van der Vaart
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Article by Barend Abeln and Jan Jacobs on the website of the ESB (Economic Statistical Reports)
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