Fundamental Principles of Efficient Healthcare Operations Management.
The fundamental principles of management are as objective as the laws of physics. However, the laws of management are frequently violated by healthcare organizations. This post summarizes some fundamental management principles and references the book that covers examples of their applications.
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It is already recognized that ED improvement alone will not result in reduced overcrowding, boarding, and length of stay. EDs are intertwined with downstream units, such as the ICU, ORs, PACU, and nursing wards. The output of the upstream units (EDs) becomes the input to the downstream units. Local flow improvement in separate units will not result in improved flow across the entire hospital system. When a downstream unit’s capacity is insufficient, the entire system backs up, and it is the ED that feels the consequences. Improving flow inside a single unit without addressing the downstream capacity to handle the flow just shifts the bottleneck elsewhere. A quantitative analysis of the patient flow in the hospital system from ED to discharge is needed, along with appropriate metrics. It is presented, e.g., in the book "Healthcare Management Engineering in Action", Springer, 2024 https://link.springer.com/book/10.1007/978-3-031-53663-2
in section 2.14 'The Entire Hospital System Patient Flow: Interdependency of ED, ICU, OR and NU and System Throughput.' See also section 8.5 'The expected number of patients discharged from the ED. Is the ALOS a good predictor?'
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It is already recognized that ED improvement alone will not result in reduced overcrowding, boarding, and length of stay. EDs are intertwined with downstream units, such as the ICU, ORs, PACU, and nursing wards. The output of the upstream units (EDs) becomes the input to the downstream units. Local flow improvement in separate units will not result in improved flow across the entire hospital system. When a downstream unit’s capacity is insufficient, the entire system backs up, and it is the ED that feels the consequences. Improving flow inside a single unit without addressing the downstream capacity to handle the flow just shifts the bottleneck elsewhere. A quantitative analysis of the patient flow in the hospital system from ED to discharge is needed, along with appropriate metrics. It is presented, e.g., in the book "Healthcare Management Engineering in Action", Springer, 2024 https://link.springer.com/book/10.1007/978-3-031-53663-2
in section 2.14 'The Entire Hospital System Patient Flow: Interdependency of ED, ICU, OR and NU and System Throughput.' See also section 8.5 'The expected number of patients discharged from the ED. Is the ALOS a good predictor?'