A proposal of a management framework to optimize waiting queue in healthcare organizations

The internal dynamics of a hospital represent a complex non-linear structure. To plan and manage day-to-day running of a hospital requires a thorough understanding of the system together with detailed information for decision-making. The main objective of a hospital is to offer services of good quality to their patients utilizing their medical expertises with the support of their specialized and expensive infrastructures: personnel, intensive care units, surgical operations units, specialized laboratories besides beds for in-patient stay, ambulances for emergency transfers, pharmacy for the required medicines and the other logistic infrastructures like restaurant for preparing food and the laundry service. To maintain high quality standards these resources have to be coordinated in order to eliminate “slack” at various resources centres and the inefficiencies caused by discharge delays, late-start surgeries and slow laboratory turnaround. For this reason we can say that hospitals need a planning and control system to plan patients’ processes and required capacity. Poor capacity, resources utilization and the more and more high waiting times are among the strategic issues that continue to plague hospital planners. The question is ‘how do we give patients the right services at the right times?’ The following paper presents a tool to manage, plane and coordinate the resources in a hospital in order to reduce the waiting queue and increase the resources utilization. The study applies the integration concepts of ERP systems, widely used in manufacturing environments, to the healthcare organizations. Referring to DRG (Diagnostic-Related Group) and considering the hospital resources linked to the patient treatment (medical staff, nurse, surgery theatres, support departments, etc), a planning and control system is developed. It looks at the patient like the customer who needs the services offered by hospitals and at the treatment like the instrument to define the necessary resources and materials besides the lead times to provide the suitable service. Following the ERP system logic, it processes data (patients and available resources) and planes the resources utilizations according to the real patients needs, highlighting, if there are, overloads and problems. The system considers also difference between inpatient, out-patient, and emergency and integrates the resources of the different departments.