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- Iversen, Carina, et al.
(author)
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Capacity Pooling in Health Care Systems – A Conceptual Analysis
- 2018
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In: PLAN Forsknings- & tillämpningskonferens 2018, Jönköping, Sweden, 2018-10-23--2018-10-24.
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Conference paper (peer-reviewed)abstract
- The Swedish healthcare system is being challenged by a continuously increasing demand for care, while there is a lack of capacity. The use of temporary agency staff has been increasing for the past years, even though that is a short-term solution that generates high costs and can lead to impaired patient safety and deteriorating work environment. A measure to reduce the cost of temporary agency staff is to replace agency staff with less costly internal staffing agency in order to maintain the flexibility that such capacity pools create in staff planning. A capacity pool is a general capacity that can be allocated to parts of the system where the existing workload and demand for capacity is unusually high. Therefore, the use of internal capacity pools is a method to improve capacity utilisation of current resources, which is particularly important for bottlenecks in the system (i.e. physicians and nurses). From a theoretical perspective, there are several types of advantages that can be achieved with capacity pooling. However, there is a lack of systematic research on the support of the implementation of internal capacity pools in healthcare systems. Little is known about what benefits and costs that can be expected, how they can be organised, their structure and size, and their impact on healthcare performance. This paper investigates the conceptual benefits with reducing dependence on temporary agency staff in healthcare systems and replacing them with internal staffing pools and presents a planned empirical research project in the field. For instance, the use of internal capacity pools is a mean towards a more effective matching of demand with current resources and can thereby be used as a tool to improve capacity utilisation. In addition, the use of capacity pools can contribute to an enhanced work environment due to the possibility to meet large variations in demand, and thereby reduce variations in workload and overtime work.
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| 2. |
- van de Velde, Cornelis J. H., et al.
(author)
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EURECCA colorectal : Multidisciplinary Mission statement on better care for patients with colon and rectal cancer in Europe
- 2013
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In: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 49:13, s. 2784-2790
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Journal article (peer-reviewed)abstract
- Background: Care for patients with colon and rectal cancer has improved in the last twenty years however still considerable variation exists in cancer management and outcome between European countries. Therefore, EURECCA, which is the acronym of European Registration of cancer care, is aiming at defining core treatment strategies and developing a European audit structure in order to improve the quality of care for all patients with colon and rectal cancer. In December 2012 the first multidisciplinary consensus conference about colon and rectum was held looking for multidisciplinary consensus. The expert panel consisted of representatives of European scientific organisations involved in cancer care of patients with colon and rectal cancer and representatives of national colorectal registries.Methods: The expert panel had delegates of the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy & Oncology (ESTRO), European Society of Pathology (ESP), European Society for Medical Oncology (ESMO), European Society of Radiology (ESR), European Society of Coloproctology (ESCP), European CanCer Organisation (ECCO), European Oncology Nursing Society (EONS) and the European Colorectal Cancer Patient Organisation (EuropaColon), as well as delegates from national registries or audits. Experts commented and voted on the two web-based online voting rounds before the meeting (between 4th and 25th October and between the 20th November and 3rd December 2012) as well as one online round after the meeting (4th-20th March 2013) and were invited to lecture on the subjects during the meeting (13th-15th December 2012). The sentences in the consensus document were available during the meeting and a televoting round during the conference by all participants was performed. All sentences that were voted on are available on the EURECCA website www.canceraudit.eu. The consensus document was divided in sections describing evidence based algorithms of diagnostics, pathology, surgery, medical oncology, radiotherapy, and follow-up where applicable for treatment of colon cancer, rectal cancer and stage IV separately. Consensus was achieved using the Delphi method.Results: The total number of the voted sentences was 465. All chapters were voted on by at least 75% of the experts. Of the 465 sentences, 84% achieved large consensus, 6% achieved moderate consensus, and 7% resulted in minimum consensus. Only 3% was disagreed by more than 50% of the members.Conclusions: It is feasible to achieve European Consensus on key diagnostic and treatment issues using the Delphi method. This consensus embodies the expertise of professionals from all disciplines involved in the care for patients with colon and rectal cancer. Diagnostic and treatment algorithms were developed to implement the current evidence and to define core treatment guidance for multidisciplinary team management of colon and rectal cancer throughout Europe.
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