As a patient, you bear the brunt of the chaos resulting from poor management of operations at healthcare delivery organizations. Patients suffer in the form of excessive delays and cancellations of scheduled appointments, inadequate access to services, long waiting times, and compromised quality of care when care is delayed and provided in inappropriate settings or with inadequate staffing levels. One common cause behind all of these problems is artificial variability in patient flow driven by inappropriate scheduling practices. The inappropriate scheduling of elective cases, and the mixing of resources for urgent and scheduled patients, causes an unnecessary and potentially dangerous competition for those resources.

The next time you or a loved one are spared a long, agonizing hospital wait before emergency or scheduled surgery at St. John’s Hospital in Springfield, you can thank a Boston-based, Russian professor and statistician named Eugene Litvak
Kathleen O’dell, News-Leader, July 5, 2006

The Solution

Healthcare has not widely adopted scientific management methods that have been extensively and effectively employed by other industries such as airlines, telecommunications and the military. Patient flow variability management, queuing models, simulation, and many other scientific operations management tools can be used to improve quality, safety, service, and access, and to decrease healthcare cost.

Patients should ask hospitals about surgical scheduling policies when they book procedures – including what contingency plans surgical units have if there is no bed available when they come out of surgery.
Laura Landro, The Informed Patient, The Wall Street Journal, August 10, 2005.

Questions you can ask of your care providers:

  • Insist on being placed in the most appropriate designated unit (such as a total joint unit if you are undergoing hip replacement, for example) if you need inpatient hospital care. Inquire about the organization’s specific rules about placing patients on particular units
  • Insist to not be kept waiting in the emergency room for an excessive period of time,
  • Insist to not be kept waiting prior to surgery, or after surgery in the recovery unit
  • Check if the provider has specific guidelines for clinically acceptable waiting times for different types of patients, how the provider performs relative to these guidelines and what procedures are in place to review delays in providing care
  • Find out if your hospital manages the number of daily elective admissions in order to minimize delays for non-elective admissions
  • Inquire if the care delivery organization separates resources for urgent / emergent patients from electively scheduled patients and, if they do not, ask them why
  • If you experienced waits, delays or other consequences of poor care during your last hospital stay, ask why