| 1. |
- Rosenbäck, Ritva, et al.
(författare)
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Hospital Staffing during the COVID-19 Pandemic in Sweden.
- 2022
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 10:10
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Tidskriftsartikel (refereegranskat)abstract
- Staff management challenges in the healthcare system are inherently different during pandemic conditions than under normal circumstances. Surge capacity must be rapidly increased, particularly in the intensive care units (ICU), to handle the increased pressure, without depleting the rest of the system. In addition, sickness or fatigue among the staff can become a critical issue. This study explores the lessons learned by first- and second-line managers in Sweden with regard to staff management during the COVID-19 pandemic. A mixed-methods approach was used, with preliminary qualitative interview (n = 38) and principal quantitative questionnaire (n = 272) studies, based on principal component and multiple regression analyses. The results revealed that the pandemic created four types of challenges relating to staff management: staff movement within hospitals; addition of external staff; addition of hours for existing staff through overtime and new shift schedules; and avoidance of lost hours due to sickness or fatigue. Furthermore, the effects of these managerial challenges were different in the first wave than in later waves, and they significantly differed between the ICU and other units. Therefore, a greater proactive focus on staff management would be beneficial in future pandemic situations.
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| 2. |
- Fagefors, Carina, 1989, et al.
(författare)
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The creation of short-term flexibility in health care capacity management
- 2019
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Ingår i: PLANs Forsknings- och tillämpningskonferens 2019.
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Konferensbidrag (refereegranskat)abstract
- Background: The fact that unpredictable variations in supply and demand for capacity in the healthcare systems creates a need for flexibility is well known. The major types of tools used in the healthcare system to create short-term volume flexibility on the supply side include overtime, temporary staff from internal calling lists, mowing staff across units, staff pools, queuing patients, and purchasing services from external healthcare providers. Objective: The purpose of this paper is to explore where and to what extent the major types of tools for short-term flexibility on the supply side are used in the healthcare system. Method: A questionnaire was developed and distributed among department managers (N = 237; n = 106) in the Region Västra Götaland healthcare system. The respondents were asked to indicate on a seven-point Likert-type scale to what extent they used each tool to create short-term flexibility in capacity. Each manager’s unit was positioned on an acute/planned scale and on an inpatient/outpatient scale, and classified as primarily medical, surgical or psychiatrical. Data were analyzed with multiple regression. Results: A number of significant tendencies were found, for example, that acute units tend to use overtime and internal staffing pools to create flexibility to a larger extent, and patient queues and external healthcare providers to a smaller extent, than planned units do. Conclusion: In order to manage capacity efficiently on an aggregate level in the healthcare system, the prerequisites as well as the required managerial approaches differ substantially between different parts of the system. These differences must be addressed when, for example, capacity pools are considered.
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| 3. |
- Sternberg, Henrik, 1978, et al.
(författare)
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Using crowdsourced data to analyze transport crime
- 2018
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Ingår i: International Journal of Logistics Research and Applications. - : Informa UK Limited. - 1367-5567 .- 1469-848X. ; 21:2, s. 133-147
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Tidskriftsartikel (refereegranskat)abstract
- Anecdotal evidence suggests that harsh social conditions in the road haulage industry are having an impact on transport crime. This paper analyses transport crime, and demonstrates how to use a combination of official statistics and crowdsourced data in the process. A hierarchical regression analysis was applied to investigate the relations among different factors in order to predict transport crime threats. A secondary data set on transport crime from the Swedish Police was combined with primary crowdsourced data from volunteer observations of trucks in Sweden from both high-wage and low-wage countries. The findings imply that transportation is more vulnerable to antagonistic threats in geographical areas where the low-wage hauliers operate more frequently. For policymakers and practitioners, these findings provide useful guidance for the planning of security measures. To the authors' knowledge, this paper is the first exploratory study of its kind that uses a combination of official statistics and crowdsourced data.
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| 4. |
- Fagefors, Carina, 1989, et al.
