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Health care trends now point to a shift toward patient care that is process-driven. An adjustment to the logistical principles used by healthcare facilities to set up the stages of care during the course of treatment would be ideal for the smooth implementation of this innovative trend (Vos, Groothuis, & van Merode, 2007). When constructing a new hospital, there are opportunities to integrate novel ideas and create designs that adhere to required logistical concepts (Roth & Menor, 2003). This study analyzes a hospital design case study while taking into account the evaluation strategy used to rate the design layout, accounting for the operations management choices, and coming to the right layout recommendations in the conclusion.
Designing new hospitals is purposed to improve on efficiency and enhance service provision to patients. Designing a layout is a challenging undertaking due to future uncertainties that have to be factor in the designing process. These factors may include future patient numbers, the patient volume composition and the technologies that may be integrated in latter periods. These factors are considered to prevent operational failures and reduce inefficiency in the new hospital. Operational failures which result in "breakdowns in internal supply chains that prevent work from being completed," are the main challenges faced by hospitals (Tucker, Heisler, & Janisse, 2014). Hospital personnel have up to 10% of their time consumed by the negative effects of such failures. Hence the need to ensure that hospital design layouts account for as many variables as possible to reduce cases of operational failure as soon as the hospitals are built and functional.
An operations management perspective of a hospital requires maximizations of output – delivery of service to patients – with the available resources. This is done while taking account of different service delivery requirements which include appointments, emergencies/urgent or the semi-urgent patient needs (Vos et al., 2007). Hence, there is need to realize short output times and movement distances in the building locations. Hospitals have all their elements related to each other; from corridors, consultation and examination rooms, the reception areas and the waiting facilities. The hospital design layout ensures that all these elements have the capacity to accommodate future changes in the general factors being considered (Vos et al., 2007). Hence the design layout in essence is an attempt to create the most appropriate floor plan in accordance with projections for the future situational developments.
In this particular case study, a method of evaluation that involves discrete event simulation is employed. The steps in this evaluation method are; distinguishing the segments of the floor’s plan, determining the flow of goods and people, designing experiments, implementing the resulting model, and running the simulation experimenting and analysing the results. The hospital’s floor plan is represented as segments in the simulation model (Vos et al., 2007). The simulation is a model of the hospital’s estimated operational rates and has its variables changing at separate points of times. The simulation model contains an estimated number of goods and people expected at normal functioning capacity. The segments are designated as locations with limited capacity.
The number of people present in a given segment is provided by the simulation as a performance indicator of the maximum value of the number of people present in a segment at the same time (Vos et al., 2007). The floor plan is then designed to be able to support the number of people represent by this figure. Additionally, the simulation model offers the number of times the maximum capacity can be exhausted in given timeslots. This is done by setting up experiments to investigate flow intensity and direction of movement. Such experiments are set up to test the ability to adapt to developments.
In this particular case, a merger of two hospitals will see that a new hospital is built in a new location. It is intended to introduce a '21st century airport' 'operations management concept' in the 'design of an outpatient clinic'(Vos et al., 2007). The discrete event model was appropriately implemented to investigate the hospital’s capacity and functionality. This was to be done in the sense that minimal space was to be maximized by centralizing waiting areas. The evaluation model was to test whether the design layout allows for efficient movement of people and goods (Roth & Menor, 2003).
The model as tested for functionality and the ability to meet future developments asserted its ability to support functionality. However, it also demonstrated that it fell short at meeting future developments since certain variables indicated over congestion at certain corridors in the hospital at certain times. This is because contrary to estimations, the centralized waiting rooms had the effect of affecting flow of movement within the corridors. Hence, according to the results, the hospital management is risking a great deal by building a hospital with limited flow of goods and people.
A look at the operation management decisions that were made in the evaluation were to ensure functionality and ability to adapt to future developments. By these criteria, the evaluation process was guided by a few decisions. First, was a look at maximum capacity of various segments, then the capacity to hold at the various timeslots and then followed by logistical concept considering technology and patient type variations (Vos et al., 2007). They should have also included future technology adaptations, flexible for a future in-patient facilities, and greater capacity in case an increase in the demand for services resulted in a corresponding increase in patients (Tucker et al., 2014).
In conclusion, the hospital model lacks in its ability to accommodate increased volumes sufficiently and thus the design layout requires a revision. I would recommend decentralized waiting rooms to increase flexibility in certain parts of the hospital. Additionally, I would also recommend the standardization of consultation room sizes to create more space for the waiting rooms thus reducing congestion.
Roth, A. V., & Menor, L. J. (2003). Insights into service operations management: a research agenda. Production and Operations management, 12(2), 145-164.
Tucker, A. L., Heisler, W. S., & Janisse, L. D. (2014). Organizational factors that contribute to operational failures in hospitals.
Vos, L., Groothuis, S., & van Merode, G. G. (2007). Evaluating hospital design from an operations management perspective. Health care management science, 10(4), 357-364.
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