We Focused on Improving the Quality of Care, Not Necessarily the Delivery of Care

Operations Research (OR) is still considered to be relatively new to healthcare despite the field’s outstanding reputation in physics, industrial engineering, manufacturing, and transportation/logistics. Many discoveries and accomplishments that utilized OR resulted in Nobel Prizes! The US in the past has been so focused on improving the quality of care, that it failed to focus on improving the delivery of care. If healthcare claims a desire to be more efficient and effective in delivering care to their patients, then why not take let the professionals take the lead?

Carter states in his article about Operations Research (OM) and Management Science (MS), “The health care industry faces many of the same issues confronting other industries, but with some significant political differences. If you try working in the health care area without understanding the politics behind the issues, you are asking for some grief. At the same time, health care represents a huge segment of the economy, and it needs our help.” This statement true, could be for several reasons:

1. OR/MS has not been successful more successful in the healthcare field “starting with a lack of interest and support on the part of health care managers. ‘Introduction to OR/MS’ is not a common component of most Masters of Health Administration programs.”

2. There is an attitude that OR diverts funds away from direct clinical care. “It is difficult to convince managers, particularly in the Canadian system, to divert limited funds away from direct patient care into better administration.” But this belief is in fact the opposite. OR diverts funds in the short term, but actually in the long term, increases funds through better efficiency.

3. To address the elephant in the room, “Unlike any private sector business, no one is really in charge of a hospital. Managers make resource allocation decisions, but doctors decide what the hospital does with those resources. A horizontal cleavage divides the clinical workers from the containment sector, and there is little cooperation between the two.” The author states, “No private industry would survive with the level of waste and inefficiency commonly seen in health care.”

The author addresses the particular issue, “In my experience, one of the major causes of inefficiency in the health care system is what I call ‘localized expertise.’ People working in the health care system are very knowledgeable about their own area but have relatively little understanding of what goes on in the next department.” This creates an atmosphere of different business entities that do not effectively and efficiently coordinate the care of a patient through a health system. This largely results from conflicting interests and lack of communication between both administration and the clinical staff.

Remember, just because an administrator has a first aid kit at home does not make him a doctor just like how a doctor that knows how to balance a checkbook does not make him an administrator. It takes both parties cooperation, understanding, and respect for the other’s field.



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