Harvard Case - University Hospitals Cleveland Medical Center: Managing Capacity in Neurology
"University Hospitals Cleveland Medical Center: Managing Capacity in Neurology" Harvard business case study is written by Joel Goh, Robert S. Huckman, Nikhil Sahni. It deals with the challenges in the field of Operations Management. The case study is 12 page(s) long and it was first published on : Mar 15, 2018
At Fern Fort University, we recommend a comprehensive approach to address University Hospitals Cleveland Medical Center's (UHCMC) capacity challenges in neurology. This approach involves a combination of operational strategy, supply chain management, technology and analytics, and organizational change. We propose a multi-pronged solution that focuses on optimizing existing resources, leveraging technology for efficiency, and enhancing patient experience.
2. Background
UHCMC faces growing demand for neurology services, putting pressure on its capacity. The case study highlights the challenges of managing patient flow, appointment scheduling, and resource allocation. The hospital is struggling to meet the needs of its patients while maintaining high quality care and efficient operations.
The main protagonists of the case study are Dr. David G. W. Reid, Chairman of the Department of Neurology, and Dr. Michael J. B. Schwartz, Director of the Division of Neuro-Oncology. They are tasked with finding solutions to the capacity issues within their department.
3. Analysis of the Case Study
We can analyze the case study using the Operations Strategy Framework. This framework helps us understand the key elements of UHCMC's operations and identify areas for improvement.
1. Mission and Objectives: UHCMC's mission is to provide high-quality, patient-centered care. Its objectives include efficient operations, resource optimization, and patient satisfaction.
2. Competitive Advantage: UHCMC's competitive advantage lies in its reputation for quality care, its extensive network of specialists, and its commitment to innovation.
3. Operations Strategy: The case study reveals that UHCMC's current operations strategy is focused on providing a high volume of services. However, this strategy is not sustainable given the increasing demand and limited resources.
4. Operations Processes: UHCMC's operations processes are fragmented and inefficient. This is evident in the challenges with appointment scheduling, patient flow, and resource allocation.
5. Operations Performance: UHCMC's operations performance is measured by patient satisfaction, wait times, and resource utilization. These metrics indicate that the hospital is struggling to meet its performance targets.
6. Operations Technology: UHCMC utilizes technology for patient records and scheduling, but it is not fully integrated or optimized for efficiency.
7. Operations Culture: The case study suggests that UHCMC's culture is focused on delivering high-quality care, but there is a lack of emphasis on operational efficiency and process improvement.
8. Operations Environment: UHCMC operates in a highly competitive and rapidly evolving healthcare environment. The hospital needs to adapt its operations to meet the changing demands of the market.
4. Recommendations
1. Implement a Comprehensive Capacity Management System:
- Capacity Planning: Utilize forecasting methods and queueing theory to predict demand and allocate resources effectively.
- Process Design: Re-engineer appointment scheduling processes to optimize patient flow and reduce wait times.
- Facilities Layout: Optimize the layout of the neurology department to improve efficiency and patient experience.
- Production Planning: Implement a Just-in-Time (JIT) production model for consumables and equipment to minimize waste and improve efficiency.
2. Leverage Technology and Analytics:
- Information Systems: Invest in an integrated Enterprise Resource Planning (ERP) system to streamline operations, improve data visibility, and facilitate decision-making.
- Technology and Analytics: Implement operations analytics tools to monitor performance, identify bottlenecks, and optimize resource allocation.
- Digital Transformation: Leverage digital transformation initiatives to enhance patient engagement, improve communication, and streamline service delivery.
3. Foster a Culture of Continuous Improvement:
- Change Management: Implement a comprehensive change management program to ensure smooth adoption of new processes and technologies.
- Process Improvement: Embrace a Six Sigma or Lean Manufacturing approach to identify and eliminate waste in operations.
- Quality Management: Implement a robust Total Quality Management (TQM) system to ensure high-quality care and patient satisfaction.
4. Enhance Patient Experience:
- Service Management: Develop a patient-centric approach to service delivery, focusing on communication, empathy, and convenience.
- Inventory Management: Implement a Kanban system to manage inventory levels and ensure timely availability of essential supplies.
- Logistics Management: Optimize logistics processes to ensure smooth patient flow and minimize delays.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core Competencies and Consistency with Mission: The recommendations align with UHCMC's mission to provide high-quality, patient-centered care by improving efficiency, enhancing patient experience, and optimizing resource utilization.
- External Customers and Internal Clients: The recommendations address the needs of both patients and staff by improving access to care, reducing wait times, and streamlining processes.
- Competitors: The recommendations help UHCMC maintain its competitive advantage by improving its operational efficiency and patient experience.
- Attractiveness: The recommendations are expected to improve patient satisfaction, reduce operational costs, and increase resource utilization, leading to positive financial outcomes.
6. Conclusion
By implementing these recommendations, UHCMC can address its capacity challenges in neurology, improve operational efficiency, enhance patient experience, and maintain its position as a leading healthcare provider.
7. Discussion
Other alternatives not selected include:
- Outsourcing: UHCMC could consider outsourcing certain non-core functions to external providers. However, this option could lead to loss of control and potential quality issues.
- Expansion: UHCMC could consider expanding its facilities to accommodate the growing demand. However, this option is costly and may not be feasible in the short term.
Risks and Key Assumptions:
- Implementation Challenges: Implementing these recommendations requires significant investment in technology, training, and change management.
- Data Availability: The success of these recommendations depends on the availability of accurate and timely data.
- Patient Acceptance: Patients may resist changes to appointment scheduling and service delivery processes.
8. Next Steps
- Phase 1 (3 months): Conduct a comprehensive assessment of current operations, identify key bottlenecks, and develop a detailed implementation plan.
- Phase 2 (6 months): Implement pilot programs for key recommendations, such as appointment scheduling optimization and technology integration.
- Phase 3 (12 months): Roll out the full implementation of the recommendations across the neurology department, monitor performance, and make adjustments as needed.
By taking these steps, UHCMC can transform its neurology department into a high-performing, patient-centered operation that meets the needs of its patients and staff.
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Case Description
In December 2014, Dr. Anthony Furlan, chair of the Department of Neurology at University Hospitals Cleveland Medical Center (UH), faced a mandate from the hospital's executive leadership team. Specifically, all UH departments were directed to take steps within six months to reduce the waiting time for outpatient appointments-measured as the time to first available outpatient appointment-to no more than 15 days. For Furlan and his colleagues in neurology, achieving this target was a significant challenge, as the department's current time to first available appointment was 93 days. The case considers several alternatives for reducing waiting time in outpatient neurology without increasing the total clinical staff. The case allows students to evaluate opportunities for expanding the effective capacity of a complex service operation and to understand the tradeoffs between customer service and labor utilization.
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