The creation of short-term flexibility in health care capacity management

Paper in proceeding, 2019

Background: The fact that unpredictable variations in supply and demand for capacity in the healthcare systems creates a need for flexibility is well known. The major types of tools used in the healthcare system to create short-term volume flexibility on the supply side include overtime, temporary staff from internal calling lists, mowing staff across units, staff pools, queuing patients, and purchasing services from external healthcare providers.
Objective: The purpose of this paper is to explore where and to what extent the major types of tools for short-term flexibility on the supply side are used in the healthcare system.
Method: A questionnaire was developed and distributed among department managers (N = 237; n = 106) in the Region Västra Götaland healthcare system. The respondents were asked to indicate on a seven-point Likert-type scale to what extent they used each tool to create short-term flexibility in capacity. Each manager’s unit was positioned on an acute/planned scale and on an inpatient/outpatient scale, and classified as primarily medical, surgical or psychiatrical. Data were analyzed with multiple regression.
Results: A number of significant tendencies were found, for example, that acute units tend to use overtime and internal staffing pools to create flexibility to a larger extent, and patient queues and external healthcare providers to a smaller extent, than planned units do.
Conclusion: In order to manage capacity efficiently on an aggregate level in the healthcare system, the prerequisites as well as the required managerial approaches differ substantially between different parts of the system. These differences must be addressed when, for example, capacity pools are considered.