Improving the Flow of Patients Through Healthcare Organizations

Tactical capacity planning under uncertainty - a capacity limitation analysis

PURPOSE

Tactical capacity planning is crucial when hospitals must cope with substantial changes in patient requirements, as recently experienced during the Covid-19 pandemic. However, there is only little understanding of the nature of capacity limitations in a hospital, which is essential for effective tactical capacity planning.

DESIGN/METHODOLOGY/APPROACH

We report a detailed analysis of capacity limitations at a Norwegian tertiary public hospital and conducted 22 in-depth interviews. The informants participated in capacity planning and decision-making during the Covid-19 pandemic. Data are clustered into categories of capacity limitations and a correspondence analysis provides additional insights.

FINDINGS

Personnel and information were the most mentioned types of capacity limitations, and middle management and organizational functions providing specialized treatment felt most exposed to capacity limitations. Further analysis reveals that capacity limitations are dynamic and vary across hierarchical levels and organizational functions.

RESEARCH LIMITATIONS/IMPLICATIONS

Future research on tactical capacity planning should take interdisciplinary patient pathways better into account as capacity limitations are dynamic and systematically different for organizational functions and hierarchical levels.

PRACTICAL IMPLICATIONS

We argue that our study possesses common characteristics of tertiary public hospitals, including professional silos and fragmentation of responsibilities along patient pathways. Therefore, we recommend operations managers in hospitals to focus more on intra-organizational information flows to increase the agility of their organization.

ORIGINALITY/VALUE

Our detailed capacity limitation analysis at a tertiary public hospital in Norway during the Covid-19 pandemic provides novel insights into the nature of capacity limitations, which may enhance tactical capacity planning.

Sustainable Supply Chain Management Practices and Sustainable Performance in Hospitals: A Systematic Review and Integrative Framework

Hospital supply chains are responsible for several economic inefficiencies, negative environmental impacts, and social concerns. However, a lack of research on sustainable supply chain management specific to this sector is identified. Existing studies do not analyze supply chain management practices in an integrated and detailed manner, and do not consider all sustainable performance dimensions. To address these gaps, this paper presents a systematic literature review and develops a framework for identifying the supply chain management practices that may contribute to sustainable performance in hospitals. The proposed framework is composed of 12 categories of management practices, which include strategic management and leadership, supplier management, purchasing, warehousing and inventory, transportation and distribution, information and technology, energy, water, food, hospital design, waste, and customer relationship management. On the other side, performance categories include economic, environmental, and social factors. Moreover, illustrative effects of practices on performance are discussed. The novelty of this document lies in its focus on hospital settings, as well as on its comprehensiveness regarding the operationalization of practices and performance dimensions. In addition, a future research agenda is provided, which emphasizes the need for improved research generalizability, empirical validation, integrative addressing, and deeper analysis of relationships between practices and performance.