Creating Short-Term Volume Flexibility in Healthcare Capacity Management

Abstract

It is well-known that unpredictable variations in supply and demand of capacity in healthcare systems create the need for flexibility. The main tools used to create short-term volume flexibility in the healthcare system include overtime, temporary staff from internal calling lists, moving staff across units, internal staffing pools, external staffing agencies, queuing patients, and purchasing care from external providers. We study the creation of short-term volume flexibility in healthcare systems to manage short-term capacity losses and demand fluctuations. A questionnaire was developed and distributed among healthcare managers in the Region Västra Götaland healthcare system. Respondents were asked to what extent they used each tool to create short-term flexibility in capacity. Data were analyzed using multiple regression analysis. Several significant tendencies were found, including that acute units use overtime and internal staffing pools to a larger extent, and queuing patients and external providers to a lesser extent than planned units. The prerequisites and required managerial approaches used to efficiently manage aggregate capacity in the system differ substantially between different parts of the system. These differences must be addressed when, for example, capacity pools are considered. These results serve as a stepping stone towards a more thorough understanding of efficient capacity management in healthcare systems.

A systematic literature review on the utilization of extended operating room hours to reduce surgical backlogs

“…Table 1 contains four studies that analyze and discuss strategies to reduce waiting lists in non-surgical settings. These studies concern a variety of contexts in different countries, including primary care ( 16 , 18 ), outpatient clinics ( 17 , 18 ), hospital units ( 18 ), and imaging and radiology ( 19 ), and were conducted mostly before the COVID-19 pandemic ( 16 – 18 ). We observed that pre-COVID studies tend to perform deeper analysis and evaluations compared to post-COVID studies, in particular through data analysis.…”

Transforming health care systems towards high-performance organizations: qualitative study based on learning from COVID-19 pandemic in the Basque Country

“…One tool to address capacity shortages and increase operational exibility is to redeploy staff between units where they are quali ed to work, which requires a prior training process. For this, it is imperative that the types of services that can most bene t from such an approach are identi ed 35 . Sta ng plans that use exible deployments with a su ciently high number of staff are able to cope with peaks in demand and are cost-effective, as additional staff can contribute to units that require it 36 .…”

The other side of the crisis: organizational flexibility in balancing Covid-19 and non-Covid-19 health-care services

“…The focus on the imbalance between flexible and fixed resources has been explored mainly in theoretical terms for its implications for the performance of health-care services. For example, it has been argued that in a situation where the level of the demand exceeds the capacity of hospitals to deliver health-care services, organizational efficiency will depend on the capacity to protect internal routes with a buffer of focused resources and to proactively deploy flexible resources using various routes according to the type of excess demand [ 28 ].…”

“…This is evident because although reconfiguration models vary in degree, they often require an economic effort at the development stage. Flexibility is considered key in determining efficient demand management, and, it has been seen as a means to manage peak demand and to address a certain amount of volume flexibility [ 28 ].…”