One Hundred Years of Operational Research in Health—UK 1948–2048

Royston, Geoff

doi:10.1007/978-1-137-57328-5_14

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…The practice of applied healthcare OR distinguishes itself from other model-based disciplines such as health economics as it is action research based where operational researchers participate collaboratively with those that work in or use the system to define, develop, and find ways to sustain solutions to live implementation problems [ 2 ]. The methods of OR have been used in healthcare since the 1950s [ 3 ] to analyse implementation problems in diverse areas such as emergency departments [ 4 – 6 ] and management policies for ambulance fleet [ 7 ]; acute stroke care [ 8 – 11 ], outpatient clinic waiting times [ 12 ], and locations [ 13 ]; cardiac surgery capacity planning [ 14 ]; the interface between acute and community care [ 15 ]; hospital performance [ 16 ]; scheduling and routing of nurse visits [ 17 ]; scheduling of patient appointments [ 18 ]; and many other complex implementation problems of an operational or logistical nature.…”

Section: Introductionmentioning

confidence: 99%

Operational research as implementation science: definitions, challenges and research priorities

Monks

2015

Implementation Sci

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BackgroundOperational research (OR) is the discipline of using models, either quantitative or qualitative, to aid decision-making in complex implementation problems. The methods of OR have been used in healthcare since the 1950s in diverse areas such as emergency medicine and the interface between acute and community care; hospital performance; scheduling and management of patient home visits; scheduling of patient appointments; and many other complex implementation problems of an operational or logistical nature.DiscussionTo date, there has been limited debate about the role that operational research should take within implementation science. I detail three such roles for OR all grounded in upfront system thinking: structuring implementation problems, prospective evaluation of improvement interventions, and strategic reconfiguration. Case studies from mental health, emergency medicine, and stroke care are used to illustrate each role. I then describe the challenges for applied OR within implementation science at the organisational, interventional, and disciplinary levels. Two key challenges include the difficulty faced in achieving a position of mutual understanding between implementation scientists and research users and a stark lack of evaluation of OR interventions. To address these challenges, I propose a research agenda to evaluate applied OR through the lens of implementation science, the liberation of OR from the specialist research and consultancy environment, and co-design of models with service users.SummaryOperational research is a mature discipline that has developed a significant volume of methodology to improve health services. OR offers implementation scientists the opportunity to do more upfront system thinking before committing resources or taking risks. OR has three roles within implementation science: structuring an implementation problem, prospective evaluation of implementation problems, and a tool for strategic reconfiguration of health services. Challenges facing OR as implementation science include limited evidence and evaluation of impact, limited service user involvement, a lack of managerial awareness, effective communication between research users and OR modellers, and availability of healthcare data. To progress the science, a focus is needed in three key areas: evaluation of OR interventions, embedding the knowledge of OR in health services, and educating OR modellers about the aims and benefits of service user involvement.

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Section: Introductionmentioning

confidence: 99%

Operational research as implementation science: definitions, challenges and research priorities

Monks

2015

Implementation Sci

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“…A survey provided by Rais and Viana (2010) selected research work in Operations Research (OR) applied exclusively to the problems in Healthcare. As established by Royston (2009), OR is utilized much more now to address daily hospital management, resource-constrained operations or treatment planning aspects in Healthcare. Key healthcare optimization issues include service planning, resource scheduling, logistics, medical therapeutics, disease diagnosis and preventive care.…”

Section: Discussionmentioning

confidence: 99%

A Lean transportation approach for improving emergency medical operations

Villarreal

Garza‐Reyes

Granda-Gutiérrez

et al. 2018

Production Planning & Control

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This paper extends the approach of Lean Transportation to improve the performance of Emergency Medical Processes (EMP), adapting the main concepts of the approach to incorporate the main characteristics of the EMP environment. The paper is based on an inductive theory-building process initiated from a case study in the field of Emergency Medical Services. The development of the suggested performance improvement approach was triggered from an exhaustive analysis of the process involved and an exploratory review of the existing improvement approaches available. The process of concern can be described as a specialized transportation process where human lives are at risk. Its characteristics led to a natural application of Lean Transportation. The results include a novel approach for improving the agility and efficiency of EMS processes. This is validated with an application for improving ambulance response times and turnaround times of the Red Cross operations located in Monterrey, Mexico. The approach proved to be an integrated scheme for identifying waste opportunities at a systems level. This characteristic is important to let operations management prioritize improvement efforts in a limited budget situation. This work suggests the application of the emerging Lean Transportation approach for increasing the agility performance of EMS processes.

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“…As noted at the outset, Brailsford and Vissers (2011) concluded that the main challenges in health care may come from organisational and logistical elements, rather than medical or scientific advances, and indeed the focus of this OR has been to address such challenges. Traditional "hard" OR has provided progress in health care applications, as noted in Royston's (2009) review of OR in UK health care, spanning 50 years and beyond, particularly in a small but key area, that of waiting in outpatient and accident and emergency departments. The present study has provided an example of the application of TOC to a similar issue of wait times in cancer treatment, resulting in patient wait time reductions of 84%, nursing staff overtime reductions of 67%, elimination of overtime for the other three staff groups, along with no increase in drug costs.…”

Section: Contributions Of This Research To Practice and To The Literamentioning

confidence: 99%

Using the Theory of Constraints to resolve long-standing resource and service issues in a large public hospital

et al. 2017

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Public health care providers typically struggle with the need to meet demand for services, within a limited budget. This paper describes an analysis of a large public hospital, using the Theory of Constraints' (TOC) comprehensive set of mapping tools to logically represent a problematic situation and investigate options for resolution. Based on the symptoms present, root causes and conflicts were identified, along with potential solutions. Further TOC tools were used to check for possible side effects of the solution, and identify obstacles that might impede successful implementation. Based on the TOC analysis, a trial project was implemented with significant benefits for two departments. Outcomes included dramatically reduced patient wait times and staff overtime, increased patient satisfaction, increased efficiencies, smoothed workload, and improved staff morale and retention, while maintaining patient safety and integrity of treatment, and staying within defined cost parameters.

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One Hundred Years of Operational Research in Health—UK 1948–2048

Cited by 6 publications

References 29 publications

Operational research as implementation science: definitions, challenges and research priorities

Operational research as implementation science: definitions, challenges and research priorities

A Lean transportation approach for improving emergency medical operations

Using the Theory of Constraints to resolve long-standing resource and service issues in a large public hospital

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