Table 4 Result matrix
From: Development of a maturity model for demand and capacity management in healthcare
Physicians’ unit Hosiptal A | Nurses’ unit Hospital A | Physicians’ unit Hospital B | Nurses’ unit Hospital B | Department management Hospital A + B | ||
|---|---|---|---|---|---|---|
Meetings | before | 1.2 Marginal “We don’t look into it much. Because there are always explanations for the way things look). And the pandemic we’ve been through doesn’t make things easier” | 1.2 Marginal “We have organized a waiting list group. We go through our waiting lists and have a closer look on things that have gotten stuck” | 1.1 Absent ”I think we should at least compare ourselves with hospital A” | 1.1 Absent “I think that XX (the physicians’ manager) keeps track of it, because even though the nurses have their own clinic, we are dependent on the doctors” | 1.1 Absent “In order for it to work I think it needs something from the outside, some support like we have through our HR or financial support. Someone who is on the team.” |
after | 1.4 Class “Previously, I was left alone with the production issues. No one else looked at it and understood it. That’s one reason why this is so good, that we look at it together and talk about production and why it is a certain way.” | 1.4 Class “Just recently when we had a quality revision, we looked at the files together and had some doubts. Then we called a medical secretary and she came and helped us” | 1.3 Standard “I think that we need those frequent follow-ups. But it’s hard for us to find the time”. | 1.2 Marginal “I think that this also could be a permanent thing at our staff meetings, For us nurses to be more involved, asking questions like, ”This is what the previous month looked like, any thoughts?”” | 1.3 Standard “But just the fact that we’ve had these continuous dialogues… It feels like we have made some progress and, above all, that we are more in control than we used to be” | |
Processes | before | 2.2 Marginal ”The irregular doctors’ scheduling is quite a challenge” | 2.1 Absent “Well I don’t have a very good grip on that (DCM)]. I rely quite much on my staff” | 1.3 Standard “Some weeks there are more doctors scheduled for clinic than we have rooms” | 2.1 Absent “Well at the moment, I must admit I don’t look at the production data” | 2.1 Absent ”We do what we are used to. It varies with the first-line managers, and suddenly they are replaced…Production is a tricky area to tackle in the midst of all the other issues.” |
after | 2.3 Standard “Now we have realised that we do a lot of things apart from the patient, important things that take time. It reduces stress to be reminded of that.” | 2.3 Standard “As for the nurses, this serves as a confirmation that they’re doing a great job, which is fun and rewarding to show them” | 2.3 Standard “I have all this in my head actually. But I reckon it has some benefits in practise. Eventually someone will take over that lacks this overview” | 2.2 Marginal ”We’ve got something that is not only for the doctors. There is still a lot of work to be done though” | 2.2 Marginal “We haven’t yet discussed these issues together in the management forum. It would have been interesting to share with each other” | |
Information Technology | before | 3.1 Absent “It is hard to keep track of things when you only have the waiting list and the appointment schedule” | 3.1 Absent “We got four nurses that schedule the doctors’ appointments. So they have quite an insight” | 3.1 Absent ”We only look at the waiting list” | 3.1 Absent “Right now, I need to familiarise myself with these things. So where can I find those numbers?” | 3.1 Absent ”People don’t think of these things, they have their weekly schedule and their own waiting list to worry about”. |
after | 3.3 Standard “I’m a bit old school. I wasn’t born with a computer in my hand, so if I can do it, then most people can” | 3.3 Standard “You are afraid that things would disappear, that you would accidentally delete or destroy something” | 3.3 Standard “I think it’s an advantage to be able to show it clearly and have it organized in a neat way.” | 3.3 Standard ”I’m not that good at Excel, but here you can actually understand what you see”. | 3.3 Standard “We now got a tool, for follow-ups above all. It feels like we’ll be able to handle it ourselves eventually” | |
Management support | before | 4.2 Marginal “Well, I think we are pretty much left on our own” | 4.2 Marginal “We might have discussed it at our monthly management forum. It’s been more a case of saying “Well, this wasn’t good” | 4.2 Marginal “It’s not on the agenda. We have new managers with little insight own the matter. The previous ones, well they might have been partially familiar with it.” | 4.2 Marginal “Well I’m sure it will be in focus eventually” | 4.2 Marginal “The issue doesn’t get any focus in our management. Or maybe a little, but mostly in terms of economics and the like” |
after | 4.2 Marginal “We definitely talk about production now but the responsibility is still ours. Because, I think it’s difficult for our managers to familiarise themselves with the everyday life here” | 4.3 Standard “I believe there is a plan to get this to work out. It’s not just something that should be done for the sake of doing it” | 4.2 Marginal “Well, I consider their support a bit vague” | 4.2 Marginal “Production is more in focus now. So they are interested obviously, but in between the follow-ups, I don’t think there is much talk about it” | 4.2 Marginal “I don’t’ think they have figured out how to tackle these issues. We, however have more structure than we had before” | |
Organizational development | before | 5.2 Marginal “Well, we made a one-off effort there in the autumn” | 5.2 Marginal “You make this effort and then you go back to business as usual and it goes on for a while, But after some time it’s like “oh, that has gotten bad, now we have to make an effort again”” | 5.2 Marginal “I saw that Tuesdays were always so crowded, and then, I managed to get an extra room” | 5.1 Absent “Right now, it feels that no matter what you’d like to change at this place, the answer will be that it’s very, very difficult” | 5.1 Absent “It’s not THAT bad, but there are certainly things to do. Right now, everybody digs where they stand” |
after | 5.3 Standard “Since direct patient contact is actually quite a small part of my doctors’ total work hours, it’s probably redundant to tweak and change their actual total patient time” | 5.3 Standard “I’m now able to focus on my own staff. It’s always the doctors and their production we follow. But now we’ve also got a better opportunity to improve nurses’ situation” | 5.2 Marginal “It helps us visualise things, but it won’t automatically change anything” | 5.1 Absent ”If we just keep track of planning, adjust the schedule and appointments, we can target the areas with the biggest needs” | 5.2 Marginal “And the more we talk about these issues, address them and involve the staff, the more good ideas pop up. But if we never show it, it won’t happen” | |
Mindset/culture | before | 6.3 Standard ”I definitively think these issues can be improved” | 6.2 Marginal “It is so hard to grasp how many patients are waiting, it feels like a big cloud” | 6.1 Absent ” So it’s an extremely complex system and I find it difficult to see how it can be planned in any other way” | 6.2 Marginal “I’m a bit worried about how I can manage to fit this in timewise” | 6.3 Standard ”And a big challenge is that we are stuck in a rut. That is something that I hope will improve” |
After | 6.3 Standard “I think this work is fun and interesting, but it is not easy” | 6.3 Standard ”It makes sense, but at the same time it is complex, no doubt” | 6.2 Marginal “Even though you can revise your plan, it’s still hard since many things are out of your control. There are plenty of things you can’t plan for.” | 6.3 Standard “I think we’ll be encouraged to see that our efforts pay off, because that’s clearly shown here. But there’s still a lot of work to be done” | 6.4 Class “Now we have a responsibility to keep track of what the next step is and that while we may not be able to take three steps at the time. With each step we’ll get further” |