As someone with an interest in healthcare policy, you spend much energy trying to solve important issues such as the quality and safety of care delivery, emergency room overcrowding, nurse staffing, access to care and cost. One of the root causes of all of these challenges is artificial variability in the flow of certain (scheduled) types of patients through the care delivery system. Take, for example, the flow of elective (scheduled) and emergency admissions to a hospital. See one hospital’s experience over a three month period.
The systemic effect of artificial patient flow variability is periodic overcrowding and average under utilization of key healthcare resources such as inpatient beds, operating rooms, cardiac catheterization labs and so on, which leads to increased cost. Inpatient beds in the US, for example, have an average utilization of only about 67%1. We believe that this utilization can be increased to 80% or higher, which would provide access for almost the entire uninsured and under-insured population at virtually zero additional capital cost to the system.
As long as artificial variability in scheduled patient flow is tolerated, it is not going to be possible to achieve substantive or sustainable improvements in quality, safety, access or cost. We believe that any policy initiative to address these key issues must encourage the use of the tools and methods of operations management and patient flow variability management as its integral component.
1 Source: OECD Health Data 2009, data is for 2005