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Deployment of Industrial Management Methods for Healthcare Services
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Deployment of Industrial Management Methods for Healthcare Services

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (30 September 2020) | Viewed by 10083

Special Issue Editors

Prof. Dr. Paul Lillrank

E-Mail Website
Guest Editor
Department of Industrial Engineering and Management, Aalto University, FI-00076 Aalto, Finland
Interests: healthcare operations management; health systems science; quality management; service research
Special Issues, Collections and Topics in MDPI journals
Dr. Paulus Torkki

E-Mail Website
Guest Editor
Department of Public Health, Faculty of Medicine, University of Helsinki, 00100 Helsinki, Finland
Interests: Healthcare Operations Management; Health Systems Science; Quality Management; Service Research

Special Issue Information

Dear Colleagues,

A Topical Collection on Deployment of Industrial Management Methods for Health Services, in the International Journal of Environmental Research and Public Health, is being organized. For detailed information on the journal, I refer you to https://www.mdpi.com/journal/ijerph.

Healthcare is a troubled sector of society. Nowhere does it work to the satisfaction of all constituencies: patients, professionals, payers, and politicians. In advanced countries, healthcare expenditure has for decades increased faster than economic growth. While Clinical Medicine and Pharmacology deliver new cures, the quality and productivity of health services is stagnant.

Industrial Management (IM), also known as Operations Management, is the science and practice of productivity. When productivity improves, more can be had for less. IM has a prominent track record in manufacturing industries.

IM methods have been implemented for more than two decades in healthcare, often labelled total quality management (TQM), lean six sigma, or theory of constraints (TOC). So far, however, there is little, if any evidence of productivity and quality improvements comparable to manufacturing and high-volume services, such as retail banking and airlines. The literature on the subject is mostly case studies and anecdotal evidence.

The unsatisfactory results of IM deployment in healthcare have many explanations. The ordinary suspects are resistance to change, ignorance, professional pride, regulation, lack of competition, and dysfunctional incentives. While these are commonplace issues in all organizational change initiatives, there is also a growing concern that IM methods, for very fundamental reasons, are not applicable in all areas of healthcare services. Markets cannot work because of information asymmetry; only a third of clinical decisions are based on evidence; demand never saturates; and IM cannot deal with explorative and nonroutine processes and may be applicable only in the areas that resemble mass manufacturing, such as mass vaccination, high-volume diagnostics, or elective surgery.

The core of healthcare is the healing relationship between individuals. That entails craft production. However, services need to be produced in huge volumes, reliably, and at affordable cost. The challenge of IM in healthcare is to figure out, how to deliver personalized care with mass production efficiency.  

This Topical Collection invites empirical and theoretical articles that describe, explore, analyze, and discuss the phenomena and problems associated with IM deployment in healthcare. The research problems are, though not exclusviely, the following:

  • Evidence and analysis of success and failure in IM deployment;
  • Performance measurement in healthcare—which are the relevant objectives?
  • At what system level could and should IM have an impact—micro, meso, or macro?
  • Comparative analysis of different IM approaches in healthcare;
  • The nature of health service production systems in comparison to other industries;
  • Information and Communication Technology (ICT) deployment in healthcare;
  • Personalized medicine and care—are mass customization and modularization possible?

Prof. Paul Lillrank
Dr. Paulus Torkki
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Healthcare
  • Health service production
  • Industrial Management
  • Operations Management
  • Productivity and quality of services
  • Health Systems Science
  • Lean Healthcare
  • TOC in Healthcare
  • TQM in Healthcare
  • Personalized care
  • Modularization
  • Mass customization

Published Papers (4 papers)

