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• Exercise | September 2013 (Revised September 2020)

  Process Analytics Simulation: Solutions

  Robert S. Huckman, Aizan Radzi, Willy Shih, Roy D. Shapiro and Michael W. Toffel

  A set of exercises and instructions to be used with the Process Simulator software made by Pro Model. These exercises allow students to investigate the impact of variable processing times on the performance of simple in-line processes. Includes color exhibits.

  Keywords: Operations; Business Processes; Performance; Measurement and Metrics;

  Citation:

  Huckman, Robert S., Aizan Radzi, Willy Shih, Roy D. Shapiro, and Michael W. Toffel. "Process Analytics Simulation: Solutions." Harvard Business School Exercise 614-029, September 2013. (Revised September 2020.)  View Details

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• Case | HBS Case Collection | November 2016 (Revised August 2020)

  Improving Access at VA

  Ryan W. Buell, Robert S. Huckman and Sam Travers

  In 2015, the Department of Veterans Affairs (VA) ran the largest healthcare system in the United States, with over 1,700 sites of care that served nearly 9 million veterans. One year earlier, a scandal had erupted over a cover-up of the excessive wait times veterans faced to get medical appointments in some VA facilities. The fallout led to the resignation of the Secretary of Veterans Affairs, a criminal investigation by the Federal Bureau of Investigation, and the eventual replacement of 14 of VA’s top 17 leaders. This case documents the efforts of the new leadership team to improve access, regain trust, and transform the organization to address the broadening medical needs of the nation's growing veteran population.

  Keywords: Service Operations; Service Delivery; Social Issues; Health Care and Treatment; Government Administration; Performance Improvement; Public Administration Industry; Health Industry; United States;

  Citation:

  Buell, Ryan W., Robert S. Huckman, and Sam Travers. "Improving Access at VA." Harvard Business School Case 617-012, November 2016. (Revised August 2020.)  View Details

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• Article | Annals of Emergency Medicine

  The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding

  Brian Franklin, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris and Eric Goralnick

  Delayed access to inpatient beds for admitted patients contributes significantly to emergency department (ED) boarding and crowding, which have been associated with deleterious patient safety effects. To expedite inpatient bed availability, some hospitals have implemented discharge lounges, allowing discharged patients to depart their inpatient rooms while awaiting completion of the discharge process or transportation. This conceptual article synthesizes the evidence related to discharge lounge implementation practices and outcomes. Using a conceptual synthesis approach, we reviewed the medical and gray literature related to discharge lounges by querying PubMed, Google Scholar, and Google and undertaking backward reference searching. We screened for articles either providing detailed accounts of discharge lounge implementations or offering conceptual analysis on the subject. Most of the evidence we identified was in the gray literature, with only three peer-reviewed articles focusing on discharge lounge implementations. Articles generally encompassed single-site descriptive case studies or expert opinions. Significant heterogeneity exists in discharge lounge objectives, features, and apparent influence on patient flow. Although common barriers to discharge lounge performance have been documented, including underuse and care team objections, limited generalizable solutions are offered. Overall, discharge lounges are widely endorsed as a mechanism to accelerate access to inpatient beds, yet the limited available evidence indicates wide variation in design and performance. Further rigorous investigation is required to identify the circumstances under which discharge lounges should be deployed as well as how discharge lounges should be designed to maximize their effect on hospitalwide patient flow, ED boarding and crowding, and other targeted outcomes.

  Keywords: health care delivery; emergency room; operations improvement; operations management; Health Care and Treatment; Service Delivery; Operations; Management; Performance Improvement; Service Operations;

  Citation:

  Franklin, Brian, Sharif Vakili, Robert S. Huckman, Sarah Hosein, Nicholas Falk, Katherine Cheng, Maria Murray, Sheila Harris, Charles A. Morris, and Eric Goralnick. "The Inpatient Discharge Lounge as a Potential Mechanism to Mitigate Emergency Department Boarding and Crowding." Annals of Emergency Medicine 75, no. 6 (June 2020): 704–714.  View Details

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