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Biomedical subjects

J M Vissers

Publications and source records attributed to J M Vissers.

4 recordsLinked to original sources

Towards decision support for waiting lists: an operations management view.

This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare--national, regional, hospital and process--that each contributes to the existence of waiting lists through managerial decision making. In addition, different underlying mechanisms in demand and supply are distinguished, which together explain the development of waiting lists. It is our contention that within this framework a series of situation specific models should be designed to support communication and decision making. This is illustrated by the modelling of the demand for cataract treatment in a regional setting in the south-eastern part of the Netherlands. An input-output model was developed to support decisions regarding waiting lists. The model projects the demand for treatment at a regional level and makes it possible to evaluate waiting list impacts for different scenarios to meet this demand.

Cataract Extraction↗

Health care management modelling: a process perspective.

Modelling-based health care management ought to become just as popular as evidence based medicine. Making managerial decisions based on evidence by modelling efforts is certainly a step forward. Examples can be given of many successful applications in different areas of decision making: disease process modelling, screening and prevention policy development, resource allocation, waiting lists and waiting times, patient scheduling. Also examples can be given which would have benefited by prior modelling, for example adverse effects of health care system reform decisions. This contribution aims at giving an overview of health care management modelling areas, and observations from a European perspective on developing successful health care management models. The overview is created by presenting different reference frameworks for mapping health care management modelling applications. We report a development from an almost arbitrary list of applications used for bibliographic purposes (scheduling, simulation, queueing, etc.) towards frameworks that focus on the process of delivery. The advantage of mapping modelling applications in this way is that we are able to position contributions within a reference framework with a focus on processes, with the patient process at the top. The acceptance of process-orientation as a basis for modelling has consequences for the way models are developed. Close cooperation between modeller and manager and a profound insight into the dynamics of the modelling area concerned are important requirements for developing successful models. This is illustrated for waiting lists as an area of modelling.

Decision Making, Organizational↗

Patient flow based allocation of hospital resources.

The current practice of allocating resources within a hospital introduces peaks and troughs in the workloads of departments and leads therefore to loss of capacity. This happens when requirements for capacity coordination are not adequately taken into account in the decision making process of allocating resources to specialties. The first part of this research involved an analysis of the hospital's production system on dependencies between resources, resulting in a number of capacity coordination requirements that need to be fulfilled for optimized resource utilization. The second, modelling, part of the study involved the development of a framework for resource management decision making, of a set of computer models to support hospital managerial decision making on resource allocation issues in various parts of the hospital, and of an implementation strategy for the application of the models to concrete hospital settings. The third part of the study was devoted to a number of case-studies, illustrating the use of the models when applied in various resource management projects, such as a reorganization of an operating theatre timetable, or the development of a master plan for activities of a group of general surgeons serving two locations of a merged hospital system. The paper summarizes the main findings of the study and concludes with a discussion of results obtained with the new allocation procedure and with recommendations for future research.

Bed Occupancy↗