When one measures hospital activity of individual clinicians, units, and departments, there is always the challenge of aiming for balancing workload. However, it is a known fact that there is a human level variation as regards speed, focus, and efficiency. Obviously, volume is not a measure of quality of care, for which we need key performance indicators. I am interested to know of evidence or experience whereby volume and quality can be effectively reconciled.
This isn't an easy question to answer.
Firstly you have the planned operation and the expected complexity of that operation, then you have waht actually happened, part of which can be the result of the sugeon and part as a result of the patient.
Next you rightly say you have the quality. then you have the speed and the natural variation.
Then there is the issue of balancing workload. What is a balanced workload and why do we want to achieve this. Are we measuring for planning purposes or ....?
Personally, I would probably not focus on speed of operation too much. What we want is an operation that gives a good outcome for the patient in terms of clinical results aand quality of life, without rework.
Does that help at all?
mike
Thanks Mike for your reply. By balancing workload, what I mean is that if in for example the department of gastroenterology in a hospital, you have five consultant gastroenterologists, to what extent should one compare volume of patients seen, number of endoscopies done etc... My question above is how can this volume be reconciled with a holistic perspective of quality of care taking the above human variations into consideration? This is important I believe when conducting departmental reviews.
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