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Introduction

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Healthcare Service Management

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Abstract

A healthcare service system is complex in nature largely because of its interacted autonomous entities, such as patients and service providers. Partially due to this reason, a healthcare service system may exhibit certain complex phenomena, such as periodically emptying the queue for specific services, which may result in unreasonable service performance that is quite different from managers’ expectations. Therefore, proposing an approach to systematically understanding the healthcare services from a complex systems self-organizing perspective is of paramount importance in addressing many challenging healthcare service management problems, such as shortening long wait times, and figuring out the underlying reasons that account for the specific spatio-temporal patterns of wait times. This chapter first introduces a conceptual model for a healthcare service system with a brief review about its complex nature and the importance of the interactions between the factors and entities in the system. The commonly-faced healthcare service management problems in practice relating to wait times management are summarized. Then, it presents a data-driven complex systems modeling (D2CSM) approach, which includes the following four specific methods, i.e., Structural Equation Modeling (SEM)-based analysis, integrated prediction, service management strategy design and evaluation, and behavior-based autonomy-oriented modeling, to systematically understanding healthcare services and addressing the wait time management problems. Finally, this chapter introduces the profiles of the cardiac care system in Ontario, Canada, which is the research scenario in this book.

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Notes

  1. 1.

    Note: This figure was adapted from the open systems model [5, p. 90].

  2. 2.

    https://www.corhealthontario.ca/. Last accessed on April 11, 2019.

  3. 3.

    http://www.lhins.on.ca/home.aspx. Last accessed on April 11, 2019.

  4. 4.

    http://www12.statcan.gc.ca/census-recensement/2006/index-eng.cfm. Last accessed on April 10, 2019.

  5. 5.

    https://maps.google.com/.

References

  1. World Health Organization. Strengthening health systems to improve health outcomes: WHO’s framework for action. 2007. http://www.who.int/healthsystems/strategy/everybodys_business.pdf. Last accessed on April 11, 2019.

  2. O. Gallay. Agent-Based Routing in Queueing Systems: Self-Organization in Production and Service Networks: From Stylized Models to Applications. LAP Lambert Academic Publishing, 2010.

    Google Scholar 

  3. L.V. Bertalanffy. General System Theory: Foundations, Development, Applications, 1st ed. George Braziller, New York, 1969.

    Google Scholar 

  4. D. Katz and R.L. Kahn. The Social Psychology of Organizations. Wiley, 1978.

    Google Scholar 

  5. T.G. Cumming and C.G. Worley. Organization Development and Change, 9th ed. Cengage Learning, OH, USA, 2008.

    Google Scholar 

  6. Department of Health and Human Services Data Council, Centers for Disease Control and Prevention, National Center for Health Statistics, National Committee on Vital and Health Statistics. Shaping a health statistics vision for the 21st century. 2002. https://www.ncvhs.hhs.gov/wp-content/uploads/2014/05/21st-final-report.pdf. Last accessed on April 11, 2019.

  7. L.R. Hearld, J.A. Alexander, I. Fraser, and H.J. Jiang. How do hospital organizational structure and processes affect quality of care? A critical review of research methods. Medical Care Research and Review, 65(3):259–299, 2008.

    Article  Google Scholar 

  8. E. Warren. Final intervention report: An evidence-based approach to improving orthopedic flow and wait times. Ottawa: Canadian Health Services Research Foundation (CHSRF), 2012.

    Google Scholar 

  9. Office of the Auditor General of Ontario. 2009 annual report: 4.09 hospitals–management and use of surgical facilities. 2009. http://www.auditor.on.ca/en/content/annualreports/arreports/en09/409en09.pdf. Last accessed on April 11, 2019.

  10. Cardiac Care Network of Ontario. Access to urgent PCI for ST segment elevation myocardial infarction: Final report and recommendations. 2004. http://www.ccn.on.ca/ccn_public/UploadFiles/files/Access-To-Urgent-PCI-Final_20040705.pdf. Last accessed on August 15, 2017.

  11. S.F. Lakha, B. Yegneswaran, J.C. Furlan, V. Legnini, K. Nicholson, and A. Mailis-Gagnon. Referring patients with chronic noncancer pain to pain clinics. Canadian Family Physician, 57(3):e106–e111, 2011.

    Google Scholar 

  12. D.A. Alther, T.A. Stukel, and A. Newman. The relationship between physician supply, cardiovascular health service use and cardiac disease burden in Ontario: Supply-need mismatch. The Canadian Journal of Cardiology, 24(3):187–193, 2008.

