Centre for Research and Development (CFUG), Region Gävleborg/Uppsala University, Gävle, Sweden.
Faculty of Health and Occupational Studies, Department of Caring Science, University of Gävle, Gävle, Sweden.
BMC Health Serv Res. 2024 Sep 23;24(1):1109. doi: 10.1186/s12913-024-11456-4.
The aim of this paper is to develop a maturity model (MM) for demand and capacity management (DCM) processes in healthcare settings, which yields opportunities for organisations to diagnose their planning and production processes, identify gaps in their operations and evaluate improvements.
Informed by existing DCM maturity frameworks, qualitative research methods were used to develop the MM, including major adaptations and additions in the healthcare context. The development phases for maturity assessment models proposed by de Bruin et al. were used as a structure for the research procedure: (1) determination of scope, (2) design of a conceptual MM, (3) adjustments and population of the MM to the specific context and (4) test of construct and validity. An embedded single-case study was conducted for the latter two - four units divided into two hospitals with specialised outpatient care introducing a structured DCM work process. Data was collected through interviews, observations, field notes and document studies. Thematic analyses were carried out using a systematic combination of deductive and inductive analyses - an abductive approach - with the MM progressing with incremental modifications.
We propose a five-stage MM with six categories for assessing healthcare DCM determined in relation to patient flows (vertical alignment) and organisational levels (horizontal alignment). Our application of this model to our specific case indicates its usefulness in evaluating DCM maturity. Specifically, it reveals that transitioning from service activities to a holistic focus on patient flows during the planning process is necessary to progress to more advanced stages.
In this paper, a model for assessing healthcare DCM and for creating roadmaps for improvements towards more mature levels has been developed and tested. To refine and finalise the model, we propose further evaluations of its usefulness and validity by including more contextual differences in patient demand and supply prerequisites.
本文旨在为医疗环境中的需求和能力管理（DCM）流程开发一个成熟度模型（MM），为组织提供机会来诊断其规划和生产流程，发现运营中的差距，并评估改进。
受现有 DCM 成熟度框架的启发，采用了定性研究方法来开发 MM，包括在医疗保健环境中进行重大调整和补充。使用 de Bruin 等人提出的成熟度评估模型的开发阶段作为研究程序的结构：（1）确定范围，（2）设计概念 MM，（3）调整和将 MM 应用于特定环境，以及（4）构建和有效性测试。对后两个阶段进行了嵌入式单案例研究-将四个单位分为两家具有专门门诊护理的医院，引入了结构化的 DCM 工作流程。通过访谈、观察、现场笔记和文件研究收集数据。使用系统的演绎和归纳分析相结合的方法进行主题分析 - 一种溯因方法 - 随着 MM 的逐步修改。
我们提出了一个五阶段 MM，有六个类别，用于评估与患者流量（垂直对齐）和组织级别（水平对齐）相关的医疗保健 DCM。我们将该模型应用于我们的特定案例，表明其在评估 DCM 成熟度方面的有用性。具体而言，它表明在规划过程中从服务活动过渡到对患者流程的整体关注是向更高级别发展的必要条件。
本文开发并测试了一种用于评估医疗保健 DCM 并为朝着更成熟水平改进创建路线图的模型。为了完善和最终确定该模型，我们建议进一步评估其在包括患者需求和供应前提条件方面更多的上下文差异方面的有用性和有效性。
