INDUSTRIAL ENGINEERING APPLICATIONS IN HEALTH CARE SYSTEMS:INTRODUCTION TO INDUSTRIAL ENGINEERING IN HEALTH CARE DELIVERY SYSTEMS

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INTRODUCTION TO INDUSTRIAL ENGINEERING IN HEALTH CARE DELIVERY SYSTEMS

Frank Gilbreth is considered to be the first to use industrial engineering tools for methods improve- ment in a hospital situation. He applied his motion study techniques to surgical procedures in 1913 (Nock 1913); (Gilbreth 1916). In the 1940s, Lillian Gilbreth published articles explaining the benefits of using methods-improvement techniques in hospitals and in nursing (Gilbreth 1945, 1950). In 1952, a two-week workshop was conducted at the University of Connecticut on the application of methods improvement in hospitals (Smalley 1982). Also in 1952, the American Hospital Association (AHA) created a Committee on Methods Improvement. This committee prepared several papers on methods- improvement activities in hospitals and published them in its interim report in 1954.

In the late 1950s, the American Hospital Association started offering workshops on methods improvement around the country. Universities added courses on the application of methods improve- ment in hospital administration and industrial engineering programs. Gradually, other industrial en- gineering techniques were studied and applied to various hospital problems. The growing use of industrial engineering techniques in hospitals resulted in the foundation of the Hospital Management Systems Society (HMSS) in Atlanta in 1961, which subsequently moved to Chicago in 1964. The Institute of Industrial Engineers also recognized the expanding role of industrial engineering tech- niques and formed a hospital section in 1964. This section changed its name to the Health Services Division in 1977, reflecting the broader scope of the field. In 1988, the Institute of Industrial Engineers approved the formation of the Society for Health Systems (SHS) to replace the Health Services Division. In 1987, HMSS changed its name to Healthcare Information and Management Systems Society (HIMSS) to recognize the growing role of information systems in health care. Both HIMSS and SHS offer a number of seminars and workshops throughout the year related to the application of information systems and industrial engineering in health care. They also cosponsor annual HIMSS conference in February and the annual SHS conference in September / October of each year. Many of the industrial engineers working in the health care industry are members of both organizations.

Educational institutions started offering industrial engineering programs with specialization in health care systems. Many industrial engineers today work for hospitals and health systems, while others work as consultants in health care. The industrial engineers working in health care systems are usually referred as management engineers or operations analysts. Smalley (1982) gives a detailed history of the development of the use of industrial engineering in hospitals.

Industrial engineers gradually realized that many industrial engineering techniques initially applied to manufacturing / production systems were equally applicable in service systems such as health care systems. Almost all of the industrial engineering tools and techniques have been applied to health care systems. In this chapter, the application of only some of these techniques to health care systems will be discussed. From the examples presented here, readers should be able to appreciate the appli- cation of other techniques to health care systems. The application of the following techniques in health care systems is discussed here:

1. Methods improvement and work simplification

2. Staffing analysis

3. Scheduling

4. Queuing and simulation

5. Statistical analysis

6. Optimization

7. Quality improvement

8. Information systems / decision support systems

The emphasis will be on the application in health care, not on the techniques themselves, because the details of industrial engineering techniques are given in the other chapters of this Handbook. Applications will be discussed using various hospital departments as examples. For individuals not familiar with health care systems, Goldberg and Denoble (1986) describe various hospital depart- ments.

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