Patient
As a patient, you bear the brunt of the chaos resulting from poor management of operations at healthcare delivery organizations. Patients suffer in the form of excessive delays and cancellations of scheduled appointments, inadequate access to services, long waiting times, and compromised quality of care when care is delayed and provided in inappropriate settings or with inadequate staffing levels. One common cause behind all of these problems is artificial variability in patient flow driven by inappropriate scheduling practices. The inappropriate scheduling of elective cases, and the mixing of resources for urgent and scheduled patients, causes an unnecessary and potentially dangerous competition for those resources.
“The next time you or a loved one are spared a long, agonizing hospital wait before emergency or scheduled surgery at Cincinnati Children’s Hospital in the US or Toronto General in Canada you can thank a Boston-based Russian professor and statistician named Eugene Litvak.”
– Kathleen O’dell, News-Leader, July 5, 2006
The Solution
flow variability management, queuing models, simulation, and many other scientific operations management tools can be used to improve quality, safety, service, and access, and to decrease healthcare cost.
“Patients should ask hospitals about surgical scheduling policies when they book procedures – including what contingency plans surgical units have if there is no bed available when they come out of surgery.”
Laura Landro, The Informed Patient,, The Wall Street Journal, August 10, 2005.
Questions you can ask of your care providers:
- Insist on being placed in the most appropriate designated unit (such as a total joint unit if you are undergoing hip replacement,(for example) if you need inpatient hospital care. Inquire about the organization’s specific rules about placing patients on particular units
- Insist to not be kept waiting prior to surgery or after surgery in the recovery unit
- Check if the provider has specific guidelines for clinically acceptable waiting times for different types of patients,how the provider performs relative to these guidelines and what procedures are in place to review delays in providing care
- Find out if your hospital manages the number of daily elective admissions in order to minimize delays for non-elective admissions
- Inquire if the care delivery organization separates resources for urgent / emergent patients from electively scheduled patients and if they do not, ask them why
- If you experienced waits, delays or other consequences of poor care during your last hospital stay, ask why
Cost reduction through optimal patient Flow Variability Management Healthcare Cost Corner
Hospital costs can be decreased by millions of dollars annually by adopting the Institute for Healthcare Optimization’s approach to managing variability in healthcare delivery.
Case Study
See how Cincinnati Children’s Hospital increased annual revenue by $137M, and avoided $100M in cost, while improving quality of care.
Resources
Joint Commission Resources Book
The IHO’s approach to managing variability in healthcare delivery is the central theme of Joint Commission Resources’ new book.
See Commission Results
IOM Report: Transforming Health Care Scheduling and Access
The Institute of Medicine (IOM) recommended IHO Variability Methodology as one of the six principles to address the compelling issue of access to healthcare.
Get the Report