Advanced services in hospital logistics in the German health service sector

Sustainable Supply Chain Management Practices and Sustainable Performance in Hospitals: A Systematic Review and Integrative Framework

Hospital supply chains are responsible for several economic inefficiencies, negative environmental impacts, and social concerns. However, a lack of research on sustainable supply chain management specific to this sector is identified. Existing studies do not analyze supply chain management practices in an integrated and detailed manner, and do not consider all sustainable performance dimensions. To address these gaps, this paper presents a systematic literature review and develops a framework for identifying the supply chain management practices that may contribute to sustainable performance in hospitals. The proposed framework is composed of 12 categories of management practices, which include strategic management and leadership, supplier management, purchasing, warehousing and inventory, transportation and distribution, information and technology, energy, water, food, hospital design, waste, and customer relationship management. On the other side, performance categories include economic, environmental, and social factors. Moreover, illustrative effects of practices on performance are discussed. The novelty of this document lies in its focus on hospital settings, as well as on its comprehensiveness regarding the operationalization of practices and performance dimensions. In addition, a future research agenda is provided, which emphasizes the need for improved research generalizability, empirical validation, integrative addressing, and deeper analysis of relationships between practices and performance.

Service modularity in managing healthcare logistics

Purpose

The purpose of this paper is to examine how modularity is used for enabling value creation in managing healthcare logistics services.

Design/methodology/approach

Material logistics of four different kinds of hospitals is examined through a qualitative case study. The theoretical framework builds on the literature on healthcare logistics, service modularity and value creation.

Findings

The case hospitals have developed their material logistics independently from others when looking at the modularity of offerings, processes and organisations. Services, such as assortment management, shelving and developing an information platform, have been performed in-house partly by the care personnel, but steps towards modularised and standardised solutions are now being taken in the case hospitals, including ideas about outsourcing some of the services.

Research limitations/implications

This paper proposes seven modularity components for healthcare logistics management: segmentation, categorisation and unitisation of offerings, differentiation and decoupling of processes, and centralisation and specialisation of organisations. Thus, this study clarifies the three-dimensional concept of modularity as a cognitive frame for managing logistics services with heterogeneous customer needs in a rapidly changing healthcare environment.

Practical implications

Modularity offers a tool for developing logistics services inside the hospital and increases possibilities to consider also external logistics service providers.

Social implications

Managing healthcare logistics services through modularity has potential social implications in developing healthcare processes and changing the usage of health services. On a wider scale, modularity is helping healthcare systems reaching their goals in terms of service quality and cost.

Originality/value

This paper shows the context-specific antecedents of service modularity and the usage of modular thinking in managing healthcare logistics.

Process optimization in the emergency department by the use of point-of-care-testing (POCT) in life-threatening conditions: comparative best practice examples from Germany and Malta

PURPOSE

Point-of-care testing (POCT) at the Emergency Department (ED) attains better objectives in patient care while aiming to achieve early diagnosis for faster medical decision-making. This study assesses and compares the benefits of POCT in the ED in Germany and Malta, while considering differences in their health systems.

METHODOLOGY/APPROACH

This chapter utilizes multiple case study approach using Six Sigma. The German case study assesses the use of POCT in acute coronary syndrome patients, compared to the central lab setting. The Maltese case study is a pilot study of the use of medical ultrasonography as a POCT to detect abdominal free fluid in post-blunt trauma.

FINDINGS

This study provides clear examples of the effectiveness of POCT in life-threatening conditions, as compared to the use of traditional central lab or the medical imaging department. Therapeutic quality in the ED and patient outcomes directly depend upon turnaround time, particularly for life-threatening conditions. Faster turnaround time not only saves lives but reduces morbidity, which in the long-term is a critical cost driver for hospitals.

ORIGINALITY/VALUE

The application of Six Sigma and the international comparison of POCT as best practice for life-threatening conditions in the ED.