Developing lean and agile health care supply chains

Abstract

Purpose -The objective of this exploratory paper is to find out what is important to consider when developing a supply chain in health care, what is required in order to establish a supply chain orientation and how lean and agile can be used as process strategies in order to improve supply chain performance. Design/methodology/approach -In order to build an empirical framework for using both lean and agile strategies in health care supply chain management illustrative examples are provided from a Swedish health care setting describing the patient flow and planning processes. Findings -Supply chain management has potential to work well as a philosophy for patient flow in the health care sector. However, it should not only be about the use of the concept of lean in health care, as in fact is the case in practice today. It is rather about organizing for quick response and flexibility in a hybrid strategy through combining lean and agile process strategies. This can only be done if a systems approach is applied together with a strategic orientation, where cooperative efforts by the supply chain members should synchronize and converge operational as well as strategic capabilities into a unified whole. Practical implications -The analysis in the paper underlines the importance of focusing on both agility and leanness combined. Hospitals or health care systems that introduce such an approach, as opposed to only relying on lean strategies, could gain both competitive advantages and improved performance. Originality/value -In health care, even more so than in the manufacturing industry, containment of costs without sacrificing quality is important. This paper applies SCM techniques, tools and concepts that have not been used previously for patient flow in a health care setting, combining lean and agile in one and the same analysis.

A comparative study of manufacturing and service sector supply chain integration via the uncertainty circle model

“…Similar issues face the service sector since increases in process service time uncertainty are posited to lead to less favourable customer responses and a decline in demand (Kumar and Krishnamurthy, 2008). While improving the yield ratios in manufacturing can reduce process uncertainty and improve delivery performance, in the service sector high utilisation (yield ratios) of resources can lead to long service times and queues when demand exceeds capacity (Aronsson et al, 2011;Di Mascio, 2007). Competing value chains are also generators of process uncertainty when they vie for the same resources and production capacity (Towill, 1999).…”

“…Competing value chains are also generators of process uncertainty when they vie for the same resources and production capacity (Towill, 1999). This can be extremely serious when a person's health is involved, since a patient can pass through several different healthcare value streams (specialist care centres) to receive treatment; leading to delays and potential service failure (Aronsson et al, 2011).…”

Discretion in the “Backyard of Law”: Case Handling of Debt Relief in Sweden

“…the organization's managers, legal policy staff and IT expertise (cf. Aronsson et al, 2011;Hall, 2012;Ley and Seelmeyer, 2008). Lipsky claimed that the frontline staff often work in situations "too complicated to reduce to programmatic formats," and when subjected to formalization they tend to "create capacities to act with discretion and hang on to discretionary capacities they have enjoyed in the past" (Lipsky, 1980, p. 15, 19).…”

“…It is obvious that the SEA reorganizations have been influenced by the general impact of NPM ideas in the Swedish public sector, encompassing both management bureaucracy practices such as case management systems, productivity-oriented performance measures, and even some "lean" principles focusing on "customer value" and "doing more with less" (cf. Aronsson et al, 2011;Hall, 2012). The question is to what extent these changes still leave space for interpretation and judgement.…”

Can locker box logistics enable more human-centric medical supply chains?

“…In such events, the supply chain needs to be agile, responding quickly in order to cater for demand. However, due to the structure of the healthcare supply chain which consists of an external chain (delivering goods to the hospital) and internal hospital chain (distributing delivered goods to end users throughout the hospital), the fast flow of goods is often stalled by the interface between the two (Aronsson et al 2011). …”