(författare)
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Application of portfolio theory to healthcare capacity management
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Healthcare systems worldwide are faced with continuously increasing demand for care, while simultaneously experiencing insufficient capacity and unacceptably long patient waiting times. To improve healthcare access and availability, it is thus necessary to improve capacity utilization and increase the efficiency of existing resource usage. For this, variations in healthcare systems must be managed judiciously, and one solution is to apply a capacity pooling approach. A capacity pool is a general, collaborative capacity that can be allocated to parts of the system where the existing workload and demand for capacity are unusually high. In this study, we investigate how basic mean-variance methodology from portfolio theory can be applied as a capacity pooling approach to healthcare systems. A numerical example based on fictitious data is used to illustrate the theoretical value of using a portfolio approach in a capacity pooling context. The example shows that there are opportunities to use capacity more efficiently and increase service levels, given the same capacity, and that a mean-variance analysis could be performed to theoretically dimension the most efficient pooling organization. The study concludes with a discussion regarding the practical usefulness of this methodology in the healthcare context.
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| 5. |
- Fagefors, Carina, 1989, et al.
(författare)
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Creating short-term volume flexibility in healthcare capacity management
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 17:22, s. 1-18
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Tidskriftsartikel (refereegranskat)abstract
- It is well-known that unpredictable variations in supply and demand capacity in healthcare systems create the need for flexibility. The main tools used to create short-term volume flexibility in the healthcare system include overtime, temporary staff from internal calling lists, moving staff across units, internal staffing pools, external staffing agencies, queuing patients, and purchasing care from external providers. We study the creation of short-term volume flexibility in healthcare systems to manage short-term capacity losses. A questionnaire was developed and distributed among department managers in the Region Västra Götaland healthcare system. Respondents were asked to what extent they used each tool to create short-term flexibility in capacity. Data were analyzed using multiple regression analysis. Several significant tendencies were found, including that acute units use overtime and internal staffing pools to a larger extent, and patient queues and external providers to a smaller extent than planned units. The prerequisites and required managerial approaches used to manage aggregate capacity in the system efficiently differ substantially between different parts of the system. These differences must be addressed when, for example, capacity pools are considered. These results serve as a steppingstone towards a more thorough understanding of efficient capacity management in healthcare systems.
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| 6. |
- Gharaibeh, Lina, et al.
(författare)
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Building Information Modelling in the wood construction industry : Challenges and level of implementation
- 2022
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Konferensbidrag (refereegranskat)abstract
- Building information modelling (BIM) is becoming a necessity for the wood construction industry, this is due to its high level of prefabrication and complex digital procedures using wood sawing machines and sophisticated cuttings. This research examines the levelof BIM implementation in the wood construction industry in Sweden from industry experts prospective. Data was collected through interviews with industrial practitioners and academics. This research provides an important list of challenges that need to be considered to increase the level of BIM implementation in the wood construction industry. The research also provides recommendations for future research to aid in increasing the level of BIM implementation in the wood construction industry in Sweden.
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| 7. |
- Fagefors, Carina, 1989, et al.
(författare)
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Capacity pooling in healthcare systems – results from a mixed methods study
- 2019
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Ingår i: The 31st Annual NOFOMA Conference: Supply Chain Designs and Sustainable Development of Societies. ; , s. 91-106
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Konferensbidrag (refereegranskat)abstract
- Purpose: In this paper, we examine how pooling – a theoretically based strategy for capacity planning – can be used to create a higher service level at a given total capacity in the healthcare sector. The purpose of the study is to explore the practical obstacles for such a strategy in healthcare systems. Design/methodology/approach: A mixed methods approach was employed, where interviews were conducted with specialty department managers at Sahlgrenska University Hospital to identify perceived obstacles forcapacity pooling. Based on the results, a questionnaire was developed and distributed among managers in the Region Västra Götaland healthcare system. Data were analysed with a confirmatory factor analysis (CFA) and an explorative principal component analysis (PCA). Findings: Six different categories of potential obstacles for capacity pooling were identified during the interviews, namely competence, geography, culture, system, planning, and recruitment. These categories could not be confirmed by the CFA, but in the PCA we instead identified four obstacles for capacity pooling that were similar to the factors in the interview study. These were; threshold heights, community view, recruitment difficulties and physical distance. Practical implications: We conclude this study with presenting four obstacles to use capacity pools in the healthcare sector. These obstacles should be considered in order to introduce capacity pooling successfully in the healthcare system. Original/value: While there are some previous research results in the literature regarding capacity pooling in healthcare systems, they are typically anecdotal and descriptive. This is the first attempt to provide a systematic overview that could generate generalizable results.
