PURPOSE: The purpose of this paper is to present a conceptual framework that would enable the effective application of time based competition (TBC) and work in process (WIP) concepts in the design and management of effective and efficient patient processes. DESIGN/METHODOLOGY/APPROACH: This paper discusses the applicability of time-based competition and work-in-progress concepts to the design and management of healthcare service production processes. A conceptual framework is derived from the analysis of both existing research and empirical case studies. FINDINGS: The paper finds that a patient episode is analogous to a customer order-to-delivery chain in industry. The effective application of TBC and WIP can be achieved by focusing on through put time of a patient episode by reducing the non-value adding time components and by minimizing time categories that are main cost drivers for all stakeholders involved in the patient episode. RESEARCH LIMITATIONS/IMPLICATIONS: The paper shows that an application of TBC in managing patient processes can be limited if there is no consensus about optimal care episode in the medical community. PRACTICAL IMPLICATIONS: In the paper it is shown that managing patient processes based on time and cost analysis enables one to allocate the optimal amount of resources, which would allow a healthcare system to minimize the total cost of specific episodes of illness. Analysing the total cost of patient episodes can provide useful information in the allocation of limited resources among multiple patient processes. ORIGINALITY/VALUE: This paper introduces a framework for health care managers and researchers to analyze the effect of reducing through put time to the total cost of patient episodes.
PURPOSE: The purpose of this paper is to present a conceptual framework that would enable the effective application of time based competition (TBC) and work in process (WIP) concepts in the design and management of effective and efficient patient processes. DESIGN/METHODOLOGY/APPROACH: This paper discusses the applicability of time-based competition and work-in-progress concepts to the design and management of healthcare service production processes. A conceptual framework is derived from the analysis of both existing research and empirical case studies. FINDINGS: The paper finds that a patient episode is analogous to a customer order-to-delivery chain in industry. The effective application of TBC and WIP can be achieved by focusing on through put time of a patient episode by reducing the non-value adding time components and by minimizing time categories that are main cost drivers for all stakeholders involved in the patient episode. RESEARCH LIMITATIONS/IMPLICATIONS: The paper shows that an application of TBC in managing patient processes can be limited if there is no consensus about optimal care episode in the medical community. PRACTICAL IMPLICATIONS: In the paper it is shown that managing patient processes based on time and cost analysis enables one to allocate the optimal amount of resources, which would allow a healthcare system to minimize the total cost of specific episodes of illness. Analysing the total cost of patient episodes can provide useful information in the allocation of limited resources among multiple patient processes. ORIGINALITY/VALUE: This paper introduces a framework for health care managers and researchers to analyze the effect of reducing through put time to the total cost of patient episodes.
Authors: Ian Litchfield; Louise Bentham; Ann Hill; Richard J McManus; Richard Lilford; Sheila Greenfield Journal: BMJ Qual Saf Date: 2015-08-06 Impact factor: 7.035