The excuse me dance of physical therapy in a hospital situation Optimization of the occupancy of the physical therapy department

Dijk, Yke van (2010) The excuse me dance of physical therapy in a hospital situation Optimization of the occupancy of the physical therapy department.

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Abstract:Problem description This thesis concerns the physical therapy department. A major issue in this department is the occupancy of the examination rooms. The hospital is short in the number of square meters and having a department with a low occupancy of their rooms might be a chance for the hospital board to find some spaces for other specialties. The actual occupancy of the examination rooms is low, but the therapists experience during some parts of the day an occupancy that is too high. Research objective The research question that is central in this thesis is: “How can the productivity of the physical therapy department be increased?” Before getting to an answer of the research question the most important problem areas of the physical therapy department need to be addressed. The first problem is the presence of therapists, on some days during the week a lot of therapists are present and on other days there not enough therapists are present. So the therapists are not evenly spread during the week. The second problem is the occupancy of the examination rooms, which is too low (33.7%). Third, patients are rejected because there is no room available to treat them in. Approach Solving these problems will ideally improve the productivity of the physical therapy department. There are a number of ways to solve these problems. They can be solved at an operational level, and at a tactical level. On the operational management level, the introduction of a new planning method will lead to an improvement in the efficiency of the department. The main part of the new planning method is done by the receptionists instead of by the therapists themselves. The receptionist will not only take the agenda of the therapists into account, but also the occupancy of the examination rooms. This way the examination rooms can be planned optimally and the number of examination rooms can be reduced. On the other hand double planning of the examination rooms will no longer be an issue, this results in fewer rejected patients and the patients can receive treatment in the most suitable situation. Aside from the change in planning of the patients, another contribution of the new planning method is a more even distribution of the therapists during the week. Consequently, there are enough therapists to treat all clinical patients on Friday afternoon. Moreover, the problem on Monday morning, when there are so many therapists, there is almost no room to treat the patients, is solved. On the tactical management level, a change in the number of examination rooms can solve the problem of the occupancy of the examination rooms. In order to calculate the number of examination rooms needed to perform the treatments a simulation model is presented. The interventions in the simulation model concern the number of patients, the number of therapists and the number of examination rooms. The effects of the interventions can be calculated without disturbing the actual process at the department. Results Based on the simulation study, an increase of 65% (to 3565 patients) of the number of patients is needed to reach an occupancy of 57% of the examination rooms. To be able to treat all these patients, a total of 33 FTE are necessary. According to the simulation study and based on the current number of patients (2161) and therapists (24.5 FTE) the number of examination rooms can be reduced from nine to five, resulting in an overall occupancy of the rooms of 49%. However, with the use of a better planning method a higher occupancy can even be obtained. The five examination rooms need to be used more flexibly; there should be two pelvis rooms and three multi-functional rooms (where all patients can receive treatment except pelvis patients). However, an increase of 65% is not likely to be obtained. An increase of 15% (to 2493 patients), will be more likely when the extra effort is made to recruit more patients. According to the simulation study, the number of examination rooms can be decreased by three and achieve an occupancy of 57%. The number of therapists needed is 26 FTE. Implementation For these kinds of changes the therapists need to understand the need for the change and the implications it has for them. Also an effort should be made to avoid the resistance against the change to make sure the implementation will be successful. Conclusion and recommendation The department should decrease the number of examination rooms by three to six rooms. This way there is growth is still possible. One recommendation is to start implementing the new planning method as soon as possible, with keeping in mind the resistance it brings along, and how to solve it. Another recommendation is to start the register the waiting time of the patient.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Industrial Engineering and Management MSc (60029)
Link to this item:http://purl.utwente.nl/essays/60827
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