Integrated decision making in healthcare: an operations research and management science perspective

The pressure on healthcare systems rises as both demand for healthcare and expenditures are increasing steadily. As a result, healthcare professionals face the challenging task to design and organize the healthcare delivery process more effectively and efficiently. Designing and organizing processes is known as planning and control. Healthcare planning and control lags behind manufacturing and control for various reasons. One of the main causes is the fragmented nature of healthcare planning and control. Healthcare organizations such as hospitals are typically organized as a cluster of autonomous departments, where planning and control is also often functionally dispersed. As the clinical course of patients traverses multiple, thus interdependent, departments, an integrated approach to healthcare planning and control is likely to bring improvements. This thesis aims to contribute to integrated decision making in healthcare in two ways. First, it develops a framework, taxonomy, and extensive literature review to support healthcare professionals in structuring and positioning planning and control decisions in healthcare. The framework and taxonomy can be used to break down planning functions, determine managerial responsibilities and deficiencies, and to identify adjacent planning decisions influencing each other. Second, this thesis proposes planning approaches to develop resources allocation and patient admission plans for multiple departments, multiple resources and multiple patient types, thereby integrating decision making for a chain of healthcare resources. The planning approaches are developed with techniques from Operations Research and Management Science (OR/MS).