Capacity Planning
Capacity planning is an interesting topic; looking at organizations max inputs to create a maximum output, to meet market demands without creating an imbalance of supply through inefficiencies. The article addressed is on capacity planning in the health care industry. Examining the current methods of hospital and health care capacity planning, and a suggested process to alter current systems and increase efficiency for both the customer and the health care professionals.
Hospitals are an interesting industry, they are a service that is demanded; and in large enough demand that the current means to supply is not enough. People across the world are in need of health care and waiting lists for numbers of different services grow. Currently most “hospital capacity planning remains dominated by ‘bed numbers’ “(Rechel, B), however as time goes on many professionals see this not to be the best practice. Some of the problems associated with the bed number approach include: the services provided for each bed, and estimating a future demand of services (Rechel, B). Though bed numbers do not provide an accurate resource of what services will be needed, it is a cost effective and easy way to plan on capacity; and because of that, it is the most used.
When running a hospital patients are the customers, and like any industry one of the goals is customer satisfaction. However many practices we see today do not put the customer first; it schedules customers around the company. It would be insane to suggest adapting the system to work on customer time; however, the idea of certain processes to be based on customer availability could prove a viable suggestion. Hospitals are not the most efficient with their time, as “patients often spend most of their time in hospitals waiting for something to happen” (Rechel, B). Examples of this can be seen all over: waiting rooms, and then once called into another section of waiting, and then a nurse will most likely assist you, and then again more waiting, until the doctor comes in. If a patient needs to come back for a follow up, again another waiting process; or if staying at the hospital in a bed accuracy of “admission and discharge” (Rechel, B) are often not processed to their full potential causing another wait. Beds are not an accurate plan of measuring capacity, if admitted for too long or too short then there becomes an inefficiency in the capacity of that bed and therefore, creates waste.
Waste is an interesting concept and comes from the idea of lean thinking; “the concept of waste is far-reaching and includes: unnecessary inventory, waiting, mistakes, un-planned re admission and inappropriate procedures” (Rechel, B). Waste by this definition can be seen in many industries; however, it directly relates to beds as a poor capacity planner. Beds dictate when admitted but not treatment needed, nor the materials needed to treat that individual affecting not only human capacity; but inventories too, therefore creating waste. A suggested new way of capacity planning for hospitals is through lean thinking, with the aid of care/ critical pathways.
Lean thinking is an interesting and “highly evolved method of managing an organization to improve the productivity, efficiency and quality of its products or services” (Principles of Lean Thinking ( Revision D), 2004) . This means that for health care and hospitals to effectively capacity plan they must look into a number of different means of prediction. Looking back to the idea of waiting and waste we can see that “patients are processed in batches “(Rechel, B). Once processed, at one spot they move to the next, in a very similar fashion to that of an assembly line. Lean thinking looks at treating your patient as a customer and providing a “mass-customized approach, where individualized service is provided by tailoring a standardized set of processes”(Rechel, B). In essence a set of guidelines to follow for processes that are similar; reducing time in assessing the situation and determining a solution. This would reduce waste in time waiting, and unnecessary extended stays. Increasing patient flow by initially separating different kinds of patients based on clinical conditions, will reduce initial wait times for minor issues or follow-ups and allow for more customers to be helped. Then have designated staff to deal with different issues only, not working across all departments. The number of staff and size of unit would be determined on frequency, duration, and materials needed for conditions in that sector. By working in specifics and basing capacity off average turnaround time per department per process, allows resources and capacity to be used to the full potential and maximize efficiency. However this idea will not be a change overnight it would require large amounts of time, energy and money to make a transition, however once in place lean thinking would increase efficiency and improve capacity planning.
One tool that is referred to in the article is that of care pathways which focuses on the process of increasing the number of outcomes, reducing time for each process, and therefore lowering cost, while minimizing outcome variation. Care /critical pathways in the hospital industry is derived from combining hospital “tools with business process re-engineering techniques” (Reducing clinical variations with clinical pathways: do pathways work?, 2003) and then using these pathways as a benchmark to increase speed and outcomes as intended. A number of studies have been done and “results demonstrated that it is possible to achieve this goal” (Reducing clinical variations with clinical pathways: do pathways work?, 2003) .
Hospital and health care capacity planning is based most often on bed numbers, this method is inefficient yet is low cost, however other options are available. Having care pathways as a tool to contribute to lean thinking provides a foundation to change in hospital capacity planning. Allowing hospitals to maximize capacity will reduce waste and increase efficiency allowing more customers to be treated faster and more consistently, while reducing wait time.
Works Cited
Principles of Lean Thinking ( Revision D). (2004, 7). Retrieved 1 28, 2012, from National Research Council Canada: http://www.itc.mb.ca/downloads/resources_by_topic/princ_lean%20thinking/PrinciplesofLeanThinkingRevD2004.pdf
Rechel, B., Wright, S., Barlow, J., & McKee, M. (2010). Policy & Practice. Hospital capacity planning: from measuring stocks to modelling flows. Bulletin Of The World Health Organization, 88(8), 632-636. doi:10.2471/BLT.09.073361
Reducing clinical variations with clinical pathways: do pathways work? (2003). International Journal for Quality in Health Care , 15 (6), 509–521.
