University of Twente Student Theses


Assessing operational excellence and decisive factors to support performances of hospitals departments

Schaik, L.A.W.F.J. van (2018) Assessing operational excellence and decisive factors to support performances of hospitals departments.

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Abstract:Healthcare expenditures only increased over the past decade. The Dutch healthcare expenditures has risen from 12.3% in 2005 until 13.8% in 2015 of the gross domestic product. A major proportion of it goes to medical and long-term care(1). Reasons for this growth are the increasing demand for care and the rapid development of healthcare technology. Hence, the way patients are treated and the organisation of healthcare institutions are changed. Institutions have to deliver medical care in a more efficient and effective way, to keep up with the demand. Therefore, hospitals have therefore, an increasing attention for efficiency and management. This phenomenon led to the application of logistical concepts from industry. Just-in-Time, Focussed Factory, Lean Manufacturing, Six Sigma and Manufacturing Resource Planning are examples of Operational Management (OM) concepts that are used in the health care institutions (2). The basic idea of OM is making processes valuable and efficient. Continues improvement of efficiency, flexibility and quality are keywords of OM and ensure organisation to keep their processes valuable. Industry is familiar with this OM concept for decades due to a fearsome competition within the sector. The use of OM in healthcare knows two main pitfalls: the lack of dialog and cooperation between all stakeholders and mismatching the concepts characteristics and the needs of the hospital system (2-4). So, the several concepts that are already being used by healthcare institutions do not always result in the expected effect. This raises the question what lessons the healthcare sector should learn from OM. Unfortunately, most knowledge about the use of OM is from industry. Research into the use of OM in healthcare is, to our knowledge, limited to case studies or specific interventions. There is little known about generalizable instruments to assess the effects of OM in healthcare. To evaluate OM, it is important to narrow it down. OM can be dissected into four operations: resource capacity planning (RCP), medical planning, financial planning and material planning(2). In previous research a questionnaire was developed to evaluate the presences and use of RCP on departmental level of hospitals(5). In this questionnaire, RCP describes the dimensioning, planning, scheduling, monitoring and control of renewable resources. As far as we know, the RCP questionnaire is the only questionnaire for measuring RCP on tactical and operational offline level in hospital departments. It examines the presence of RCP elements in different phases of the Plan-Do-Check-Act cycle (PDCA) (6). A previous pilot study pointed out that the questionnaire provides a clear representation of RCP performance of hospital departments. However, a correlation of only the Plan phase elements and the efficiency was found. In contrast to the pilot study, the aim of this research is to determine which of the elements from all phases influences the performance of the hospital departments. Hence, the research question is: What are RCP success factors for the performance of hospital departments.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:44 medicine, 58 process technology, 85 business administration, organizational science
Programme:Health Sciences MSc (66851)
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