The supply chain that really matters; Healthcare

From birth to death, we are all part of the healthcare system; we rely on hospitals, doctors, nurses etc to provide preventive care and to treat our illnesses. Healthcare is perhaps one of the most important indicators of quality of life and longevity in a society.

However healthcare consumes an increasing percentage of our economic product. This rising cost can be attributed in part to the increase of life expectancy and to the expense of new treatments, but also it can be attributed to inefficiencies in healthcare delivery.

Patient flow represents one of the most challenging aspects of the healthcare system. When the system works well, patients flow at a steady path, moving efficiently through the stages of care, and every stage is completed with minimal delay, however,  when the system is broken, patients accumulate meaning the patients suffer considerable queuing delays.

Healthcare has unique features that make queueing problems particularly difficult to solve:

-  Queues create additional work for clinicians. Patients must be monitored and served while waiting, and their conditions can deteriorate, necessitating additional work once they get to be treated. Thus, as queues become large, the workload increases and the capacity to serve patients deteriorate.

- It can be difficult to distinguish productive waiting from unproductive waiting. In a traditional queueing system the most desirable outcome is instantaneous service, however, in a hospital, it is undesirable to reduce the length of stay to zero, as patients need to be monitored and cared during recovery periods. This can result in conflicting objectives in managing hospital beds when trying to separate productive waiting (recovery) from unproductive waiting (waiting for tests).

At hospitals, care is provided through many specialized departments, therefore when a patient arrives at the emergency department encounters repeated waits as he or she progresses from stage to stage, waiting for rooms, equipment, physicians, nurses, technicians, beds, records, gurneys and so forth. When the system becomes overloaded, the patient may wait hours or even days from being seen in the emergency department until being given the ok.

We can summarize the three major causes of queues in hospitals:

- Idle capacity due to a failure to synchronize resources (ensuring that technicians, nurses, physicians, patients, etc are present at the same time).

- Inadequate communication to ensure the relevant departments are prepared to receive patients from other areas.

- Inefficient processes that require more work than necessary or un-needed repetition of work.

Some reasons that will lead to patients waiting for placement in a hospital are can be other patients waiting too long to complete the discharge process, beds remaining idle too long from when a patient departs until the bed is prepared for the next patient, poor communication between the emergency department and the ward, a shortage of technicians, or even because there is an inadequate number of gurneys to transport patients etc.

Working on improving patient flow at hospitals will not only save money but also will save lives.