Facets of operational performance in an emergency room (ER)

This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's operational performance in general and the trade-offs in flow times, inventory levels (that is the number of patients waiting in the system), and resource utilization; (3) the impacts of potential process and staffing changes to improve the ER's performance. Specifically, the paper discusses four proposals for streamlining the patient flow: establishing designated tracks (fast track, diagnostic track), creating a holding area for certain type of patients, introducing a protocol that would reduce the load on physicians by allowing a registered nurse to order testing and treatment for some patients, and potentially and in the longer term, moving from non-ER specialist physicians to ER specialists. The paper's findings are based on analyzing the paths and flow times of close to two thousand patients in the emergency room of the Medical Center of Leeuwarden (MCL), The Netherlands. Using exploratory data analysis the paper presents generalizable findings about the impacts of various factors on ER's lead-time performance and shows how the proposals fit with well-documented process improvement theories. © 2010 Elsevier B.V. All rights reserved.

Különböző beszerzői magatartásminták a magyarországi kórházak körében (Behaviour of the Hungarian hospital in their relationship with drug suppliers.)

A szerzők kutatásának célja a magyar kórházak gyógyszerbeszállítókkal kapcsolatos magatartásának jobb megértése. A szervezeti viselkedés természetéből adódóan a szerzők kutatásukat a komplexitás paradigmájára támaszkodva (Mucchielli, 2004) végezték el. Ahhoz, hogy kórházak beszerzési döntéseinek komplex eljárásait megvizsgálják, egy vegyes kutatási módszer alkalmazására volt szükség. Elméleti háttérként az üzleti kapcsolatok értékének integrált modelljét alkalmazták. A tanulmányban bemutatják egy kvantitatív és egy kvalitatív kutatás eredményeit a magyarországi kórházak és a gyógyszerbeszállítók közötti üzleti kapcsolatokban. ________________ The main goal of this research is to better understand the behaviour of the Hungarian hospital in their relationship with drug suppliers. The nature of the organisational behaviour guides the authors to conduct their research on the complexity paradigm (Mucchielli, 2004). To be able to explore the complex procedure of purchasing decisions in the hospitals, they applied a research design based on mixed method research. As a theoretical background the authors used the integrated model of business relationship value. In their paper they introduce the results of a quantitative and a qualitative research about the business relationships between hospitals and drug suppliers in Hungary.