A Clinics Operation Queue Vanished, Thanks to Modern Production Planning

"I got involved in the area because of all the frustration I have experienced in healthcare over the years," he says. "There is a great need for improved production planning. The greatest need in healthcare is not medical, it is organisational."

The surgery clinic in Skövde was a fairly typical hospital clinic a few years ago. Its queue for operations was an average of 120 days long. Staff worked hard and had a high level of stress, but they found resolving the situation difficult, and planning processes were poorly developed.

An improvement project was launched at the clinic in spring 2010. Anders Plantin was given the role as project manager at the same time that he initiated a study on change in his role as researcher.

When the study was completed two years later, it was clear that the project had generated very positive and concrete results. The clinic did not receive additional resources during the period, but the duration of the operation queue is currently down to 30 days on average. This is exactly the right amount of time to be able to match operation times with the right patients. Staff do not feel like their workload has increased, but rather that work is more evenly distributed with fewer overloaded days.

"It is not a matter of people hustling even more," says Anders Plantin. "And the project did not arise as a result of demands to save money; rather, it arose based on a decision to train employees in improvement. The change was propelled by the employees' personal commitment. I believe this is crucial for sustainable change."

The improvement project consisted of several different processes and measures (see fact box). One concrete example is that there is a more constant number of surgeons on duty at the operation ward. The number of surgeons previously varied between 2 and 8, while the number of other staff in the operating rooms was more constant. The number of physicians was generally the limiting factor.

Anders Plantin is a PhD student at the Centre for Healthcare Improvement (CHI) research centre at Chalmers, where organisational problems in healthcare are addressed. Understanding of production planning, for example, has been developed in the manufacturing industry for over 50 years. Researchers at CHI are working to adapt know-how from industry so it can be transferred to the realities of healthcare – something that will become increasingly important in the future as the challenges faced by healthcare continue to grow due to an ageing population, amongst other things.

CHI's director Andreas Hellström says there are enormous opportunities for improvement in Swedish healthcare in the same way that the surgery clinic improved in Skövde.

"Several studies show that 20 to 30 per cent of healthcare costs arise due to poor efficiency," he says. "These are the first costs that must be eliminated, rather than resorting to general cutbacks. A great deal can be achieved through modern know-how on quality, logistics and organisation." -- Chalmers