Waiting time is inherent to the healthcare service sector in India and a major challenge faced by almost every big hospital is queuing. Long waiting time can be a reflection of inefficiency in hospital operations. The outpatient department (OPD) has the biggest queue as compared to other departments in hospital operations. This study comprises of in-depth analysis of OPD from different dimensions. Like in many big hospitals across India, the OPD of Fortis Escorts Hospital in Jaipur, India is managed using experience and rule of thumb rather than strategic research-based techniques such as queuing theory. The Fortis Escorts Hospital in Jaipur receives a large number of patients each day which results in longer waiting time for patients due to long queues. To address this challenge, a SWOT analysis was conducted for the OPD of Fortis Escorts Hospital Jaipur (FEHJ) which resulted into dissecting the queuing problem and coming out with solutions knowing where the hospital operations can excel and where there is a scope of improvement to make the working and processes better. Additionally, after examining the problem analytically and applying queuing theory, measures were suggested to improve the delay points and make the OPD more efficient in order to gain a high patient satisfaction rating.

The hospitals over the last few years have been facing major issues and challenges; the patients aspire world-class health care quality delivery while state and health insurance companies demand the delivery at the lowest price. Lean which eliminates the waste and Six Sigma which decreases the variation in hospital processes are complementary quality improvement tools that can help to achieve these goals. The lean principles have been now successfully applied to the delivery of health care over the last few years. Lean management primary begins with underlying principle of eliminating waste. In order for lean methodology to be successful and able to enhance the operations the hospital must first work to create an organizational culture that is receptive to lean thinking. The commitment to start lean must start from the top management, and the junior staff must be involved. Whether manufacturing a car or delivering health care to a patient, the industry worker or health personal relies on multiple, disorganized, chaotic and complex in-built system and processes to accomplish the goal to deliver value to the customer or patient. It is a widely held dictum that once the lean principles are applied rigorously and throughout an entire organization, it can have a positive impact on productivity, cost, quality and timely delivery in a resource limited settings of Indian subcontinent. In hospital industry, the operational efficiency means rapid access to care, minimum waiting time while at the same time delivering defect free quality care at the minimum cost. We believe the Lean Six Sigma (LSS) is a panacea management philosophy to overcome the burgeoning health and hospital industry challenges.

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Learning outcomes The learning outcomes are as follows: identify and evaluate the impact of risk factors for health-care organizations during crisis; evaluate the role of different organizational factors in building resilient health-care organizations; define organizational resilience in a health-care context; and apply the effect-strategy-impact resilience framework. Case overview / synopsis September 2022 found Ranjan Thakur, the Hospital Director at Manipal Hospital, Jaipur (MHJ) reflecting on MHJ’s resilience toward future health-care crises. MHJ was established in the capital city Jaipur of the Indian state of Rajasthan in 2014, as a 225-bed multispecialty unit of the nationally renowned Manipal Health Enterprises Ltd. As the Hospital Director, Thakur had been responsible for navigating his team and the hospital through the multiple health-care related challenges exacerbated by the multiple waves of the Covid-19 pandemic in a large Indian state with a sizable rural and semiurban population. Though Thakur and his team of doctors had worked through the vulnerabilities of their health-care ecosystem, mapping the risks and mitigating the same, Thakur asked himself if they had done enough. He wondered how a health-care institution such as theirs could sustain effective health-care delivery during future crises situations to deliver high-quality health care to the vulnerable communities. Had they effectively mapped MHJ’s vulnerabilities and built resilience into the hospital’s functioning? The backdrop of the case is public health in the state of Rajasthan (Jaipur), and the case is rich in detailing social factors such as behavior issues of patients, doctors and nurses; operational factors such as standardization of treatment and standard operating procedures, availability of resources, clinical concerns; leadership and management of the hospital through the pandemic. This case can be used by instructors to teach organizational resilience building in the health-care context. Complexity academic level Graduate- and executive-level courses in managing change during crisis in health-care context; health-care management/leadership. Supplementary materials Teaching notes are available for educators only. Subject code CSS 7: Management Science.