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Research

9 pages, 339 KiB  
Article
Application of Portfolio Theory to Healthcare Capacity Management
by Carina Fagefors and Björn Lantz
Int. J. Environ. Res. Public Health 2021, 18(2), 659; https://doi.org/10.3390/ijerph18020659 - 14 Jan 2021
Cited by 4 | Viewed by 2002
Abstract
Healthcare systems worldwide are faced with continuously increasing demand for care, while simultaneously experiencing insufficient capacity and unacceptably long patient waiting times. To improve healthcare access and availability, it is thus necessary to improve capacity utilization and increase the efficiency of existing resource [...] Read more.
Healthcare systems worldwide are faced with continuously increasing demand for care, while simultaneously experiencing insufficient capacity and unacceptably long patient waiting times. To improve healthcare access and availability, it is thus necessary to improve capacity utilization and increase the efficiency of existing resource usage. For this, variations in healthcare systems must be managed judiciously, and one solution is to apply a capacity pooling approach. A capacity pool is a general, collaborative capacity that can be allocated to parts of the system where the existing workload and demand for capacity are unusually high. In this study, we investigate how basic mean-variance methodology from portfolio theory can be applied as a capacity pooling approach to healthcare systems. A numerical example based on fictitious data is used to illustrate the theoretical value of using a portfolio approach in a capacity pooling context. The example shows that there are opportunities to use capacity more efficiently and increase service levels, given the same capacity, and that a mean-variance analysis could be performed to theoretically dimension the most efficient pooling organization. The study concludes with a discussion regarding the practical usefulness of this methodology in the healthcare context. Full article
(This article belongs to the Special Issue Deployment of Industrial Management Methods for Healthcare Services)
32 pages, 871 KiB  
Article
Practicing Integrated Care Pathways in Norwegian Hospitals: Coordination through Industrialized Standardization, Value Chains, and Quality Management or an Organizational Equivalent to Improvised Jazz Standards
by Per Magnus Mæhle, Ingrid Kristine Small Hanto and Sigbjørn Smeland
Int. J. Environ. Res. Public Health 2020, 17(24), 9199; https://doi.org/10.3390/ijerph17249199 - 9 Dec 2020
Cited by 1 | Viewed by 2552
Abstract
The goal of coordinating pathways for cancer patients through their diagnostic and treatment journey is often approached by borrowing strategies from traditional industries, including standardization, process redesign, and variation reduction. However, the usefulness of these strategies is sometimes limited in the face of [...] Read more.
The goal of coordinating pathways for cancer patients through their diagnostic and treatment journey is often approached by borrowing strategies from traditional industries, including standardization, process redesign, and variation reduction. However, the usefulness of these strategies is sometimes limited in the face of the complexity and uncertainty that characterize these processes over time and the situation at both patient and institutional levels. We found this to be the case when we did an in-depth qualitative study of coordination processes in patient pathways for three diagnoses in four Norwegian hospitals. What allows these hospitals to accomplish coordination is supplementing standardization with improvisation. This improvisation is embedded in four types of emerging semi-formal structures: collegial communities, networks, boundary spanners, and physical proximity. The hierarchical higher administrative levels appear to have a limited ability to manage and support coordination of these emerging structures when needed. We claim that this can be explained by viewing line management as representative of an economic–administrative institutional logic while these emerging structures represent a medical–professional logic that privileges proximity to the variation and complexity in the situations. The challenge is then to find a way for emergent and formal structures to coexist. Full article
(This article belongs to the Special Issue Deployment of Industrial Management Methods for Healthcare Services)
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18 pages, 534 KiB  
Article
Creating Short-Term Volume Flexibility in Healthcare Capacity Management
by Carina Fagefors, Björn Lantz and Peter Rosén
Int. J. Environ. Res. Public Health 2020, 17(22), 8514; https://doi.org/10.3390/ijerph17228514 - 17 Nov 2020
Cited by 11 | Viewed by 3558
Abstract
It is well-known that unpredictable variations in supply and demand of capacity in healthcare systems create the need for flexibility. The main tools used to create short-term volume flexibility in the healthcare system include overtime, temporary staff from internal calling lists, moving staff [...] Read more.
It is well-known that unpredictable variations in supply and demand of capacity in healthcare systems create the need for flexibility. The main tools used to create short-term volume flexibility in the healthcare system include overtime, temporary staff from internal calling lists, moving staff across units, internal staffing pools, external staffing agencies, queuing patients, and purchasing care from external providers. We study the creation of short-term volume flexibility in healthcare systems to manage short-term capacity losses and demand fluctuations. A questionnaire was developed and distributed among healthcare managers in the Region Västra Götaland healthcare system. Respondents were asked to what extent they used each tool to create short-term flexibility in capacity. Data were analyzed using multiple regression analysis. Several significant tendencies were found, including that acute units use overtime and internal staffing pools to a larger extent, and queuing patients and external providers to a lesser extent than planned units. The prerequisites and required managerial approaches used to efficiently manage aggregate capacity in the system differ substantially between different parts of the system. These differences must be addressed when, for example, capacity pools are considered. These results serve as a stepping stone towards a more thorough understanding of efficient capacity management in healthcare systems. Full article
(This article belongs to the Special Issue Deployment of Industrial Management Methods for Healthcare Services)
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16 pages, 705 KiB  
Article
Does Focus Improve Performance in Elective Surgery? A Study of Obesity Surgery in Sweden
by Anna Svarts, Luca Urciuoli, Anders Thorell and Mats Engwall
Int. J. Environ. Res. Public Health 2020, 17(18), 6682; https://doi.org/10.3390/ijerph17186682 - 14 Sep 2020
Cited by 1 | Viewed by 1598
Abstract
Recent studies have found positive effects from hospital focus on both quality and cost. Some studies indicate that certain patient segments benefit from focus, while others have worse outcomes in focused hospital departments. The aim of this study was to establish the relationship [...] Read more.
Recent studies have found positive effects from hospital focus on both quality and cost. Some studies indicate that certain patient segments benefit from focus, while others have worse outcomes in focused hospital departments. The aim of this study was to establish the relationship between hospital focus and performance in elective surgery. We studied obesity surgery procedures performed in Sweden in 2016 (5152 patients), using data from the Scandinavian Obesity Surgery Registry (SOReg) complemented by a survey of all clinics that performed obesity surgery. We examined focus at two levels of the organization: hospital level and department level. We hypothesized that higher proportions of obesity surgery patients in the hospital, and higher proportions of obesity surgery procedures in the department, would be associated with better performance. These hypotheses were tested using multilevel regression analysis, while controlling for patient characteristics and procedural volume. We found that focus was associated with improved outcomes in terms of reduced complications and shorter procedure times. These positive relationships were present at both hospital and department level, but the effect was larger at the department level. The findings imply that focus is a viable strategy to improve quality and reduce costs for patients undergoing elective surgery. For these patients, general hospitals should consider implementing organizationally separate units for patients undergoing elective surgery. Full article
(This article belongs to the Special Issue Deployment of Industrial Management Methods for Healthcare Services)
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