CHOIR in practice

Integrated decision making in healthcare

An operations research and management science perspective

Peter Hulshof

The pressure on healthcare systems rises as both demand for healthcare and expenditures are increasing steadily. As a result, healthcare professionals face the challenging task to design and organize the healthcare delivery process more effectively and efficiently. Designing and organizing processes is known as planning and control. Healthcare planning and control lags behind manufacturing and control for various reasons. One of the main causes is the fragmented nature of healthcare planning and control. Healthcare organizations such as hospitals are typically organized as a cluster of autonomous departments, where planning and control is also often functionally dispersed. As the clinical course of patients traverses multiple, thus inter-

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dependent, departments, an integrated approach to  healthcare planning and control is likely to bring improvements.

This thesis aims to contribute to integrated decision making in healthcare in two ways. First, we develop a framework, taxonomy, and extensive literature review to support healthcare professionals in structuring and positioning planning and control decisions in healthcare. The framework and taxonomy can be used to break down planning functions, determine managerial responsibilities and deficiencies, and to identify adjacent planning decisions influencing each other. Second, we propose planning approaches to develop resources allocation and patient admission plans for multiple departments, multiple resources and multiple patient types, thereby integrating decision making for a chain of healthcare resources. The planning approaches are developed with techniques from Operations Research and Management Science (OR/MS).

Biography: Peter Hulshof was born in Groenlo, the Netherlands, on June 19th, 1983. In 2001, he obtained his Atheneum degree at the Staring College in Lochem, with a strong interest in the combination of Mathematics, Physics and Economics. As a result of these combined interests, Peter started his studies Industrial Engineering and Management at the University of Twente in the same year. During his studies, Peter focused on operations management and logistics, with an emphasis on healthcare, and he participated in three internships, in New York, Paris and in the Netherlands. He obtained his Master of Science degree with a thesis research on vehicle routing and order planning in the oil and gas sector at the decision software company ORTEC. In this research period, Peter became enthousiastic about creating insight by research, and he applied for a PhD-position at the Center for Healthcare Operations and Improvement Research at the University of Twente. He started his PhD with a combined position at the University of Twente and the Reinier de Graaf hospital in 2008, under the supervision of dr.ir. Erwin W. Hans and prof.dr. Richard J. Boucherie. Currently, Peter is a consultant at The Boston Consulting Group (BCG).