Health care management science
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Health Care Manag Sci · Jun 2009
What is the best workflow for an operating room? A simulation study of five scenarios.
Parallel induction of anesthesia improves operating room (OR) efficiency. To support decision-making as to optimal facilities and optimal use of resources, we compared the cost-efficiency of several workflow models of parallel induction to that of the traditional model, using discrete-event simulation. For each scenario, average number of procedures performed, surgery time, daily over- and underutilized time, and staffing costs per operation were assessed. ⋯ All parallel work-flow models demonstrated better cost-efficiency than the traditionally sequenced working pattern. Staffing costs per procedure were 7% lower in the best induction model than in the traditional model. When short procedures were scheduled separately, differences between induction models were small.
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Health Care Manag Sci · Jun 2009
Exploring new operational research opportunities within the Home Care context: the chemotherapy at home.
Home Care (HC) services provide complex and coordinated medical and paramedical care to patients at their homes. As health care services move into the home setting, the need for developing innovative approaches that improve the efficiency of home care organizations increases. ⋯ Our interest is focused on issues specific to the anti-cancer drug supply chain. We identify various models that can be developed and analyze one of them.
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Health Care Manag Sci · Jun 2009
Restructuring patient flow logistics around patient care needs: implications and practicalities from three critical cases.
To make hospitals more patient-centered it is necessary to intervene on patient flow logistics. The study analyzes three innovative redesign projects implemented at three Italian hospitals. The three hospitals have reorganized patient flow logistics around patient care needs using, as proxies, the expected length of stay and the level of nursing assistance. ⋯ The study describes the changes implemented as well as the results achieved and draws some general lessons that provide useful hints for those other hospitals involved in such type of redesign projects. The paper ends by discussing some policy implications. In fact, the results achieved in the three cases investigated provide interesting material for further discussion on clinical, operational, and economic issues.