UNDERSTANDING SYSTEM FAILURE IN HEALTH CARE: A MENTAL MODEL FOR DEMAND MANAGEMENT

Dieter Hartmann, John Bicheno, Bruno Emwanu, Teresa Sharon Hattingh

Abstract


The load on health systems caused by systemic overburden leads to heightened costs, longer waiting times, a reduced quality of care, andassociated problems. This may be caused by ’failure demand’; however, its definition is inadequate for a complex hierarchical system. Although accounting for a significant proportion of load in other industries, the academic assessment of failure demand in health care remains limited. We present a novel way of identifying repeat consumption, which we loosely equate with failure demand. We present a framework that can be used to identify ‘system failure’, the trigger for later repeat consumption. This provides new insight into understanding whether common events represent system failure. A diagnostic framework was developed from observations, the literature, and brainstorming. Commonly observed exit scenarios in health care were tested against the framework to create a system-failure list. The framework and the categorisation table were shared with eight international Lean health-care experts. Following feedback, the framework and categorisations were fine-tuned and consensus was achieved via member-checking. Identifying and managing failure demand for these settings can lead to a reduced system load, thus reducing costs and increasing system efficiency and quality.


Keywords


Failure demand; Health care; System Failure; Efficiency; Demand Management; Quality; Health Policy

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DOI: https://doi.org/10.7166/32-2-2344

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Copyright (c) 2021 Dieter Hartmann, John Bicheno, Bruno Emwanu, Teresa Sharon Hattingh


ISSN 2224-7890 (on-line) ; ISSN 1012-277X (print)


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