Most of the current literature on healthcare operations management
is focused on importing principles and methods from manufacturing.
The evidence of success is scattered and nowhere near what has been
achieved in other industries. This book develops the idea that the
logic of production, and production systems in healthcare is
significantly different. A line of thing that acknowledges the
ingenious characteristics of health service production is
developed. This book builds on a managerial segmentation of
healthcare based on fundamental demand-supply constellations.
Demand can be classified with the variables urgency, severity, and
randomness. Supply is constrained by medical technology (accuracy
of diagnostics, efficacy of therapies), patient health behavior
(co-creation of health), and resource availability. Out of this
emerge seven demand-supply-based operational types (DSO):
prevention, emergencies, one-visit, electives, cure, care, and
projects. Each of these have distinct managerial characteristics,
such as time-perspective, level of co-creation, value proposition,
revenue structure, productivity and other key performance
indicators (KPI). The DSOs can be envisioned as platforms upon
which clinical modules are attached. For example, any Emergency
Department (ED) must be managed to deal with prioritization,
time-windows, agitated patients, the necessity to save and
stabilize, and variability in demand. Specific clinical assets and
skill-sets are required for, say, massive trauma, strokes, cardiac
events, or poisoning. While representing different specialties of
clinical medicine they, when applied in the emergency - context,
must conform to the demand-supply-based operating logic. A basic
assumption in this book is that the perceived complexity of
healthcare arises from the conflicting demands of the DSO and the
clinical realms. The seven DSOs can neatly be juxtaposed on the
much-used Business Model Canvas (BMC), which postulates the
business model elements as value proposition; customer segments,
channels and relations; key activities, resources and partners; the
cost structure; and the revenue model.
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