Understanding production and capacity planning in healthcare

Abstract

Healthcare organizations and systems are increasingly facing many challenges, such as struggling with patients in ques, waiting to get an appointment for surgery. Most long waiting times are only getting worse because of the COVID-19 pandemic. More so, the COVID-19 pandemic has led to cancelations of thousands of surgeries and the care burden is growing large. The flow efficiency in Swedish hospitals is in need of improvement and has been a well-known problem on a national and regional level for years. Low flow efficiency has been hard to improve due to the existence of variation in demand as well as in production and capacity at various system levels. More specifically, understanding and balancing variation over time regarding demand (i.e., the inflow of patients) versus the production and capacity to manage these patient flows is key to an improved flow efficiency on an operational level. Based on the empirical material, possible areas of improvement are suggested to better plan production and capacity so that it matches inflow. This thesis was conducted by developing a theoretical framework consisting of literature regarding variations, flow theory, Lean Healthcare and Improvement Science. Moreover, questionnaires and semi-structured interviews were performed with an aim to develop conceptual understanding of the healthcare environment. This study agrees with the common idea that an adequate flow efficiency is difficult to achieve, as well as a sustainable production and capacity planning (PCP), due to the presence of variation. Amongst several findings, communication and collaboration between various professions has shown to be a barrier when trying to achieve a well thought out PCP. At the same time, communication, collaboration and understanding of each other's professions is key to be able to conduct sustainable improvements. Practically, this study has identified barriers regarding PCP in healthcare and suggestions of how to come to terms with these. Theoretically, this study has illuminated the shortage in Lean Management, Lean Healthcare, as well as Improvement Science literature regarding soft values, such as collaboration and communication. Also, there was no clear connection between Lean Management, Lean Healthcare or Improvement Science regarding PCP. Moreover, this paper provides evidence that there are still different, sometimes conflicting, perspectives in healthcare. The findings of this study are relevant for various healthcare organizations as well as for researchers in the area of PCP and Improvement Science in a healthcare context.