University Hospitals Cleveland Medical Center: Managing Capacity in Neurology

Joel  Goh; Robert S. Huckman; Nikhil  Sahni

Case | HBS Case Collection | March 2018

University Hospitals Cleveland Medical Center: Managing Capacity in Neurology

by Joel Goh, Robert S. Huckman and Nikhil Sahni

Abstract

In December 2014, Dr. Anthony Furlan, chair of the Department of Neurology at University Hospitals Cleveland Medical Center (UH), faced a mandate from the hospital’s executive leadership team. Specifically, all UH departments were directed to take steps within six months to reduce the waiting time for outpatient appointments—measured as the time to first available outpatient appointment—to no more than 15 days. For Furlan and his colleagues in neurology, achieving this target was a significant challenge, as the department’s current time to first available appointment was 93 days. The case considers several alternatives for reducing waiting time in outpatient neurology without increasing the total clinical staff. The case allows students to evaluate opportunities for expanding the effective capacity of a complex service operation and to understand the tradeoffs between customer service and labor utilization.

Keywords: health care; Hospitals; capacity planning; scheduling; Health Care and Treatment; Service Operations; Performance Capacity; Health Industry; North America; United States; Ohio; Cleveland;

Language: English

Format: Print

12 pages

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Citation:

Goh, Joel, Robert S. Huckman, and Nikhil Sahni. "University Hospitals Cleveland Medical Center: Managing Capacity in Neurology." Harvard Business School Case 618-062, March 2018.

Article | Annals of Internal Medicine | 2010

Estimating the Attributable Cost of Physician Burnout in the United States

Shasha Han, Tait D. Shanafelt, Christine A. Sinsky, Karim M. Awad, Liselotte N. Dyrbye, Lynne C. Fiscus, Mickey Trockel and Joel Goh

Background: Although physician burnout is associated with negative clinical and organizational outcomes, its economic costs are poorly understood. As a result, leaders in health care cannot properly assess the financial benefits of initiatives to remediate physician burnout.
Objective: To estimate burnout-associated costs related to physician turnover and physicians reducing their clinical hours at national (U.S.) and organizational levels.
Design: Cost-consequence analysis using a mathematical model.
Setting: United States.
Participants: Simulated population of U.S. physicians.
Measurements: Model inputs were estimated by using the results of contemporary published research findings and industry reports.
Results: On a national scale, the conservative base-case model estimates that approximately $4.6 billion in costs related to physician turnover and reduced clinical hours is attributable to burnout each year in the United States. This estimate ranged from $2.6 billion to $6.3 billion in multivariate probabilistic sensitivity analyses. At an organizational level, the annual economic cost associated with burnout related to turnover and reduced clinical hours is approximately $7600 per employed physician each year.
Limitations: Possibility of nonresponse bias and incomplete control of confounders in source data. Some parameters were unavailable from data and had to be extrapolated.
Conclusion: Together with previous evidence that burnout can effectively be reduced with moderate levels of investment, these findings suggest substantial economic value for policy and organizational expenditures for burnout reduction programs for physicians.

Keywords: Physicians; burnout; Health; Health Care and Treatment; Employees; Cost; Programs; Policy; Health Industry;

Citation:

Han, Shasha, Tait D. Shanafelt, Christine A. Sinsky, Karim M. Awad, Liselotte N. Dyrbye, Lynne C. Fiscus, Mickey Trockel, and Joel Goh. "Estimating the Attributable Cost of Physician Burnout in the United States." Annals of Internal Medicine 170, no. 11 (June 4, 2019): 784–790. View Details

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University Hospitals Cleveland Medical Center: Managing Capacity in Neurology

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