How improving access times had unforeseen consequences: a case study in a Dutch hospital

Area of Science:

• Healthcare Management
• Operations Research
• Service Operations

Background:

• Reducing patient access times is a key goal in healthcare.
• Increasing service capacity is a common strategy to improve access.
• The impact of variability on capacity utilization and access times requires further investigation.

Purpose of the Study:

• To investigate the consequences of increasing healthcare capacity on patient access times.
• To explore how patient waiting times and resource utilization are affected by variability.
• To identify the drivers of fluctuations in access times within a secondary care setting.

Main Methods:

• Retrospective case study combining primary and secondary data.
• Analysis of hospital database records (patient flow, resource utilization, access times).
• Qualitative data from field observations and semi-structured interviews with healthcare professionals.

Main Results:

• Managerial decisions to increase capacity and patient inflow led to artificial variability.
• Significant and undesirable fluctuations in patient access times were observed.
• A 'multiplier effect' was identified, exacerbating fluctuations in service delivery.

Conclusions:

• Increasing capacity does not always straightforwardly reduce access times.
• Capacity expansion can introduce new forms of artificial variability in healthcare.
• This phenomenon has detrimental consequences for patient access and service efficiency in healthcare environments.