![]() The general implication of this study is to be careful not to inadvertently make a bad capacity situation worse by diverting patients from specific points of care. This “early” discharge strategy indeed worked to open capacity in the short term, but there was an unintended consequence: It increased the “bounce-back” (re-admission) rate to the ICU, thus increasing demand for the ICU (and effectively reducing peak ICU capacity). ![]() System interdependencies mean that changes in one part of the system can generate unintended consequences.įor instance, a study of ICU care by Diwas Singh KC and Christian Terwiesch found that as ICUs reached full capacity utilization, physicians responded by shortening lengths of stay for patients. For example, demand for baby delivery rooms spurs demand for postpartum and neonatal care. ![]() Health care systems are composed of many interconnected points of care, and the demands across them are not independent. Be aware of systems interdependencies and unintended consequences. To help alleviate system congestion, health care managers should follow two principles:ġ. During the Covid-19 outbreak, hospitals have been forced to redesign patient flow in real time, grappling with such issues as: Which care can be moved from a hospital to an alternative setting (even the home)? Which procedures for which patients can be safely postponed? What policies do we put in place to determine how long patients (those with and those without Covid-19) need to stay in the hospital or utilize an ICU? Managing flow means proactively shaping how, when, and where among these nodes patients (both infected and uninfected) receive care. It is still necessary to manage the way patients enter and proceed through the various nodes of the health care delivery system. While social-distancing measures, travel restrictions, and shelter-in-place orders are effective in dampening demand, they are only part of the solution. Managing DemandĪ pandemic generates an enormous demand shock for health care systems already running at close to full capacity. It is based on a central reality: Tackling shortages and supply constraints requires a comprehensive strategy aimed at both the demand- and supply-side roots of the problem. This article, which draws from the best practices in supply chain and operations management, can help struggling hospitals and other care providers increase the odds they will have those resources.
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