    Article  Google Scholar 

  13. A.J. Bagnall, S.G. Goodman, K.A. Fox, R.T. Yan, J.M. Gore, A.N. Cheema, T. Huynh, D. Chauret, D.H. Fitchett, A. Langer, and A.T. Yan. Influence of age on use of cardiac catheterization and associated outcomes in patients with non-ST-elevation acute coronary syndromes. The American Journal of Cardiology, 103(11):1530–1536, 2009.

    Article  Google Scholar 

  14. P. Smith, J. Frank, and C. Mustard. Trends in educational inequalities in smoking and physical activity in Canada: 1974-2005. Journal of Epidemiology and Community Health, 63:317–323, 2009.

    Article  Google Scholar 

  15. A. Tramarin, S. Campostrini, K. Tolley, and F.D. Lalla. The influence of socioeconomic status on health service utilisation by patients with AIDS in North Italy. British Journal of Clinical Pharmacology, 45(6):859–866, 1997.

    Google Scholar 

  16. N.A. Christakis and J.H. Fowler. The spread of obesity in a large social network over 32 years. The New England Journal of Medicine, 257:370–379, 2007.

    Article  Google Scholar 

  17. R. Chunara, L. Bouton, J.W. Ayers, and J.S. Brownstein. Assessing the online social environment for surveillance of obesity prevalence. PLoS ONE, 8(4), 2013.

    Article  Google Scholar 

  18. Ontario Ministry of Finance. Long-term sustainability of Ontario public services. In Ontario’s Long-Term Report on the Economy, pages 43–54, 2010. http://www.fin.gov.on.ca/en/economy/ltr/2010/. Last accessed on April 11, 2019.

  19. J. Mackay and G. Mensah. The Atlas of Heart Disease and Strokes. World Health Organization, Geneva, 2004.

    Google Scholar 

  20. D.A. Alter, E.A. Cohen, W. Wang, K.W. Glasgow, P.M. Slaughter, and J.V. Tu. Cardiac procedures. In Access to Health Services in Ontario, 2nd., J.V. Tu, S.P. Pinfold, P. McColgan, and A. Laupacis, eds., Institute for Clinical Evaluative Sciences, Ontario, 2006. https://www.ices.on.ca/Publications/Atlases-and-Reports/2006/Access-to-health-services-2nd-ed. Last accessed on April 11, 2019.

  21. J.E. Seidel, C.A. Beck, G. Pocobelli, J.B. Lemaire, J.M. Bugar, and H. Quan. Location of residence associated with the likelihood of patient visit to the preoperative assessment clinic. BMC health services research, 6:13, 2006.

    Article  Google Scholar 

  22. S.L. Grace, A. Evindar, B.L. Abramson, and D.E. Stewart. Physician management preferences for cardiac patients: Factors affecting referral to cardiac rehabilitation. The Canadian Journal of Cardiology, 20(11):1101–1107, 2004.

    Google Scholar 

  23. Institute of Medicine. The Future of the Public’s Health in the 21st Century. The National Academies Press, Washington, DC, 2003.

    Google Scholar 

  24. B. Barua and N. Esmail. Waiting your turn: Wait times for health care in Canada. 2012. https://www.fraserinstitute.org/sites/default/files/waiting-your-turn-2012-rev.pdf. Last accessed on April 11, 2019.

  25. K. Resnicow and E.P. Page. Embracing chaos and complexity: A quantum change for public health. American Journal of Public Health, 98(8):1382–1389, 2008.

    Article  Google Scholar 

  26. L.A. Lipsitz. Understanding health care as a complex system: The foundation for unintended consequences. The Journal of the American Medical Association, 308(3):243–244, 2012.

    Article  Google Scholar 

  27. Cardiac Care Network of Ontario. Patient, physician and Ontario household survey reports: Executive summaries. http://www.ccn.on.ca/ccn_public/uploadfiles/files/ccn_survey_exec_sum_200508.pdf. 2005. Last accessed on August 15, 2017.

  28. H.C. Wijeysundera, T.A. Stukel, A. Chong, M.K. Natarajan, and D.A. Alter. Impact of clinical urgency, physician supply and procedural capacity on regional variations in wait times for coronary angiography. BMC Health Services Research, 10:5, 2010.

    Article  Google Scholar 

  29. H.A. Simon. Bounded rationality and organizational learning. Organization Science, 2(1):125–134, 1991.

    Article  Google Scholar 

  30. H.R. Priesmeyer and L.F. Sharp. Phase plane analysis: Applying chaos theory in health care. Quality Management in Health Care, 4(1):62–70, 1995.

