Designing the accident and emergency system: lessons from manufacturing.
OBJECTIVE
To review the literature on manufacturing process design and demonstrate applicability in health care.


METHODS
Literature review and application of theory using two years activity data from two healthcare communities and extensive observation of activities over a six week period by seven researchers.


RESULTS
It was possible to identify patient flows that could be used to design treatment processes around the needs of the patient. Some queues are built into existing treatment processes and can be removed by better process design. Capacity imbalance, not capacity shortage, causes some unnecessary waiting in accident and emergency departments.


CONCLUSIONS
Clinicians would find that modern manufacturing theories produce more acceptable designs of systems. In particular, good quality is seen as a necessary pre-requisite of fast, efficient services.
Walley
P
P
Warwick Business School, University of Warwick, Coventry CV4 8AA, UK. ompw@wbs.warwick.ac.uk
D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006302:Health Services Research / Q000379:methods; D006749:Hospital Design and Construction; D006801:Humans; D007221:Industry; D011787:Quality of Health Care; D013222:State Medicine / Q000458:organization & administration; D013598:Systems Theory; D006113:United Kingdom