With the current number of staff, we can maintain the recent level of health care in the Netherlands - even with an increasing demand for care. This is claimed by Prof Richard Boucherie, PhD, of the Center for Healthcare Operations Improvement and Research (CHOIR) of the University of Twente. By making use of mathematical models, much better use can be made of scarce resources, such as beds, operating theatres and staff. "Much of our research shows that sizeable returns on efficiency are quite easily feasible. By using our algorithms, up to 30% more patients can be treated with the same number of staff.”
In the Netherlands, the working population is declining, society is ageing and the demand for care is increasing. If we don't do something, the Netherlands will soon have to cope with a considerable shortage of staff in health care. However, a major efficiency coup can be achieved in health care while retaining or even improving the current level of quality. Solely by improving the logistics of health care. This is claimed by Prof Richard Boucherie, PhD, of CHOIR (set up by Boucherie together with Prof Erwin Hans), the largest research centre for health care logistics in the Netherlands, which carries out research at the interface of mathematics, health care and economics.
Planning in health care is difficult. Often you do not know in advance how many patients you will have to treat and how long individual treatments will take in practice. However, this uncertainty does not mean that these matters can't be taken into account. CHOIR's mathematical models help to make the right decisions despite uncertain conditions.
Making optimal use of scarce resources
Various studies carried out by CHOIR in the ten years of its existence show that up to 30% returns on efficiency in health care are quite easily feasible. As a result, it will be possible to retain the current level of health care in the Netherlands - possibly for even twenty years - with the current number of staff. To this end, CHOIR researchers are taking a close (mathematical) look at the health care logistics of health care institutions. The key is that they are not examining individual processes, but the entire process of integrated care within an institution and that they are designing processes to make optimal use of scarce resources such as staff, operating theatres and hospital beds. A broad range of studies, carried out over the course of the years, shows that the approach works. For example, using the CHOIR algorithms, the Netherlands Cancer Institute/Antoni van Leeuwenhoek hospital managed to realize a sixth operating theatre without needing any extra nursing staff. And it has emerged that a 10 to 20% increase of productivity is feasible in various nursing departments of the Academic Medical Centre in Amsterdam.
Three PhD defences
CHOIR's approach is effective because for half of their time, the researchers work as members of staff in the hospital they are studying, thus being directly involved in the implementation of their proposals. Boucherie: "This is a good approach because our researchers – who are deeply involved not only in research, but also in the daily practice of care – can actually tackle the problems that arise on the workfloor."
On 21 and 22 November, another three CHOIR researchers of the University of Twente will defend their PhD thesis to obtain their doctoral degree, all of whom did research into logistical improvements in health care. The thesis of Theresia van Essen shows that by solely adjusting the planning of operations, 20% fewer beds are needed in the orthopaedics department of the Haga Hospital. Peter Hulshof developed a planning method that finds a balance between the stable entry of groups of patients, strategically determined production targets and the efficient deployment of scarce resources.
And together with the company ORTEC, Egbert van der Veen developed a method for ensuring that the preferences of health care staff and the requirements of the collective labour agreement can be properly incorporated into staff planning. In connection with these three PhD defences, CHOIR will be organising the CHOIR in Practice symposium on 21 and 22 November. This symposium also concludes the Logidoc project which was funded by STW.
CHOIR
CHOIR, the Center for Healthcare Operations Improvement and Research of the University of Twente, is part of the UT research institute CTIT. It is the largest research centre for health care logistics in the Netherlands and is ranked among the world's top 3. CHOIR works together with more than forty health care institutions in the Netherlands.
Note for the press
For more information or interview requests, please contact the UT spokesperson for scientific information Joost Bruysters (Tel. +31 6 1048 8228).