    Article  Google Scholar 

  31. H.R. Priesmeyer, L.F. Sharp, L. Wammack, and J.D. Mabrey. Chaos theory and clinical pathways: A practical application. Quality Management in Health Care, 4(4):63–72, 1996.

    Article  Google Scholar 

  32. M. Arndt and B. Bigelow. Commentary: The potential of chaos theory and complexity theory for health services management. Health Care Management Review, 25(1):35–38, 2000.

    Article  Google Scholar 

  33. J.W. Begun and K.R. White. The profession of nursing as a complex adaptive system: Strategies for change. Research in the Sociology of Health Care, 16:189–203, 1999.

    Google Scholar 

  34. D.P. Smethurst and H.C. Williams. Self-regulation in hospital waiting lists. Journal of the Royal Society of Medicine, 95:287–289, 2002.

    Article  Google Scholar 

  35. J. Liu, X. Jin, and K.C. Tsui. Autonomy Oriented Computing: From Problem Solving to Complex Systems Modeling. Kluwer Academic Publishers, New York, 2004.

    MATH  Google Scholar 

  36. Institute of Medicine (US) Committee on Health and Behavior: Research, Practice, and Policy. Individuals and families: Models and interventions. In Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Washington (DC): National Academies Press (US), 2001. http://www.ncbi.nlm.nih.gov/books/NBK43749/. Last accessed on April 11, 2019.

  37. J.J. Mira, S. Lorenzo, and I. Navarro. Hospital reputation and perceptions of patient safety. Medical Principle and Practice, 23(1):92–94, 2014.

    Article  Google Scholar 

  38. D.P. Smethurst and H.C. Williams. Are hospital waiting lists self-regulating? Nature, 410:652–653, 2001.

    Article  Google Scholar 

  39. S.B. Buchbinder and N.H. Shanks. Introduction to Health Care Management, Second Edition. Jones and Bartlett Learning, MA, 2011.

    Google Scholar 

  40. World Health Organization. Building leadership and management capacity in health. 2007. http://www.who.int/management/FrameworkBrochure.pdf. Last accessed on April 11, 2019.

  41. T. Schoenmeyr, P.F. Dunn, D. Gamarnik, R. Levi, D.L. Berger, B.J. Daily, W.C. Levine, and W.S. Sandberg. A model for understanding the impacts of demand and capacity on waiting time to enter a congested recovery room. Anesthesiology, 110:1293–1304, 2009.

    Article  Google Scholar 

  42. P.I. Buerhaus, D.O. Staiger, and D.I. Auerbach. The Future of the Nursing Workforce in the United States: Data, Trends, and Implications. Jones and Bartlett Publishers, Boston, MA, 2009.

    Google Scholar 

  43. J. Liu, L. Tao, and B. Xiao. Discovering the impact of preceding units’ characteristics on the wait time of cardiac surgery unit from statistic data. PLoS One, 6(7):e21959, 2011.

    Article  Google Scholar 

  44. L. Tao, J. Liu, and B. Xiao. Effects of geodemographic profiles on healthcare service utilization: A case study on cardiac care in Ontario, Canada. BMC Health Services Research, 13:239, 2013.

    Article  Google Scholar 

  45. M. Knapman and A. Bonner. Overcrowding in medium-volume emergency departments: Effects of aged patients in emergency departments on wait times for non-emergent triage-level patients. International Journal of Nursing Practice, 16:310–317, 2010.

    Article  Google Scholar 

  46. C. Sanmartin, J.M. Merthelot, and C.N. Mcintosh. Determinants of unacceptable waiting times for specialized services in Canada. Healthcare Policy, 2(3):e140–e154, 2007.

    Google Scholar 

  47. J.F. Hair, R.E. Anderson, R.L. Tatham, and W.C. Black. Multivariate Data Analysis: With Readings, 5th ed. Pearson Prentice Hall, Englewood Cliffs, NJ, 1998.

    Google Scholar 

  48. R. Liu, L. So, S. Mohan, N. Khan, K. King, and H. Quan. Cardiovascular risk factors in ethnic populations within Canada: Results from national cross-sectional surveys. Open Medicine, 4(3):E143, 2010.

    Google Scholar 

  49. J. Li, L. Guo, and N. Handly. Hospital admission prediction using pre-hospital variables. In Proceedings of the 2009 IEEE International Conference on Bioinformatics and Biomedicine, Washington D.C., USA, pages 283–286, 2009.

