Capacity and Process Management

what is included in capacity and process mgmt?

health services operations mgmt and financial mgmt

what are the levels of planning for capacity management?

strategic choices (right resources, correct quantity), tactical mgmt (allocation of resources), ops planning (scheduling of patients)

describe strategic choices

right resources and correct quantity

describe tactical mgmt

allocation of resources

describe ops planning

scheduling of patints

list the steps of the design cycle

problem definition, analysis and diagnosis, solution design, intervention, evalutation (problem mess at center)

give examples of predictable variation

seasonal patterns, supply chain (leading and following capacities), differences in patient complexity

give examples of unpredictable variation

fluctuation in demand, fluctuation in capacity, fluctuation in time needed for activity

strategies for addressing variability

predict, variation reduction, buffering

what are the implications of turnover time being treated as utilized

no incentive for speed

which includes turnover, gross or net?

gross (bigger)

what is ehrlang loss model used for

balancing capacity and demand (calculating utilization and refused admissions)

what are the inputs and outputs for the Erhlang Loss Model

inputs: arrival, LOS, number of beds outputs: utilization, refusals

In a supply chain, does more variation within units tend to increase or decrease the output?

decrease

in a supply chain, does more variation within units tend to increase or decrease expected work in progress?

increase

explain links between operational and financial performance

investments needed for core business, which earns cash for financing, which are used to purchase investments

what type of model is an EOQ

deterministic analytical model

what type of model is the newsvendor model

stochastic analytical model

what is the goal of the newsvendor model

balance demand and capacity (missed revenue or idle capacity costs)

does the newsvendor model require a uniform distribution

no

what are the consequences of understaffing

customer refusal, long wait times, adverse patient outcomes

consequences of overstaffing

wasted resources (unless backlog), disengaged staff

how is modeling used in ops mgmt

models represent part of reality are used to understand, change, manage, and control

what are the steps for using a model in ops mgmt

clarify the purpose, build the model, validate BEFORE use, transform results into info

what does clarifying the purpose of the model entail

descriptive - how is it behaving, prescriptive - what should be done

what are the steps for building the model

think, decide on technique, collect data, analyze data

how to validate model before use

check with internal structure (capture what its supposed to do), outputs correspond to reality

what does eoq inform

how much to order? when to reorder?

what are the assumptions of EOQ

constant demand (D), constant lead time (L), constant purchasing cost per unit (C), constant ordering cost (K), inventory holding costs based on avg inventory Q/2 (H), all demand satisfied and no stockouts allowed (no shortage costs incurred)

how to get Z score

NORM.S.INV(service level)

what is the customer order decoupling point

point in chain when product is tied to specific customer

supply chain steps

engineer, fabricate, assemble, deliver

when does the supply chain move from forecast driven to customer driven

customer order decoupling point

what is the effect of variation in supply chains

smaller variation leads to better process performance

what are the purposes of statistical process control

determine whether process is performing as expected and differentiate between random and systemic performance variation

what are solutions to the bullwhip effect in a chain

info sharing, reduce safety stock (smaller order quantities, fast and reliable delivery), centralization

what are economies of scale

as capacity increases, the avg cost to produce decreases

what are the implications of increase in scale

decrease in avg pp cost, learning, economies of pooling, increase in patient heterogeneity

economies of scope meaning

cost savings from one org producing related services rather than separate orgs

implications in increase in scope

increase in service specific assets and human capital, learning effects, increase in different routines, increase in patient heterogeneity

what are characteristics of solution shops

customization: manage varying needs, collab problem solving, multiple stakeholders and collective responsibility, culture and tacit knowldge drive performance

what is the key to solution shops

disease group concentration

value adding processes

standardized: emphasis on reducing variation, compliance to protocol, hierarchy and individual responsibility, knowledge codified/embedded

what is the key to value adding processes

create economies of scale

name for alternative to current approach to complex v routine

separate and concentrate

approaches for hc at process level

separate and select, separate and accomodate, modularize, integrated

factors for choosing approach to specialization v customization

level of understanding/best practices for condition, stability/comorbidities, org infrastructure (consider doctor ability to design care)