Paul Lillrank - Böcker

Most of the current literature on healthcare operations management is focused on importing principles and methods from manufacturing. The evidence of success is scattered and nowhere near what has been achieved in other industries. This book develops the idea that the logic of production, and production systems in healthcare is significantly different. A line of thing that acknowledges the ingenious characteristics of health service production is developed. This book builds on a managerial segmentation of healthcare based on fundamental demand-supply constellations. Demand can be classified with the variables urgency, severity, and randomness. Supply is constrained by medical technology (accuracy of diagnostics, efficacy of therapies), patient health behavior (co-creation of health), and resource availability. Out of this emerge seven demand-supply-based operational types (DSO): prevention, emergencies, one-visit, electives, cure, care, and projects. Each of these have distinct managerial characteristics, such as time-perspective, level of co-creation, value proposition, revenue structure, productivity and other key performance indicators (KPI).The DSOs can be envisioned as platforms upon which clinical modules are attached. For example, any Emergency Department (ED) must be managed to deal with prioritization, time-windows, agitated patients, the necessity to save and stabilize, and variability in demand. Specific clinical assets and skill-sets are required for, say, massive trauma, strokes, cardiac events, or poisoning. While representing different specialties of clinical medicine they, when applied in the emergency – context, must conform to the demand-supply-based operating logic.A basic assumption in this book is that the perceived complexity of healthcare arises from the conflicting demands of the DSO and the clinical realms. The seven DSOs can neatly be juxtaposed on the much-used Business Model Canvas (BMC), which postulates the business model elements as value proposition; customer segments, channels and relations; key activities, resources and partners; the cost structure; and the revenue model.

Quality Control Circles (QCCs) are small groups of workers from the same workshop, which meet, often on their own time, to discuss ways to improve the quality of their work. They are supported by management; the circles and the support structure together are called Quality Control Circle (QCC) activity. The phenomenon is widespread in Japan: as of December 1987, 264,899 circles had been registered with more than two million members. QCC activities have spread to more than fifty countries worldwide and can be considered the most famous Japanese organizational innovation to date. The Japanese QCC, in its contribution to business application and theory, may rival the discovery of the informal organization of Hawthorne Studies frame. The Japanese QCC movement has achieved quite impressive results, which are well described in the Japanese-language literature. Of concern, however, is what sustains and causes the phenomenon. The existing literature is quite thin on these mechanisms and forces. Our aim in this research is to develop a systematic model of the organizational nature and management of Japanese QCC activities. Quality engineering and group dynamics are not part of this study; the focus is on the supporting arrangements, not on what happens within a circle. [1]

The planning and design of healthcare facilities has evolved over the previous decades from "function follows design" to "design follows function." Facilities stressed the functions of healthcare providers but patient experience was not fully considered. The design process has now crucially evolved, and currently, the impression a hospital conveys to its patients and community is the primary concern. The facilities must be welcoming, comfortable, and exude a commitment to patient well-being. Rapid changes and burgeoning technologies are now major considerations in facility design. Without flexibility, hospitals face quicker obsolescence if designs are not forward-thinking. Planning and Designing Healthcare Facilities: A Lean, Innovative, and Evidence-Based Approach explores recent developments in hospital design. Medical facilities have been adapted to the requirements of clinical functions. Recently, the needs of patients and clinical pathways have been recognized. With the patient at the center of the process, the flow of tasks becomes the guiding principle as hospital design must employ evidence-based thinking, and process management methods such as Lean become central. The authors explain new concepts to reduce healthcare delivery cost, but keep quality the primary consideration. Concepts such as sustainability (i.e., Green Hospitals) and the use of new tools and technologies, such as information and communication technology (ICT), Lean, and evidence-based planning and innovations are fully explained.

Most of the current literature on healthcare operations management is focused on importing principles and methods from manufacturing. The evidence of success is scattered and nowhere near what has been achieved in other industries. This book develops the idea that the logic of production, and production systems in healthcare is significantly different. A line of thing that acknowledges the ingenious characteristics of health service production is developed. This book builds on a managerial segmentation of healthcare based on fundamental demand-supply constellations. Demand can be classified with the variables urgency, severity, and randomness. Supply is constrained by medical technology (accuracy of diagnostics, efficacy of therapies), patient health behavior (co-creation of health), and resource availability. Out of this emerge seven demand-supply-based operational types (DSO): prevention, emergencies, one-visit, electives, cure, care, and projects. Each of these have distinct managerial characteristics, such as time-perspective, level of co-creation, value proposition, revenue structure, productivity and other key performance indicators (KPI).The DSOs can be envisioned as platforms upon which clinical modules are attached. For example, any Emergency Department (ED) must be managed to deal with prioritization, time-windows, agitated patients, the necessity to save and stabilize, and variability in demand. Specific clinical assets and skill-sets are required for, say, massive trauma, strokes, cardiac events, or poisoning. While representing different specialties of clinical medicine they, when applied in the emergency – context, must conform to the demand-supply-based operating logic.A basic assumption in this book is that the perceived complexity of healthcare arises from the conflicting demands of the DSO and the clinical realms. The seven DSOs can neatly be juxtaposed on the much-used Business Model Canvas (BMC), which postulates the business model elements as value proposition; customer segments, channels and relations; key activities, resources and partners; the cost structure; and the revenue model.

As developed economies enter a period of slower growth, emerging economies such as India have become prime examples of how more can be achieved with less. Bringing together experience and expertise from across the healthcare industry, this book examines innovations that can bring about real advances in the healthcare industry. Innovations in Healthcare Management: Cost-Effective and Sustainable Solutions explores recent innovations in healthcare from a global and Indian perspective. Emphasizing the importance of Lean healthcare and innovation, it presents low-cost, high-volume solutions that improve access to care. Providing concrete examples of the five levels of innovation present in healthcare, the book presents new concepts, methods, and tools for advancing processes and operational flow. It includes case studies of actual results in healthcare innovation from three continents that highlight emerging global trends in healthcare system innovation.The book describes how to organize resources and flows so that given targets, such as cost, clinical quality, and patient experience, can be achieved with available resources. It also covers nontraditional ecosystems of innovation that move outside of expected technological innovations, such as innovations in social persuasion, rural health delivery, and the planning and design of hospitals. The book maintains a focus on key issues across the healthcare industry—such as access to care, demand creation, patient experiences, and data—to help readers implement new ideas and new models of delivery of affordable care in healthcare systems around the world.

This book presents a general conceptual framework to translate principles of system science and engineering to service design. Services are co-created immaterial, heterogeneous, and perishable state changes. A service system includes the intended benefit to the customer and the structure and processes that accomplish this benefit. The primary focus is on the part of the service system that can reproduce such processes, called here a Service Machine, and methodological guidelines on how to analyze and design them. While the benefit and the process are designed based on the domain knowledge of each respective field, service production systems have common properties. The Service Machine is a metaphor that elicits the fundamental characteristics of service systems that do something efficiently, quickly, or repeatedly for a defined end. A machine is an artifact designed for a purpose, has several parts, such as inputs, energy flows, processors, connectors, and motors assembled as per design specifications. In case of service machine, the components are various contracts assembled on contractual frames. The book discusses Emergency Medical Services (EMS) and Emergency Departments (ED) as cases. They illustrate that service machines need to be structured to adapt to the constraints of the served market acknowledging the fact that services are co-created through the integration of producers’ and customers’ resources. This book is highly recommended for those who are interested in understanding the fundamental concepts of designing service machines.