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Performance Measurement—The Fallacy of Waiting Time Targets

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Abstract

This chapter uses the simple two-stock hospital model introduced in Chap. 2 to explore the concept of treatment waiting time targets in common use to measure the performance of health treatment services. The results suggest that the setting of such targets is purely arbitrary and perhaps more of a political aspiration than a concrete aim since achieving them is out of the practical control of hospital management. In fact, the only way to attain them would be by having the ability to continuously change service capacities over impossible ranges to track changes in referrals or by continuously adjusting lengths of stay.

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Notes

  1. 1.

    Apart from the absolute minimum time it takes to process a referral and arrange commencement of treatment, which may be several weeks.

  2. 2.

    We do show a connection between ‘waiting’ and admissions but this is just to imply a restriction on admissions so the waiting stock cannot go negative, rather than to generally control the level of the stock. Many buffer stocks are part of more complicated capacity-constrained stock/ flow chains, and their behaviour would require a more detailed explanation than we offer here.

References

  • Senge, P. M. (1990). The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Doubleday/Currency.

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  • Wolstenholme, E. F. (2003). Towards the definition and use of a core set of archetypal structures in system dynamics. System Dynamics Review, 19(1), 7–26.

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Correspondence to Eric Wolstenholme .

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Wolstenholme, E., McKelvie, D. (2019). Performance Measurement—The Fallacy of Waiting Time Targets. In: The Dynamics of Care. Springer, Cham. https://doi.org/10.1007/978-3-030-21878-2_3

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  • DOI: https://doi.org/10.1007/978-3-030-21878-2_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21877-5

  • Online ISBN: 978-3-030-21878-2

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