The duration of hospital treatments could be shortened if the various departments concerned were to share more information. Consecutive steps in a care process could be better coordinated, resulting in a smoother flow of patients. Although this may lead to lower capacity utilization, hospitals would ultimately save money as the costs of fast treatment are reimbursed by health insurers more swiftly. ‘Hospitals put too much emphasis on capacity management, when they should be focusing on improving patient throughput,’ concludes Justin Drupsteen. He will be awarded a PhD by the University of Groningen on 28 November.
It may sound disrespectful, but the complex process whereby patients are treated in a hospital is very similar to the way trains are moved around an enormous shunting yard. A holdup on one part of the track leads to the type of congestion that we have come to know as waiting lists. Although there has been some research into the logistics of hospital care, the supply chain perspective studied by Drupsteen has never been properly investigated. He carried out case studies in various hospitals to try to understand the reasons for supply chain problems.
Drupsteen focused specifically on the effects of cooperation by a number of hospital departments. If departments were to cooperate when planning consecutive treatments, they would all benefit from the resulting fast and efficient appointments system. ‘For instance, if a radiology department knows that orthopaedic surgeons are always very busy on Wednesdays, it could plan around this to ensure a constant patient flow.’
There are several reasons for departments failing to share information of this kind, says Drupsteen. ‘Unlike in a factory, the separate departments in a hospital don’t know what happens to patients. The radiologist doesn’t know where his/her patients are going next, and often has no way of finding out. In addition, treatment processes can be very uncertain, meaning that you can’t always plan more than one step ahead. Furthermore, hospitals encourage each department to make optimum use of its own facilities, but no-one is managing the general interest of the hospital.’
The answer to this problem is to integrate the planning and management of hospital treatment. Drupsteen: ‘Every hospital department should take the previous and the next step into account to create stable patient flows. This has been shown to work well in hospitals where several departments coordinate their planning procedures. To aid this, hospitals should aim for throughput rather than production per department, and resign themselves to the fact that capacity may be used less efficiently. This is ultimately better for the patients and financially beneficial to the hospitals, as the costs of fast treatment are reimbursed by the insurance companies more swiftly.’
Justin Drupsteen (Zuidwolde, 1980) studied Operations and Supply Chains at the University of Groningen. He conducted his research in the OPERA research group of the Faculty of Economics and Business. His thesis is entitled: ‘Treating planning flaws in patient flows’. Drupsteen’s supervisors were Prof. D.P. van Donk and Dr J.T. van der Vaart.
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