Volume 6 (2021-22)

Each volume of Management in Healthcare consists of four quarterly 100-page issues. Articles scheduled for Volume 6 are available to view on the 'Forthcoming content' page.

The Articles published in Volume 6 include:

Volume 6 Number 1

  • Editorial
    Simon Beckett
  • Case Studies
    Incorporating health systems engineering into COVID-19 vaccine planning and administration
    Tarin A. Casadonte, Principal Health Systems Engineer, Mayo Clinic, et al.

    The COVID-19 pandemic has created unique logistical challenges for vaccine transportation, inventory management, allocation and distribution at multiple levels — the federal government, states and healthcare institutions. Unpredictable weekly vaccine allocation from state health departments, changing population priorities, stringent vaccine requirements for ultracold storage, transportation, reconstitution and 2-dose administration intervals have presented challenges never seen before in the history of mass vaccination programmes, including those at Mayo Clinic. To meet the challenges, an efficient system of allocation and administration for COVID-19 vaccines was developed through collaboration with process engineering. To understand the challenges, ten health systems engineers from the Department of Management Engineering & Consulting at Mayo Clinic facilitated the institution-wide COVID-19 vaccine project, collaborating closely with diverse multidisciplinary teams that included physicians, nurses, pharmacists, administrative services, information technology, human resources, scheduling operations and public affairs. The internal consultants designed tools and solutions based on systems and process engineering methodologies to solve a myriad of complex problems, including identifying priority populations, using resources efficiently and minimising vaccine waste. Tools designed included a vaccine resource playbook; dynamic staffing models based on vaccine allocation, storage, inventory and distribution processes using a hub-and-spoke model; workflows and staffing models for face-to-face and drive-through vaccine administration sites; and end-of-day workflows to reduce vaccine waste. Through the collaboration, modelling and engineering, multiple sites across Mayo Clinic have implemented successful COVID-19 vaccination programmes that are efficient in resource utilisation and have minimal waste. In this paper, we share what we have learned to help other healthcare organisations prepare for future mass vaccination scenarios.
    Keywords: ccollaboration, COVID-19 pandemic, process engineering, staffing model, systems engineering, vaccine allocation, distribution, workflows

  • sekTOR-HF: A research project for cross-sectoral needs based care for patients with heart failure and for the development of an alternative remuneration model - Part 1
    Dominik Walter, Project Manager, sekTOR-HF, RHÖN-KLINIKUM AG, et al.

    Heart failure (HF) is one of the most common hospital admissions diagnoses and causes of death in Germany. In the care of HF, there are false incentives owing to quantity-based remuneration and separate remuneration models for inpatient and outpatient care. The research project of RHÖN-KLINIKUM AG, ‘sekTOR-HF’, has been promoted by the German government’s innovation fund and is intended to ensure better care for HF patients in Germany with the help of optimal coordination of the cross-sectoral care process and new incentives in remuneration. Part 1 describes the initial situation and concept that paved the way for the project in 2020. Patient inclusion began in March 2021. After the project has been completed, in November 2023, a second part will present the project evaluation and the results.
    Keywords: integrated care, network medicine, campus-concept, coordination platform, cross sectoral, network office, process management, full supply model, compensation model, bundled payment

  • Leveraging management engineering and business consulting for rapid response, mitigation and recovery during a pandemic
    Michele R. Hoover, Clinical Practice Section Head, Mayo Clinic, et al.

    The novel severe acute respiratory syndrome coronavirus 2, which causes coronavirus disease 2019 (COVID-19), has presented healthcare delivery challenges the world has never encountered before. Healthcare and its practitioners, while finding themselves in difficult situations, must still care for patients with emergent needs and ensure the safety and well-being of all patients and staff. At Mayo Clinic, effective navigation of the dynamic and complex situation created by COVID-19 required unique multidisciplinary collaborations to design and implement solutions quickly. Frontline care providers and staff of ancillary services and other critical healthcare functions partnered with the Department of Management Engineering and Consulting (ME&C) team to organise and re-engineer operations to iteratively adapt to the dynamic ‘new normal’. Health systems engineers (HSEs) and project managers (PMs) accelerated the implementation of innovative interventions by leveraging advanced engineering and consulting frameworks, models and methods. Utilising a patient and staff-centric systems approach to align electronic systems, operational processes, staffing resources and organisational infrastructure has been invaluable for speed and effectiveness. Harnessing the promise of digital technology and advanced analytics was imperative and set the stage for a broader set of possibilities to transform healthcare. These possibilities include scaling of consumer-focused virtual services in multiple and unfamiliar settings, new assets that could be reused for future emergencies, accelerating the implementation of time-sensitive solutions, applied analytics and modelling to predict clinical, financial and community impacts and reimaging the healthcare supply chain. As more has been learned about the trajectory and management of COVID-19, the need to rapidly evolve and pivot interventions for short-, medium-, and long-term applications continues. This article addresses the unique contributions of ME&C during the COVID-19 crisis and the results-oriented collaborations with staff in critical business functions. We believe that the experiences, outcomes and lessons learned through this journey are broadly transferable to other healthcare and non-healthcare organisations.
    Keywords: business consulting, COVID-19, healthcare, management engineering, pandemic, rapid intervention

