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In both rich and poor nations, public resources for health care are inadequate to meet demand. Policy makers and health care providers must determine how to provide the most effective health care to citizens using the limited resources that are available. This chapter describes current and future challenges in the delivery of health care, and outlines the role that operations research (OR) models can play in helping to solve those problems. The chapter concludes with an overview of this book – its intended audience, the areas covered, and a description of the subsequent chapters. KEY WORDS Health care delivery, Health care planning HEALTH CARE DELIVERY: PROBLEMS AND CHALLENGES 3 1.1 WORLDWIDE HEALTH: THE PAST 50 YEARS Human health has improved significantly in the last 50 years. In 1950, global life expectancy was 46 years [1]. That figure rose to 61 years by 1980 and to 67 years by 1998 [2]. Much of these gains occurred in low- and middle-income countries, and were due in large part to improved nutrition and sanitation, medical innovations, and improvements in public health infrastructure.
This book offers a comprehensive reference guide to operations research theory and applications in health care systems. It provides readers with all the necessary tools for solving health care problems. The respective chapters, written by prominent researchers, explain a wealth of both basic and advanced concepts of operations research for the management of operating rooms, intensive care units, supply chain, emergency medical service, human resources, lean health care, and procurement. To foster a better understanding, the chapters include relevant examples or case studies. Taken together, they form an excellent reference guide for researchers, lecturers and postgraduate students pursuing research on health care management problems. The book presents a dynamic snapshot on the field that is expected to stimulate new directions and stimulate new ideas and developments.
From the Preface: Collectively, the chapters in this book address application domains including inpatient and outpatient services, public health networks, supply chain management, and resource constrained settings in developing countries. Many of the chapters provide specific examples or case studies illustrating the applications of operations research methods across the globe, including Africa, Australia, Belgium, Canada, the United Kingdom, and the United States. Chapters 1-4 review operations research methods that are most commonly applied to health care operations management including: queuing, simulation, and mathematical programming. Chapters 5-7 address challenges related to inpatient services in hospitals such as surgery, intensive care units, and hospital wards. Chapters 8-10 cover outpatient services, the fastest growing part of many health systems, and describe operations research models for primary and specialty care services, and how to plan for patient no-shows. Chapters 12 – 16 cover topics related to the broader integration of health services in the context of public health, including optimizing the location of emergency vehicles, planning for mass vaccination events, and the coordination among different parts of a health system. Chapters 17-18 address supply chain management within hospitals, with a focus on pharmaceutical supply management, and the challenges of managing inventory for nursing units. Finally, Chapters 19-20 provide examples of important and emerging research in the realm of humanitarian logistics.
Operations research tools are ideally suited to providing solutions and insights for the many problems health policy-maker's face. Indeed, a growing body of literature on health policy analysis, based on operations research methods, has emerged to address the problems mentioned above and several others. The research in this field is often multi-disciplinary, being conducted by teams that include not only operations researchers but also clinicians, economists and policy analysts. The research is also often very applied, focusing on a specific question driven by a decision-maker and many times yielding a tool to assist in future decisions. The goal of this volume was to bring together a group of papers by leading experts that could showcase the current state of the field of operations research applied to health-care policy. There are 18 chapters that illustrate the breadth of this field. The chapters use a variety of techniques, including classical operations research tools, such as optimization, queuing theory, and discrete event simulation, as well as statistics, epidemic models and decision-analytic models. The book spans the field and includes work that ranges from highly conceptual to highly applied. An example of the former is the chapter by Kimmel and Schackman on building policy models, and an example of the latter is the chapter by Coyle and colleagues on developing a Markov model for use by an organization in Ontario that makes recommendations about the funding of new drugs. The book also includes a mix of review chapters, such as the chapter by Hutton on public health response to influenza outbreaks, and original research, such as the paper by Blake and colleagues analyzing a decision by Canadian Blood Services to consolidate services. This volume could provide an excellent introduction to the field of operations research applied to health-care policy, and it could also serve as an introduction to new areas for researchers already familiar with the topic. The book is divided into six sections. The first section contains two chapters that describe several different applications of operations research in health policy and provide an excellent overview of the field. Sections 2 to 4 present policy models in three focused areas. Section 5 contains two chapters on conceptualizing and building policy models. The book concludes in Section 6 with two chapters describing work that was done with policy-makers and presenting insights gained from working directly with policy-makers.
This edited volume captures and communicates the best thinking on how to improve healthcare by improving the delivery of services -- providing care when and where it is needed most -- through application of state-of-the-art scheduling systems. Over 12 chapters, the authors cover aspects of setting appointments, allocating healthcare resources, and planning to ensure that capacity matches needs for care. A central theme of the book is increasing healthcare efficiency so that both the cost of care is reduced and more patients have access to care. This can be accomplished through reduction of idle time, lessening the time needed to provide services and matching resources to the needs where they can have the greatest possible impact on health. Within their chapters, authors address: (1) Use of scheduling to improve healthcare efficiency. (2) Objectives, constraints and mathematical formulations. (3) Key methods and techniques for creating schedules. (4) Recent developments that improve the available problem solving methods. (5) Actual applications, demonstrating how the methods can be used. (6) Future directions in which the field of research is heading. Collectively, the chapters provide a comprehensive state-of-the-art review of models and methods for scheduling the delivery of patient care for all parts of the healthcare system. Chapter topics include setting appointments for ambulatory care and outpatient procedures, surgical scheduling, nurse scheduling, bed management and allocation, medical supply logistics and routing and scheduling for home healthcare.
Operations management is increasingly a critical skill needed in today’s health care leader. Managing your organization’s complex interdisciplinary processes, labor and asset productivity, and operational performance involves quantitative and qualitative skills. Covering a range of topics from quality management to data analyses, Health Care Operations Management: A Systems Approach clearly explains the important concepts and skills necessary to lead a modern health care organization. Logically organized in four parts, Health Care Operations Management: A Systems Approach looks at operations, systems and financial management; methods for improving operations; analytical tools and technology; and health care supply chain. Thoroughly revised, the new Third Edition offers new content on health plan operations, use of information technology in operations management, and analytics – topics often overlooked in most health care operational management texts.
Health Care Operations and Supply Chain Management This innovative text offers a thorough foundation in operations management, supply chain management,?and the strategic implementation of programs, techniques, and tools for reducing costs and improving quality in health care organizations. The authors incorporate the features and functions of Microsoft Excel where appropriate in their coverage of supply chain strategy, process design and analysis of health care operations, managing health care operations quality, and planning and controlling health care operations. Health Care Operations and Supply Chain Management offers real-world examples to illustrate the most current concepts and techniques such as value stream mapping and Six Sigma. In addition, the authors clearly demonstrate how operations and process improvement relate to contemporary health care trends such as evidence-based medicine and pay-for-performance. Health Care Operations and Supply Chain Management contains: Leading edge concepts and techniques Real-life data and actual examples from health care settings to underscore the main concepts in the text Instruction in the use of Microsoft Excel for health care operations and supply side management The book's numerous screen shots and detailed instructions guide the student through the use of Microsoft Excel's many functions and features.
"In Hospital Operations, two leading Operations Management experts and five practicing clinicians demonstrate how to apply new OM advances and metrics to substantially improve any hospital's performance. Replete with examples, Hospital Operations shows how to generate principles-driven breakthrough ideas to systematically improve emergency departments, operating rooms, nursing unites, and diagnostic units." -- Back cover
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.