title: Five focus strategies to organize health care delivery.
abstract: OBJECTIVE
  The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations.
  
  
  METHODS
  First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies.
  
  
  RESULTS
  The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes.
  
  
  CONCLUSIONS
  Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination.
  
  
  CONCLUSIONS
  Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization's strategy and key performance indicators.
  
  
  CONCLUSIONS
  Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.
authors.affiliation: Professor, Industrial Engineering and Management, Aalto University, Helsinki, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Peltokorpi
authors.forename: Miika
authors.initials: M
authors.lastname: Linna
authors.forename: Tomi
authors.initials: T
authors.lastname: Malmström
authors.forename: Paulus
authors.initials: P
authors.lastname: Torkki
authors.forename: Paul Martin
authors.initials: PM
authors.lastname: Lillrank
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational; D005260:Female; D005387:Finland; D017144:Focus Groups; D017408:Guidelines as Topic / Q000592:standards*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care
keywords: Demand management; Focused factory; Health care delivery; Production strategy; Service delivery; Supply management