Efficiency in the cath lab: Pursuing value-based improvements following a sociotechnical approach

Area of Science:

• Healthcare Management
• Operations Research
• Health Services Research

Background:

• Cardiac catheterization laboratories (cath labs) aim for optimal clinical outcomes and efficiency.
• This study addresses the need for methods to analyze improvement measures within a value-based healthcare (VBHC) framework.

Purpose of the Study:

• To develop methods for analyzing the added value of improvement measures in cath labs.
• To support healthcare managers in decision-making processes for efficiency and patient care enhancement.

Main Methods:

• A sociotechnical approach was used, incorporating a multicriteria evaluation model and discrete event simulation.
• Methods focused on increasing efficiency, reducing task duplication, cutting costs, and improving patient care.
• Workflow simulation modeled patient flow to assess the impact of proposed improvements and resource variations.

Main Results:

• Four key evaluation criteria were identified: admission process efficiency, schedule compliance, procedural agility, and staff training.
• Improvement measures focused on optimizing daily start-up, pre-exam assessment, and staff training.
• Prioritizing pre-exam assessment improvements and optimizing human resources allocation demonstrated significant efficiency gains and cost savings.

Conclusions:

• The proposed solution aligns with value-based healthcare principles by enhancing efficiency, care delivery, and cost optimization.
• Discrete event simulation proved effective for modeling and evaluating potential changes in cath lab operations.
• Multicriteria modeling facilitated transparent prioritization and redesign of healthcare improvements.