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| 8. |
- Andersson, Roy, et al.
(författare)
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Total productive maintenance in support processes : an enabler for operation excellence
- 2015
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Ingår i: Total Quality Management and Business Excellence. - : Informa UK Limited. - 1478-3363 .- 1478-3371. ; 26:9-10, s. 1042-1055
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Tidskriftsartikel (refereegranskat)abstract
- In order to stay competitive in today's marketplace, it is vital to reduce activities that do not create value. Lean production has in the last decade been seen as a philosophy to reduce non-value time. The office environment often presents a major improvement opportunity to reduce non-value time. Lean contributes positively to business performance applied in a manufacturing context and is also suggested to do the same in a service context. The purpose of the paper is to analyse and determine how total productive maintenance (TPM) can be applied within the support process and to identify effects from an employee and business perspective. A case study has been performed and a qualitative research approach was selected. Empirical data were gathered by using semi-structured interviews at one case company, but from several teams that had applied TPM. The result was then used as an inductive approach to explore how TPM can be applied in a support process. To implement and apply TPM within an office context, it should be structured in three steps (i) define, (ii) implement and (iii) sustain. TPM should be conducted as a part of the ordinary day-to-day work. The planning and discussions connected to TPM can be included in regular daily departmental stand-up meetings' involving everybody. The work with 5S and maintenance should also be a part of the TPM structure, connecting it as a system and not as an isolated activity. TPM can create value from both a business and an employee perspective. In the employee perspective, TPM reduces the risk of missing/forgetting areas of responsibility and creates more involvement. In the business perspective, objectives such as cost and quality are improved, but TPM also enables the reduction of waste.
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| 9. |
- Lantz, Björn, 1967, et al.
(författare)
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Using queueing models to estimate system capacity
- 2017
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Ingår i: Production Planning and Control. - : Informa UK Limited. - 0953-7287 .- 1366-5871. ; 28:13, s. 1037-1046
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Tidskriftsartikel (refereegranskat)abstract
- The true capacity of a production or service system is often difficult to estimate with sufficient accuracy. The two main methodological approaches to capacity measurement described in the literature – measurements based on engineering and physical factors and measurement based on time studies – are both characterized by conceptual as well as practical shortcomings. This paper provides analyses on how capacity measurement can be approached using queueing models, thereby eliminating some major drawbacks of other approaches. For example, the suggested method is completely insensitive to the proportional relationship between design and effective capacity, and it cannot cause any behavioural problems during measurement since it does not require direct observation of the system itself. Particularly appealing is the potential for practical application to many contexts in many regions. The validity of the approach is discussed.
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| 10. |
- Fagefors, Carina, 1989, et al.
(författare)
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Staff Pooling in Healthcare Systems - Results from a Mixed-Methods Study
- 2024
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Ingår i: Health Systems. - : Informa UK Limited. - 2047-6973 .- 2047-6965. ; 13:1, s. 31-47
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Tidskriftsartikel (refereegranskat)abstract
- This study examines how staff pooling—a theoretical strategy for capacity planning—can be used to create a higher service level at a predetermined total capacity in the healthcare sector. We develop new empirical knowledge through a systematic empirical study, using a mixed-methods approach, with a preliminary interview study followed by a principal quantitative survey study, with data from a multihospital healthcare system. This study’s purpose was to explore the perceived practical barriers for a staff pooling strategy in healthcare systems. A principal component analysis identified three primary barriers, namely recruitment difficulties, community view, and specialisation. Notably, significant differences in perceived height among these barriers were also found, and the barrier that was found to be more important was recruitment difficulties. In addition, department managers perceive the barriers as significantly lower than lower-level managers do. The results from this study have important managerial implications for healthcare systems when implementing a staff pooling approach. This study also contributes to the existing literature since, to the best of our knowledge, no previous research has been done where barriers to staff pools are systematically identified and analysed in healthcare settings using a holistic approach that includes all healthcare professions in a multihospital healthcare system.
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