The Logics Of Healthcare

Most of the current literature on healthcare operations management is focused on importing principles and methods from manufacturing. The evidence of success is scattered and nowhere near what has been achieved in other industries. This book develops the idea that the logic of production, and production systems in healthcare is significantly different. A line of thing that acknowledges the ingenious characteristics of health service production is developed. This book builds on a managerial segmentation of healthcare based on fundamental demand-supply constellations. Demand can be classified with the variables urgency, severity, and randomness. Supply is constrained by medical technology (accuracy of diagnostics, efficacy of therapies), patient health behavior (co-creation of health), and resource availability. Out of this emerge seven demand-supply-based operational types (DSO): prevention, emergencies, one-visit, electives, cure, care, and projects. Each of these have distinct managerial characteristics, such as time-perspective, level of co-creation, value proposition, revenue structure, productivity and other key performance indicators (KPI). The DSOs can be envisioned as platforms upon which clinical modules are attached. For example, any Emergency Department (ED) must be managed to deal with prioritization, time-windows, agitated patients, the necessity to save and stabilize, and variability in demand. Specific clinical assets and skill-sets are required for, say, massive trauma, strokes, cardiac events, or poisoning. While representing different specialties of clinical medicine they, when applied in the emergency – context, must conform to the demand-supply-based operating logic. A basic assumption in this book is that the perceived complexity of healthcare arises from the conflicting demands of the DSO and the clinical realms. The seven DSOs can neatly be juxtaposed on the much-used Business Model Canvas (BMC), which postulates the business model elements as value proposition; customer segments, channels and relations; key activities, resources and partners; the cost structure; and the revenue model.

Most of the current literature on healthcare operations management is focused on importing principles and methods from manufacturing. The evidence of success is scattered and nowhere near what has been achieved in other industries. This book develops the idea that the logic of production, and production systems in healthcare is significantly different. A line of thing that acknowledges the ingenious characteristics of health service production is developed. This book builds on a managerial segmentation of healthcare based on fundamental demand-supply constellations. Demand can be classified with the variables urgency, severity, and randomness. Supply is constrained by medical technology (accuracy of diagnostics, efficacy of therapies), patient health behavior (co-creation of health), and resource availability. Out of this emerge seven demand-supply-based operational types (DSO): prevention, emergencies, one-visit, electives, cure, care, and projects. Each of these have distinct managerial characteristics, such as time-perspective, level of co-creation, value proposition, revenue structure, productivity and other key performance indicators (KPI). The DSOs can be envisioned as platforms upon which clinical modules are attached. For example, any Emergency Department (ED) must be managed to deal with prioritization, time-windows, agitated patients, the necessity to save and stabilize, and variability in demand. Specific clinical assets and skill-sets are required for, say, massive trauma, strokes, cardiac events, or poisoning. While representing different specialties of clinical medicine they, when applied in the emergency - context, must conform to the demand-supply-based operating logic. A basic assumption in this book is that the perceived complexity of healthcare arises from the conflicting demands of the DSO and the clinical realms. The seven DSOs can neatly be juxtaposed on the much-used Business Model Canvas (BMC), which postulates the business model elements as value proposition; customer segments, channels and relations; key activities, resources and partners; the cost structure; and the revenue model.

**Shortlisted for the BSA Sociology of Health and Illness Book Prize 2010** What is good care? In this innovative and compelling book, Annemarie Mol argues that good care has little to do with 'patient choice' and, therefore, creating more opportunities for patient choice will not improve health care. Although it is possible to treat people who seek professional help as customers or citizens, Mol argues that this undermines ways of thinking and acting crucial to health care. Illustrating the discussion with examples from diabetes clinics and diabetes self care, the book presents the 'logic of care' in a step by step contrast with the 'logic of choice'. She concludes that good care is not a matter of making well argued individual choices but is something that grows out of collaborative and continuing attempts to attune knowledge and technologies to diseased bodies and complex lives. Mol does not criticise the practices she encountered in her field work as messy or ad hoc, but makes explicit what it is that motivates them: an intriguing combination of adaptability and perseverance. The Logic of Care: Health and the problem of patient choice is crucial reading for all those interested in the theory and practice of care, including sociologists, anthropologists and health care professionals. It will also speak to policymakers and become a valuable source of inspiration for patient activists.

This book offers an overview of service design practices for healthcare and hospital management. It explores how these practices can help to generate innovations in healthcare and contribute to the improvement of patient-centered care. Respected experts, including scholars from various disciplines and practitioners from healthcare institutions, share essential insights into established research areas, fields of work and work structures, and discuss successful approaches, methods and tools. By illustrating innovative services, products, processes, systems, and technologies, as well as their application in practice, the authors highlight the role of participating stakeholders in service design projects and the added value that comes from sharing, communicating, networking and collaborating. This book is a must-read for scholars and practitioners in the hospital and healthcare sector. It will also appeal to anyone interested in organizational development, service business model innovation, customer involvement and perceptions, and service experience.

Health care reform has become one of the most prevalent topics in recent policy discourse within and across nations. In the 1990s, common features of the health care arena elevated the importance of bargaining relationships among large, sophisticated entities as the dominant mode of decision-making, fundamentally challenging the traditional dominance of the medical profession, which had been grounded in individualized "agency" relationships between providers and patients. These developments have played out in varying ways around the globe. Carolyn Hughes Tuohy looks at the experiences of the United States, Britain, and Canada, offering an international comparative study of public policy systems, as well as a recent history of the evolution of each national health care system. What drives change in health care systems? Why do certain changes occur in some nations and not in others? Tuohy argues that the answer lies in understanding the "accidents" of history that have shaped national systems at critical moments and in the distinctive "logics" of these systems. Her study carefully delineates both the common logic of the health care arena, deriving from micro-economic characteristics and technological change, and the particular logics of national systems, put in place by specific episodes of policy change. She goes on to explore how in the wake of these episodes, the mixed market in the United States, hierarchical corporatism in Britain, and the single-payer system in Canada determined the subsequent direction and pace of change in all three countries. Finally, Tuohy provides suggestions to guide the strategic judgments that decision-makers must make within the health care system of each country. Accidental Logics uniquely departs from the descriptive literature currently available by presenting an extensive review of the evidence regarding the evolution of the health care arenas in the United States, Britain, and Canada, integrated within an explanatory framework. It is essential up-to-date reading for political scientists working in comparative politics and public policy, health policy analysts, government agency officials, and students in political science, health policy, and administration programs.

Looks at the USA, Britain and Canada to offer an international comparative study of public policy systems, as well as a recent history of the evolution of each national health care system. The book explores what drives change and why certain changes occur in some nations and not in others.

Looks at the USA, Britain and Canada to offer an international comparative study of public policy systems, as well as a recent history of the evolution of each national health care system. The book explores what drives change and why certain changes occur in some nations and not in others.