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Insights in the effects of an admissions schedule on the wards

Hooijsma, Annemaaike (2012) Insights in the effects of an admissions schedule on the wards.

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Abstract:Background In Isala Klinieken the processes at the wards are negatively affected by other processes in the hospital. The admissions schedule is supposed to be the main reason for this. The department Patient Logistics within Isala Klinieken already performed research about this on a tactical level. The current research takes the next step by broadening the scope to the operational offline level. The objective of this research is: Generating insights in the effects of operational offline scheduling decisions made for hospital admissions on the capacity planning processes at the wards. Approach To generate these insights a tool is (partly) developed to show the admissions planners the quality of their schedule. This research consists of multiple steps. First, we constructed a list of performance measures which are important for the wards and should therefore be shown to the admissions planners. We based this list on interviews and a survey on all hierarchical levels within Isala Klinieken. This resulted in a long list of performance measures. Therefore, we reduced the list by using evaluation criteria and by looking at the importance based on the interviews and the survey. Secondly, we interviewed multiple planners and the department Patient Logistics to determine how these performance measures should be displayed for the admissions planners. The third part of this research focused on how to forecast the information needed to calculate the performance measures. We partly based this on models from literature. Finally, we developed part of the tool according to the software development method Extreme Programming. Conclusions The performance measures that should be shown to the admissions planners are:  Average utilization per ward  Variability in the number of used beds over the week  Staff productivity  Variability in amount of work during the day  Constant pattern in amount of work over the week  Variability in admissions during the day  Variability in admissions over the week  Staff availability  Overutilization per ward  Overutilization on certain moments of the day A further requirement of the tool is that it should summarize these measures into a rating for the total quality of the admissions schedule. Next to this the tool should show the trends of the total quality and of the performance measures. Another important requirement for the tool is that it should be flexible. This is translated into a possibility for admissions planners to change multiple settings in the tool. During this research we developed part of the tool, namely the results for the admissions over the week and for the overutilization. For the calculations of the overutilization we build upon the tactical model of Smeenk (2011). 3 Recommendations We recommend Isala Klinieken to continue developing the proposed tool and to implement it. Next to this, we recommend changing the focus in the organization from the operating rooms more to the wards. Our final recommendation is to let the admissions for one ward be scheduled by one admissions planner or scheduling team. Currently the admissions are scheduled per specialism. Especially for the new hospital with larger wards this would mean that multiple planners schedule for the same ward. Topics for future research are:  how to change the focus within Isala Klinieken from the OR department to the wards  generating insights in other resources than wards, like for example ORs and IC  examining if there is correlation between the performance measures  improving the input for the tool  improving the method for integrating the performance measures into a rating for the total quality of the schedule
Item Type:Essay (Master)
Isala Klinieken
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Industrial Engineering and Management MSc (60029)
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