Time-based management of patient processes.
OBJECTIVE
The purpose of this paper is to present a conceptual framework that would enable the effective application of time based competition (TBC) and work in process (WIP) concepts in the design and management of effective and efficient patient processes.


METHODS
This paper discusses the applicability of time-based competition and work-in-progress concepts to the design and management of healthcare service production processes. A conceptual framework is derived from the analysis of both existing research and empirical case studies.


RESULTS
The paper finds that a patient episode is analogous to a customer order-to-delivery chain in industry. The effective application of TBC and WIP can be achieved by focusing on through put time of a patient episode by reducing the non-value adding time components and by minimizing time categories that are main cost drivers for all stakeholders involved in the patient episode.


CONCLUSIONS
The paper shows that an application of TBC in managing patient processes can be limited if there is no consensus about optimal care episode in the medical community.


CONCLUSIONS
In the paper it is shown that managing patient processes based on time and cost analysis enables one to allocate the optimal amount of resources, which would allow a healthcare system to minimize the total cost of specific episodes of illness. Analysing the total cost of patient episodes can provide useful information in the allocation of limited resources among multiple patient processes.


CONCLUSIONS
This paper introduces a framework for health care managers and researchers to analyze the effect of reducing through put time to the total cost of patient episodes.
Kujala
Jaakko
J
Department of Industrial Engineering and Management, Helsinki University of Technology, Espoo, Finland. jaakko.kujala@tkk.fi
Lillrank
Paul
P
Kronström
Virpi
V
Peltokorpi
Antti
A
D000328:Adult; D003361:Cost Allocation; D004465:Economic Competition; D017598:Efficiency, Organizational; D017050:Episode of Care; D006801:Humans; D007445:Inventories, Hospital; D008421:Materials Management, Hospital; D008875:Middle Aged; D009874:Operations Research; D019982:Organizational Case Studies; D018802:Patient-Centered Care; D017064:Process Assessment, Health Care / Q000191:economics / Q000379:methods*; D040841:Resource Allocation; D017748:Time Management; D013996:Time and Motion Studies