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Applying the variety reduction principle to management of ancillary services
Sylvia G Elkhuizen1, Jasper R C van Sambeek, Erwin W Hans
1Academic Medical Center/University of Amsterdam, Department of Innovation and Process Management, Amsterdam, the Netherlands. s.g.elkhuizen@amc.uva.nl
Background:
As central diagnostic facilities, computer tomography (CT) scans appear to be bottlenecks in many patient-care processes. This study describes a case study concerning redesign of a CT scan department in the Academic Medical Center in Amsterdam, the Netherlands.
Purposes:
The aim was to decrease access time for the CT-scan and simultaneously increase utilization level.
Methodology/Approach:
An important cause of relatively low-capacity utilization is variability in the time needed for the scanning process. We performed a qualitative and quantitative analysis of current processes; identified bottlenecks and selected interventions with the greatest expected reduction of variability in flow time.
Findings:
The most promising and most feasible opportunity appeared to be to reallocate the insertion of intravenous access lines to a preparation room. The time needed for this activity was very hard to predict and needed a lot of slack in the lead time for appointments. By removing it from the CT room, lead time could be reduced by 5 minutes. The intervention resulted in a decrease of access time from 21 days to less than 5 days, and an increase of the utilization rate from 44% to 51%. This contributed directly to patient service and indirectly to cost reduction.
Practice Implications:
Our strategy is applicable in every appointment-based hospital facility with variation in the length of time of the process. It allows to simultaneously reduce costs and improve service for the patient.
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