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Operations Management In Health Care

Operations Management In Health Care by Ruth Boaden
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About the Guest Editors Ruth Boaden is Senior Lecturer in Operations Management at the Manchester School of Management, UMIST and Director of Health Organisations Research Centre. Her research interests cover a wide range of areas within health services management and include work in IT in primary care, electronic health records, reengineering in acute trusts, critical path analysis in cancer care, the management of emergency admissions and bed management. She has published widely in these areas as well as in the areas of IT implementation and quality management. Until recently she was Director of the MSc in Operations Management, and joint editor of the International Journal of Operations & Production Management. She is now Director of the ‘‘Leadership through effective Human Resource Management’’ programme for the NHS Executive, which is run in partnership with PricewaterhouseCoopers.

Paul Gemmel ( 1966) is Professor at the Faculty of Economics and Business Administration of the Ghent University and at the Vlerick Leuven Ghent Management School, both located in Belgium. He holds a doctoral degree in Business Economics. His research is in the area of service operations management and more particularly hospital operations management. His PhD deals with admissions scheduling in acute care hospitals. In preparing his doctoral degree, he spent one year at the College of Business of the Arizona State University, Tempe, USA (1992-93). He lectures on subjects such as logistics management in healthcare institutions in the Faculty of Medicine and Health Sciences, and service operations management in the Faculty of Economics and Business Administration, both at the Ghent University. At Vlerick Leuven Ghent Management School, Paul Gemmel works together with 20 Belgian hospitals in a benchmarking and research project, called MINOZ. Paul Gemmel has published may different papers in conference proceedings. The most recent articles are published in the International Journal of Service Industry Management and the International Journal of Operations & Productions Management. He is co-editor of the book Services Management: an Integrated Approach, published by Pitman Publishing, Financial Times (1998).

In 1914 Frank Gilbreth made the remarkable statement that ‘‘a hospital is a factory, a health and happiness factory and it ought to be governed by the supreme principle that governs any other factory: the principle of maximum efficiency in relation to output’’. The statement was and still is remarkable, but in the last decade the quest for efficiency has been a major point of attention in government efforts in many countries to reduce ever increasing healthcare costs. At the same time the healthcare institutions are confronted with patients becoming more and more aware of their position and rights as customers of health care. Health policymakers and healthcare managers are looking for a successful recipe to balance an acceptable level of resource utilisation and to serve patients effectively.

One important ingredient of this recipe is the growing awareness that the flow of the patient throughout the healthcare system must be the central point of attention. Optimising flows throughout systems with limited capacity and high demand is one of the core tasks of operations management. Therefore it is not surprising that a growing amount of operations management research in healthcare is emerging. In many cases this research is triggered by specific questions and issues raised by healthcare practitioners.Acute care hospitals are certainly one of the most studied healthcare environments. Their high cost structure, but also their operational complexity is a real challenge to manage. Several of the papers in this issue particularly deal with hospital operations management. Mariolina Longo and Cristina Masella use a multi-attribute decision making methodology in order to benchmark the performance of the surgery department of eight different Italian hospitals. The particular methodology, as well as the benchmarking approach, is an innovative way of dealing with one of the most complex operations issues in healthcare.

Although the availability of surgical capacity must be considered when admitting patients, many other resources such as nursing and intensive care unit beds cannot be neglected. Ivo Adan and Jan Vissers look at how a hospital can generate an admission profile for a specialty, given a target patient throughput and utilisation of different kind of resources, while satisfying given restrictions. Integer linear programming is used in order to solve this optimisation problem.

Although the patient flow throughout the healthcare system traditionally gets a lot of attention in healthcare operations management, the other flows of materials and information should not be neglected. In a typical hospital 20 per cent to 30 per cent of the costs are related to materials management. Typical manufacturing oriented materials management principles such as MRP and JIT are increasingly applied in healthcare environments. Hugo Rivard-Royer et al. show in a case study the benefits and problems with a hybrid stockless system in a hospital and what the role of the supplier is in the success of such a system. Critical in this application is the availability of the right information.

According to Galbraith (1973), increasing the capacity to process more information is one of the possible strategies to improve co-ordination of the activities in a complex organisation. Teresa Waring and David Wainwright present a project where a software tool has been used to graphically show the process flows. The interesting point of this research is that the resulting process flows are not the result of a mere engineering analysis, but of participatory action research informed by principles derived from critical social theory. For instance the study starts with interviews giving insights into the social situation within the hospital. Conflict, stress, . . . are all social factors that can have an impact on how information is flowing throughout the organisation. Although hospitals are a major focus in many studies, the last paper in this special issue shows how operations management tools in other environments such as home healthcare environment can be applied. Federico Pasin et al. consider how to better utilise resources (e.g. technical equipment) through pooling among different institutions. Using simulation the authors aim to reduce management apprehension of resource sharing by presenting the general and individual impacts of different forms of resource pooling. The selection of papers in this special issue present a whole range of different methodologies which can be used in operations management studies, from modelling to participatory action research. We hope that this diversity inspires many other researchers in their quest to solve complex operational problems in healthcare. We believe that operations management has a lot to offer the business of healthcare – not only in terms of quantitative methodologies – and hope that the field will continue to develop in the way that this special issue demonstrates it is doing.

If you would be interested in participating in a mailing/discussion list relating to operations management in healthcare, please contact, who is thinking of establishing one if there is sufficient interest.

Ruth Boaden and Paul Gemmel
Guest Editors

Previously published in: International Journal of Operations & Production Management, Volume 22, Number 4, 2002

Emerald Publishing Limited; Read online
Title: Operations Management In Health Care
Author: Ruth Boaden; Paul Gemmel
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