Lesson 5: Resource Allocation & Workforce Scheduling

Healthcare resources & characteristics

Leading & Following Resources

Bottleneck Resources

Dedicated & Shared Resources

Continuous/Intermittently available resources

Dedicated - used for single patient group/specialty (e.g. cardiac doctor is allocated to care for cardiac patients only)

Shared - used by a number of patients (general)

Reasons: costs, quality & control of use - can be further divided into time-shared resources (e.g. operating theaters) & other shared resources (ICU)

Leading triggers the generating production on other resource that follow

Allocation capacity (leading resources) generates capacity requirements (following resources)

Insufficient capacity is allocated to following resources - whole health care pricess will be negatively affected

e.g. patient referred to CT scan after consulting doctor in outpatient clinic

scarce resource & determine overall productivity (e.g. specialist-time in outplatient clinics)

maximise use of bottleneck resources

Bottleneck resources are not necessarily leading resources (e.g. inpatient be capacity is a bottleneck resource but not a leading resource)

Available on continuous basis - EMD/Inpatient beds

Intermittent reosurces are only available during specified period (e.g. outpatient clinics)

Workforce Scheduling

Process in healthcare service requires some form of labor (e.g. nurses, patient service associate)

it must be in the right place, right time and right capacity (quantity) - organization to run smoothly & efficiently

Demand for care & expectations for service delivery are increasing but budgets & labor constraints do not allow unlimited resources to be expanded at all times

Must have balance between the level of service offered and level of utilization resources (e.g. nursing staff - at least have 1 or 2 staff nurse in one shift)

Workforce Scheduling (5 factors)

Schedule Quality - How well staff likes the plan?

Stability - Can staff count on predictable schedules?

Coverage - How well patients' needs are met?

Flexibility - Can schedule adapt to changes

Cost - Would an alternative offer better care at lower cost?

Job Sequencing

Definition

4 most popular priority rules

Important aspects of scheduling

Allocates jobs to relevant health care activities/centers and specifies the order in which jobs are to be performed

Prioritized according to a set of priority rules that try to minimize completion time, number of jobs and job lateness while maximizing facility utilization

FCFS (First come first serve)

SPT (Shoertest processing time)

EDD (earliest due date)

LPT (longest processing time)

Best priority rules?

Depends on objective

EDD - works well for jobs that have very heavy penalty on lateness

FCFS appears fair to customers (important in service systems)

LPT applies to industries in which high valued customers are given priority

SPT - minimize job flow & minimizing average numbers of jobs in the system
Disadvantage: long duration jobs may be continuously pushed back and customers may view this dimly