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Exploring types of focused factories in hospital care: a multiple case study

BACKGROUND: Focusing on specific treatments or diseases is proposed as a way to increase the efficiency of hospital care. The definition of "focus" or "focused factory", however, lacks clarity. Examples in health care literature relate to very different organizations. Our aim was...

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Autores principales: Bredenhoff, Eelco, van Lent, Wineke AM, van Harten, Wim H
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904334/
https://www.ncbi.nlm.nih.gov/pubmed/20529299
http://dx.doi.org/10.1186/1472-6963-10-154
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author Bredenhoff, Eelco
van Lent, Wineke AM
van Harten, Wim H
author_facet Bredenhoff, Eelco
van Lent, Wineke AM
van Harten, Wim H
author_sort Bredenhoff, Eelco
collection PubMed
description BACKGROUND: Focusing on specific treatments or diseases is proposed as a way to increase the efficiency of hospital care. The definition of "focus" or "focused factory", however, lacks clarity. Examples in health care literature relate to very different organizations. Our aim was to explore the application of the focused factory concept in hospital care, including an indication of its performance, resulting in a conceptual framework that can be helpful in further identifying different types of focused factories. Thus contributing to the understanding of the diversity of examples found in the literature. METHODS: We conducted a cross-case comparison of four multiple-case studies into hospital care. To cover a broad array of focus, different specialty fields were selected. Each study investigated the organizational context, the degree of focus, and the operational performance. Focus was measured using an instrument translated from industry. Data were collected using both qualitative and quantitative methods and included site visits. A descriptive analysis was performed at the case study and cross-case studies level. RESULTS: The operational performance per specialty field varied considerably, even when cases showed comparable degrees of focus. Cross-case comparison showed three focus domains. The product domain considered specialty based focused factories that treated patients for a single-specialty, but did not pursue a specific strategy nor adapted work-designs or layouts. The process domain considered delivery based focused factories that treated multiple groups of patients and often pursued strategies to improve efficiency and timeliness and adapted work-designs and physical layouts to minimize delays. The product-process domain considered procedure based focused factories that treated a single well-defined group of patients offering one type of treatment. The strategic focusing decisions and the design of the care delivery system appeared especially important for delivery and procedure based focused factories. CONCLUSIONS: Focus in hospital care relates to limitations on the patient group treated and the range of services offered. Based on these two dimensions, we identified three types of focused factories: specialty based, delivery based, and procedure based. Focus could lead to better operational performance, but only when clear strategic focusing decisions are made.
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spelling pubmed-29043342010-07-15 Exploring types of focused factories in hospital care: a multiple case study Bredenhoff, Eelco van Lent, Wineke AM van Harten, Wim H BMC Health Serv Res Research Article BACKGROUND: Focusing on specific treatments or diseases is proposed as a way to increase the efficiency of hospital care. The definition of "focus" or "focused factory", however, lacks clarity. Examples in health care literature relate to very different organizations. Our aim was to explore the application of the focused factory concept in hospital care, including an indication of its performance, resulting in a conceptual framework that can be helpful in further identifying different types of focused factories. Thus contributing to the understanding of the diversity of examples found in the literature. METHODS: We conducted a cross-case comparison of four multiple-case studies into hospital care. To cover a broad array of focus, different specialty fields were selected. Each study investigated the organizational context, the degree of focus, and the operational performance. Focus was measured using an instrument translated from industry. Data were collected using both qualitative and quantitative methods and included site visits. A descriptive analysis was performed at the case study and cross-case studies level. RESULTS: The operational performance per specialty field varied considerably, even when cases showed comparable degrees of focus. Cross-case comparison showed three focus domains. The product domain considered specialty based focused factories that treated patients for a single-specialty, but did not pursue a specific strategy nor adapted work-designs or layouts. The process domain considered delivery based focused factories that treated multiple groups of patients and often pursued strategies to improve efficiency and timeliness and adapted work-designs and physical layouts to minimize delays. The product-process domain considered procedure based focused factories that treated a single well-defined group of patients offering one type of treatment. The strategic focusing decisions and the design of the care delivery system appeared especially important for delivery and procedure based focused factories. CONCLUSIONS: Focus in hospital care relates to limitations on the patient group treated and the range of services offered. Based on these two dimensions, we identified three types of focused factories: specialty based, delivery based, and procedure based. Focus could lead to better operational performance, but only when clear strategic focusing decisions are made. BioMed Central 2010-06-07 /pmc/articles/PMC2904334/ /pubmed/20529299 http://dx.doi.org/10.1186/1472-6963-10-154 Text en Copyright ©2010 Bredenhoff et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bredenhoff, Eelco
van Lent, Wineke AM
van Harten, Wim H
Exploring types of focused factories in hospital care: a multiple case study
title Exploring types of focused factories in hospital care: a multiple case study
title_full Exploring types of focused factories in hospital care: a multiple case study
title_fullStr Exploring types of focused factories in hospital care: a multiple case study
title_full_unstemmed Exploring types of focused factories in hospital care: a multiple case study
title_short Exploring types of focused factories in hospital care: a multiple case study
title_sort exploring types of focused factories in hospital care: a multiple case study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904334/
https://www.ncbi.nlm.nih.gov/pubmed/20529299
http://dx.doi.org/10.1186/1472-6963-10-154
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