lOMoARcPSD|29391360
Seminar 1
Production Management and Services Delivery (Stockholms Universitet)
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lOMoARcPSD|29391360
Seminar 1
1.
Please compare and describe the 3B orthopaedics model and the typical procedures
performed by the faculty practice surgeons with reference to the following terms
that you find in your textbook, lecture notes and the above mentioned articles: 4Vs,
performance objectives, structural and infra-structural decision areas,
performance frontiers, trade-offs, process types.
Do you find other terms or concepts in the course literature useful as well?
The faculty perform procedures within different subspecialties. Within some subspecialties, the
procedure doesn’t seem to vary too much, whilst others vary significantly. This means that there is
not only a specific procedure that is done, but rather many. Formal responsibilities for e.g. teaching.
3B rented office space in another building owned by the hospital, which means they have no formal
responsibilities. They only specialise in one area (subspecialty) within 0rtho. All the seven surgeons
seem to specialise in a specific procedure. Junior surgeons performed a procedure outside their
immediate area of specialization.
By standardizing the procedures the surgeons have the possibility to reduce the time the surgery
takes, and hence increase the speed. This is believed to example reduce to risk for complication and
have improved medical outcomes, which in turn means better quality in providing the service.
However, since the work is so standardized, 3B organize the organisation to not need to be flexible.
Dependability is higher within 3B, and the faculty therefore has less dependability in comparison
with 3B. To minimize the tools used under a procedure and to order the material from a specific
supplier helps to reduce costs. Performance objective
Standardize work within 3B means possibility to operate more patients (high volume), well-defined
and standardized procedures (low variety), possibility to manage and plan activities/procedure in
advance (low variation). On the other hand, I find that the faculty tend to treat less patients
(lower volume), have different procedures to perform (high variety), not the same possibility to
plan in advance since more services are offered (high variation). Visibility seems to be high within
both, but somewhat lower within the faculty. You had more contact with the doctor.
Trade offs basically means that as much as we like, we can’t have everything. Sacrifice one to get the
other. 3B might not be able to help all the patients, since they only perform one specific procedure,
however they can help a lot of people within one specific area. And vice versa for the faculty.
Structural elements are found foremost in the decisions that 3B has made regarding the setup of the
procedures and which resources to allocate, whilst infrastructural rather focus on what happens during
the procedures, where one procedure is standardize, the use of same tools and supplies.
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Structural decisions primarily influence the physical arrangement and configuration of the operation’s
resources. Infrastructural decisions influence the activities that take place within the operation’s
structure. Within 3b it seems to be mores structured and efficient, whilst in the faculty it seems to be
more free based.
Efficient frontiers
Lower variation - more cost efficient. Higher variation, not so cost efficient.
2.
Which is better of the two models? What are the key criteria for your assessment?
When looking at which model is better, my key criteria were to look at the models from an
organizational type of view. With that I mean that I looked at which would benefit the hospital the
most. Based on that I believe that the 3B model sounds very effective, where you have standardized
procedures that don’t vary, the material and tools for the orthopedical procedures and the same
supplier for all operations.
I used the 4V and the five structural objectives, and found that 3b have the most positive aspects and
outcomes. Of course many positive aspects can also be considered negative in a different light. I found
that the 3B approach looks to be more efficient for the hospital. Visibility is a part that can be adapted
by the faculty.
3b has come more far in the development.
3.
How is Stockholm County Council (SLL/Region Stockholm) trying to implement the
concept of focus in healthcare (see eg Dabhilkar and Svarts, 2019)? What
similarities and differences to you find when you compare the two cases (SLL and
Rittenhouse Medical Center)?
SLL is trying to implement the concept of focus in healthcare by forming three new configurations of specialy
hospitals, NKS - highly speciality care unit, Sabbatsberg - elective care units, and Danderyd - emergency care
units for secondary care. This is similar to the 3B model since the idea is to have a more focused practice,
where resources are assigned to perform a specific procedure or in the SLL case procedures within a specific
area. This is also a difference between the cases, even though they have their “niche”, SLL is more broad.
Low degree of which patients they treat, 3b chooses the patients. Focus provides higher quality and efficiency.
Operations strategy på SLL – mer mot operation management på 3b.
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