    Google Scholar 

  50. M.L. McCarthy, S.L. Zeger, R. Ding, D. Aronsky, N.R. Hoot, and G.D. Kelen. The challenge of predicting demand for emergency department services. Academic Emergency Medicine, 15:337–346, 2008.

    Article  Google Scholar 

  51. P. Yi, S.K. George, J.A. Paul, and L. Lin. Hospital capacity planning for disaster emergency management. Socio-Economic Planning Sciences, 44:151–160, 2010.

    Article  Google Scholar 

  52. A. Ercole, D.K. Menon, and D.R. O’Donnell. Modelling the impact of pandemic influenza A(H1N1) on UK paediatric intensive care demand. Archives of Disease in Childhood, 94:962–964, 2009.

    Article  Google Scholar 

  53. S. Fomundam and J. Herrmann. A survey of queuing theory applications in healthcare. Technical report, The Institute for Systems Research, University of Maryland, 2007.

    Google Scholar 

  54. S.H. Jacobson, S.N. Hall, and J.R. Swisher. Application of discrete-event simulation in health care clinics: A survey. In Patient Flow: Reducing Delay in Healthcare Delivery, pages 211–252. Springer, R.W. Hall, eds., Springer, New York, 2006.

    Google Scholar 

  55. I. Ozkarahan. Allocation of surgical procedures to operating rooms. Journal of Medical Systems, 19(4):333–352, 1995.

    Article  Google Scholar 

  56. P.E. Plsek and T. Greenhalgh. The challenge of complexity in health care. BMJ, 323:625–628, 2001.

    Article  Google Scholar 

  57. The Complex Systems Modeling Group (CSMG). Modeling in Healthcare. American Mathematical Society, 2010.

    Google Scholar 

  58. K.E. Maani and R.Y. Cavana. Systems Thinking, System Dynamics: Managing Change and Complexity. Prentice Hall, Auckland, NZ, 2000.

    Google Scholar 

  59. Paranjape, R. and Sadanand, A. Multi-Agent Systems for Healthcare Simulation and Modeling: Applications for System Improvement. IGI Global, 2009.

    Google Scholar 

  60. D. Gefen, D.W. Straub, and M.C. Boudreau. Structural equation modeling and regression: Guidelines for research practice. Communications of the Association for Information Systems, 4:7, 2000.

    Article  Google Scholar 

  61. D.W. Gerbing and J.C. Anderson. An updated paradigm for scale development incorporating unidimensionality and its assessment. Journal of Marketing Research, 25:186–192, 1988.

    Article  Google Scholar 

  62. L. Liu. Autonomy-Oriented Computing: The nature and implications of a paradigm for self-organized computing. In Proceedings of the Fourth International Conference on Natural Computation, and the Fifth International Conference on Fuzzy Systems and Knowledge Discovery, pages 3–11, 2008.

    Google Scholar 

  63. J. Liu. Autonomous Agents and Multi-Agent Systems: Explorations in Learning, Self-Organization and Adaptive Computation. World Scientific Publishing, Singapore, 2001.

    Book  Google Scholar 

  64. Cardiac Care Network of Ontario. Cardiac surgery in Ontario: Ensuring continued excellence and leadership in patient care. 2006. http://www.ccn.on.ca/ccn_public/uploadfiles/files/Surgical_Report_October31_2006_BOARD.pdf. Last accessed on August 15, 2016.

  65. K.A. Wager, F.W. Lee, and J.P. Glaser. Health Care Information Systems: A Practical Approach for Health Care Management, 2nd ed. Jossey-Bass, San Francisco, CA, 2009.

    Google Scholar 

  66. Institute of Medicine. Clinical Data as the Basic Staple of Health Learning: Creating and Protecting a Public Good: Workshop Summary. The National Academies Press, Washington, DC, 2010.

    Google Scholar 

  67. Ontario Ministry of Finance. 2006 census highlights. http://www.fin.gov.on.ca/en/economy/demographics/census/cenhi06-1.html. Last accessed on April 11, 2019.

  68. Cardiac Care Network of Ontario. Cardiac care network: Annual report 11-12. 2012. http://www.ccn.on.ca/ccn_public/uploadfiles/files/CCN_Annual_Report_2012.pdf. Last accessed on August 15, 2017.

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Tao, L., Liu, J. (2019). Introduction. In: Healthcare Service Management . Health Information Science. Springer, Cham. https://doi.org/10.1007/978-3-030-15385-4_1

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  • DOI: https://doi.org/10.1007/978-3-030-15385-4_1

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