Category Archives: board of directors

TA (throughput accounting) and TDABC (time driven activity based costing)….the fabric, the ‘warp and woof’ of healthcare accounting?


also see: throughput accounting…a natural for hospitals? Linkedin thread also see: throughput accounting (TA) vs activity based costing (ABC) also see: FTE vs cost accounting… when PUNs equal CUEs also see: When you’re lost, use a map… also see: Graphic Simulation … Continue reading

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Getting Dr. Able out of the OR before 4pm…


narration for SHS1013 poster presentations supports  #161 “SHS2013 Clarifying OR On Time Starts” supports #107 “SHS2013 Clarifying OR Turnover Time Concept Graph” supports #113 “Resolving Resistance to OR scheduling changes; Implementing a Multi-faceted Model” also see The effects of late surgeons … Continue reading

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OR Policy Comparative Results and PreOP Congestion


See also: “SHS2013 Resolving Resistance to OR Scheduling” “SHS2013 Clarifying OR Turnover Time Concept Graph” “SHS2013 Clarifying OR On Time Starts” Many PreOp holding areas have a large variance in their usage.  To keep PreOp from being a constraint (bottleneck) for surgery (surgeons … Continue reading

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Linkedin converstion: “How will medical tourism insert itself into mainstream of US healthcare reform?”


MariaUnfollow How will medical tourism insert itself into the mainstream of U.S. healthcare reform? Under healthcare reform, employers are beginning to express interest in concepts and reform measures which have variously been labeled ―value-based, ―results-based, ―performance-based, or ―outcomes-based purchasing and … Continue reading

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Linkedin Medical Tourism excerpt: Major Diagnostic Category flaws


Medical Tourism for Group Health: Using Major Diagnostic Categories (MDCs) to Predict Medical Tourism Utilization – A Flawed Strategy that Can Lead to Unrealistic Expectations The MDC is a very commonly used term, and widely misunderstood. All diagnoses or illnesses … Continue reading

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Is Healthcare’s Insular Culture a Liability or Benefit? Linkedin thread started by Peter Hadras…


Is Healthcare’s Insular Culture a Liability or Benefit? Working recently in the healthcare industry, I keep being struck by the deep-seated culture that unless the solution or practitioner is from healthcare, then it cannot be applied to a solve a … Continue reading

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throughput accounting…a natural for hospitals? Linkedin thread.


see also: TA (throughput accounting) and TDABC (time driven activity based costing)…the fabric, the ‘warp and woof’ of healthcare accounting?   Throughput Accounting— a natural for Hospitals? In my work with increasing OR productivity, throughput accounting quickly shows the benefits of … Continue reading

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constraint theory and Pareto Optimals…


Brian Gregory, MD, MBA • Wayne, good question. Healthcare is a funny animal–you have constraints within constraints. One of the main tenets of ToC is to pick what you want to be the constraint. In the case of the OR (ER, radiology, … Continue reading

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bad research…or bad reporting?


This is an example of the perils (morbidity, mortality, and financial) of mathematical manipulation of data by researchers in basing broad conclusions without more fully understanding the processes and externalities involved: Unnecessary anesthesia adds $1B to health spending – FierceHealthcare … Continue reading

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the art of flipping rooms…


– There are two main parts to flipping rooms: intra-case and inter-case. They are complementary and work together iteratively. – An analogy of this iterative type of scheduling –adjusting individual cases(intra-case) and schedule (inter-case) to make a good fit– is … Continue reading

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a box lunch to go…


It looks as though healthcare funding will be cut shortly.  Medicare will be on the chopping block soon, reimbursements for hospitals will be down.  Those who don’t think outside the box–who never saw the lid of  the box closing–will be … Continue reading

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Do Doctors run Hospitals better?


internet: http://ftp.iza.org/dp5830.pdf local: Who Needs an MBA   So which is better, an MD, MBA, or MD / MBA?

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the dark side of hospital patient flow…Part 2


I received this email last week. Have you ever seen the drawings with the title ‘Where’s Waldo?’ Let’s play “Where’s the constraint?’ Think in terms of the discussion from my prior post ‘the dark side of hospital flow…Part 1’. Start … Continue reading

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the dark side of hospital patient flow… Part 1


Flow is defined as the quantity of some item (units of an item) passing by, leaving, or arriving at some point in a designated unit of time.  So, flow is defined by four parameters: units(1) of an item(1) , a … Continue reading

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putting it all together…intra-case and inter-case….TOT and more


There are a thousand variations of the following examples, but I hope these four graphs will get across some ideas.  For potential economic effects, see:  Wasting $2.7 million dollars a year. Each of the following graphs has 5 bars. Each … Continue reading

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predicting scheduled starts for surgery…


also see: Graphic Simulation Interactions of Constraint Theory and Lean This is getting to be fun.  Now, for a bit of applied constraint theory… In this simulation we’re considering the surgeon as the most important person…the constraint.  We don’t want … Continue reading

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Big Bwana and little bwana…


Everything in the below graph is adjustable (and is derived from less data than is normally collected in an OR). It’s quite useful when deciding how to create your portfolio of surgeons, anesthesiologists, or nurses to limit the short-comings, and … Continue reading

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the cost of late surgeons… and the revenue from early surgeons


The purple bars represent the time saved for nursing staff and anesthesia if there is a policy for the surgeon to be ready to cut 30 minutes (adjustable) before the scheduled start of cases in the morning.  The effects of … Continue reading

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Typical OR case dissected with details…


These are the relevant milestones and intervals in a typical OR case.  I left off the details so as not to detract from the comparison to the normal representation of an OR case as a single block of time with … Continue reading

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FT: “Chief profitability officers still rare”


The Financial Times has new articles emphasizing that the CFO needs to know more systems engineering, have better analytical skills, and understand IT better.  Surprised? Chief probability officers still rare Competitive difference is in the analysis Finance heads need much … Continue reading

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FT: “Competitive difference is in the Analysis”


I’ve been discussing this, and showing examples, on my weblog for some time.  Here’s a (The) major financial newspaper saying the same thing: Competitive difference is in the analysis

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FT: “Finance heads need much wider view of IT”


For those of you who won’t subscribe to Financial Times… Finance heads need much wider view of IT The Financial Times is a premier newspaper dedicated to the finance world: CFOs, CEOs, CFAs. If you pass the article along, a … Continue reading

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board can struggle with data puzzle…


Board can Struggle with Data Analysis I’ve discussed visual analytics before, and its ability to bring actionable information to both the CEO and worker on the floor.  The Financial Times has just published the above Special Report saying that boards … Continue reading

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