  • Practice paper
    Humanising healthcare through COVID-19 and beyond
    Christine Holt, Executive Vice President & Chief Operating Officer of Life Care Division and Cindy Rose, Interim Chief Experience Officer, Redeemer Health and Justin Wartell, Managing Principal, Monigle

    COVID-19 has transformed the world of healthcare, while acting as a catalyst for change on an unprecedented scale. Healthcare and hospital leaders have had to reinvent processes and develop new solutions to combat the virus and adapt to the new reality. In this paper, healthcare brand strategists and management consultants explore how the pandemic has driven innovation that is humanising healthcare on a structural, organisational and experiential level. Drawing from a series of in-depth qualitative interviews (IDIs) conducted with healthcare experience executives across the United States during Fall 2020, this contribution outlines how the industry’s leaders are implementing strategic changes in their organisations to embrace a more empathetic, human model. Supported by the 2020 Humanizing Brand Experience report quantitative survey data from more than 25,500 healthcare consumers, readers will consider the spectrum of shifts that have occurred and will learn about why these changes are likely to stay relevant in the post-pandemic era. This paper concludes with a set of strategies and considerations, including defining strategic brand experience objectives, creating cross-functional experience coalitions, focusing leadership on important experiential areas, hiring for ‘soft skills’, including empathy and communication, aligning incentives with targeted changes, and so on. These recommendations are designed to continue building on pandemic-driven management and leadership innovations in order to foster improved healthcare experiences for consumers, physicians and employees.
    Keywords: COVID-19, healthcare management, workplace flexibility, organisational models, brand strategy, brand experience, consumerisation, humanising healthcare

  • Research papers
    Promoting culturally and linguistically appropriate services (CLAS): Core leadership competencies
    Natalie S. DuMont, University of Phoenix

    Health disparities and inequitable care adversely affect diverse populations, are significant among racial and ethnic minorities and cost health-care organisations over US$400bn per year. This paper provides actionable recommendations on using culturally and linguistically appropriate services (CLAS) standards as a management tool to reduce costs and improve quality of care in behavioural health-care organisations. The qualitative Delphi study, on which the paper is based, documented the consensus of opinion from experts identifying core leadership competencies conducive to creating and sustaining CLAS standards competent organisations. Twenty-one expert executive behavioural health leaders located in the United States identified 15 leadership competencies critical to leading a CLAS standards competent organisation. The two most vital competencies were (a) cultural competence and adaption and (b) collaboration and teamwork. Effective executive behavioural health-care leaders use these unique competencies to provide clear plans and strategies to guide collaborative efforts to address health disparities. This study may promote best practices for organisations that hire and train executive behavioural health leaders by validating selection and training criteria predicted on these 15 competencies.
    Keywords: CLAS standards, core leadership competencies, executive behavioural health leaders, health disparities, executive selection, health-care management

  • Benchmarking healthcare quality in the United States
    Archie Lockamy III, Margaret Gage Bush Professor of Business, Professor of Operations Management, Brock School of Business, Samford University

    The COVID-19 pandemic has brought the quality of healthcare in the United States under increased scrutiny. The Agency for Healthcare Research and Quality (AHRQ) within the United States Department of Health and Human Services (HHS) is charged with improving the safety and quality of the US healthcare system. The purpose of this study is to benchmark healthcare quality in the United States using data provided by AHRQ. The study consists of quality measures compiled by AHRQ that are utilised by the 48 contiguous states comprising the United States along with Alaska, Hawaii and the District of Columbia. The measures are set against achievable benchmarks to assess US healthcare quality at the national, regional, divisional and state levels. The results of this study show that the Northeast region has the highest average number and percentage of healthcare quality benchmarks achieved in the United States. At the divisional level, New England leads the country in healthcare quality. An analysis at the state level reveals that Maine is the leader in healthcare quality in the Northeast region, Wisconsin and Iowa in the Midwest region, Delaware in the South region, and Colorado in the West region. The results of this study can be used by policymakers at the national, state and local levels to target healthcare quality improvement initiatives in the United States.
    Keywords: healthcare quality, US healthcare system, benchmarking, COVID-19, healthcare improvement