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Five focus strategies to organize health care delivery

机译：制定医疗保健服务的五项重点战略

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Purpose - The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations. Design/methodology/approach - First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. Findings - The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes. Research limitations/implications - Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Practical implications - Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization's strategy and key performance indicators. Originality/value - Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.
机译：目的-重点工厂是决策者为改善医疗服务而采用的概念之一。但是，混乱的焦点定义导致无法系统利用的发现。本文的目的是讨论针对医疗保健运营的战略选择。设计/方法/方法-首先，回顾有关医疗保健重点的文献，揭示概念上的挑战。其次，根据需求和必要的多样性定义了焦点的定义，并阐明了焦点的机制。提出了五种重点战略的分类，这些战略遵循了最初的想法以减少产品和市场的多样性。最后，本文研究了与重点战略相关的管理可能性。调查结果-本文提出了一个以客户为中心的五项重点战略框架，旨在减少护理途径不同特征的多样性：人口；卫生保健；卫生保健。紧迫性和严重性；疾病和症状；护理实践和流程；和护理结果。研究的局限性/意义-需要进行实证研究以评估五种策略的成本和收益，以及评估重点部门对竞争和协调的系统级影响。实际意义-焦点是一个有利条件，需要使用特定的需求和供应管理实践来加以利用。重要的是要了解焦点机制在策略之间的差异，并选择适合组织策略和关键绩效指标的焦点。独创性/价值-与以前更多的以资源为导向的方法相比，本研究提供了理论上扎实且与实际相关的以客户为中心的框架，专注于医疗保健。

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