Designing the accident and emergency system: lessons from manufacturing

Abstract

Objectives: To review the literature on manufacturing process design and demonstrate applicability in health care.

Methods: Literature review and application of theory using two years activity data from two healthcare communities and extensive observation of activities over a six week period by seven researchers.

Results: It was possible to identify patient flows that could be used to design treatment processes around the needs of the patient. Some queues are built into existing treatment processes and can be removed by better process design. Capacity imbalance, not capacity shortage, causes some unnecessary waiting in accident and emergency departments.

Conclusions: Clinicians would find that modern manufacturing theories produce more acceptable designs of systems. In particular, good quality is seen as a necessary pre-requisite of fast, efficient services.