Home > Articles > Business & Management

Introduction to Hospital Operations

Wallace J. Hopp and William S. Lovejoy introduce their book, which defines, explains, and applies management principles related to physical flows, decision making, quality, and human behavior of hospital operations.
Wallace J. Hopp and William S. Lovejoy introduce their book, which defines, explains, and applies management principles related to physical flows, decision making, quality, and human behavior of hospital operations.
This chapter is from the book

1.1. Stakeholders’ Perspectives

Thursday March 25, 2010, 8:46 p.m.

“#@%&*)^%#@!” Dr. Nate Greene swore as he clanged an easy layup clumsily off the rim.

Greene was an emergency physician from University Hospital who joined several of his medical colleagues to play basketball on Thursday evenings at a local elementary school gym. Because swearing was almost as rare as defense at these games, one of Greene’s teammates, orthopedic surgeon Dr. Ben Arnold, took notice. When the game ended and the players began leaving the gym, Arnold hung back with Greene.

“You okay?” he asked. “You seem a bit off tonight.”

“Aw,” Greene groaned. “My layups were just bricks tonight.”

“I don’t mean your shooting. That’s always terrible.” Arnold smiled. “But you seem kind of distracted tonight.”

Greene dropped the basketball banter and grew serious. “A woman I treated in the Emergency Department died in the hospital this morning. Bowel obstruction.”

“Mmmm.” Arnold commiserated. “That’s tough.”

“I knew her a little.” Greene continued. “She was taking care of both her elderly parents and a handicapped son. The family is completely devastated.”

“That is sad,” agreed Arnold. “But when it’s your time...”

“But that’s just it.” Greene’s voice rose. “I’m not sure it was her time to go.”

“Oh, oh. Did somebody screw up?” Arnold winced. “The surgeon?”

“No, not exactly.” Greene rubbed the basketball in his hands abstractedly. “I’ve been thinking about the case all day and I can’t put my finger on an outright error anywhere in the process. But we were slow at every step. The Emergency Department was crammed on Monday as usual, so she waited a long time. It took a while to get the CT scan and even longer to get the report. By the time we realized it wasn’t a virus, we’d already lost a day. Then the operating room was full, so it was another day before we got her on the schedule and a half day of delays after that. By the time they opened her up, there was no hope.” Greene dropped the ball and his voice. “I can’t help thinking that if we had been faster, she’d still be here.”

“Then it was the system that failed!” Arnold picked up the ball and began thumping it on the floor. “Every one of the people on the case did his or her job. So blame the hospital, not the people in it.”

“What are you talking about?” Greene grabbed the ball back and heaved up a shot that missed the rim by more than a foot. “The hospital is the people in it. We control what goes on there. So if it failed; we failed.”

“Are you kidding?” Arnold jeered, and not just about the wild shot. “Nobody controls the hospital. It’s too big, too complicated, and too set in its ways. That’s why I’m leaving.”

“What!” Greene had taken a step to retrieve the ball but stopped and turned to face Arnold. “Where are you going?”

“I’ve signed on with Andry Ortho,” Arnold replied. Nicolas Andry Orthopedic Surgery Center was a small physician-owned specialty hospital founded several years ago by a group of physicians from University Hospital. Greene was aware that the facility had undergone an expansion at the beginning of the year, right before the health care bill put a ban on further growth of physician-owned hospitals. But he didn’t know that Arnold had been considering joining them.

“Are you an owner?” Greene asked incredulously.

“Well, I have a piece,” Arnold admitted. “But it’s not the money that sold me. It’s the fact that the docs run the place. The hospital is small, simple, and new. We run on schedule. The IT system actually works. We can practice medicine instead of fighting the bureaucracy. The kind of system failure you had today won’t happen to us.”

“That does sound pretty good.” Greene recovered the basketball and flipped it to Arnold.

“You should join us.” Arnold launched a perfect jump shot that swished neatly through the center of the net. “We’ve been staffing the emergency facility with specialists, but demand has grown to the point where we could use a real Emergency Department doc. Specialty hospitals are the way of the future.”

“Hmmm...” Greene mused softly. “I’ll think about it.”

InformIT Promotional Mailings & Special Offers

I would like to receive exclusive offers and hear about products from InformIT and its family of brands. I can unsubscribe at any time.

Overview


Pearson Education, Inc., 221 River Street, Hoboken, New Jersey 07030, (Pearson) presents this site to provide information about products and services that can be purchased through this site.

This privacy notice provides an overview of our commitment to privacy and describes how we collect, protect, use and share personal information collected through this site. Please note that other Pearson websites and online products and services have their own separate privacy policies.

Collection and Use of Information


To conduct business and deliver products and services, Pearson collects and uses personal information in several ways in connection with this site, including:

Questions and Inquiries

For inquiries and questions, we collect the inquiry or question, together with name, contact details (email address, phone number and mailing address) and any other additional information voluntarily submitted to us through a Contact Us form or an email. We use this information to address the inquiry and respond to the question.

Online Store

For orders and purchases placed through our online store on this site, we collect order details, name, institution name and address (if applicable), email address, phone number, shipping and billing addresses, credit/debit card information, shipping options and any instructions. We use this information to complete transactions, fulfill orders, communicate with individuals placing orders or visiting the online store, and for related purposes.

Surveys

Pearson may offer opportunities to provide feedback or participate in surveys, including surveys evaluating Pearson products, services or sites. Participation is voluntary. Pearson collects information requested in the survey questions and uses the information to evaluate, support, maintain and improve products, services or sites, develop new products and services, conduct educational research and for other purposes specified in the survey.

Contests and Drawings

Occasionally, we may sponsor a contest or drawing. Participation is optional. Pearson collects name, contact information and other information specified on the entry form for the contest or drawing to conduct the contest or drawing. Pearson may collect additional personal information from the winners of a contest or drawing in order to award the prize and for tax reporting purposes, as required by law.

Newsletters

If you have elected to receive email newsletters or promotional mailings and special offers but want to unsubscribe, simply email information@informit.com.

Service Announcements

On rare occasions it is necessary to send out a strictly service related announcement. For instance, if our service is temporarily suspended for maintenance we might send users an email. Generally, users may not opt-out of these communications, though they can deactivate their account information. However, these communications are not promotional in nature.

Customer Service

We communicate with users on a regular basis to provide requested services and in regard to issues relating to their account we reply via email or phone in accordance with the users' wishes when a user submits their information through our Contact Us form.

Other Collection and Use of Information


Application and System Logs

Pearson automatically collects log data to help ensure the delivery, availability and security of this site. Log data may include technical information about how a user or visitor connected to this site, such as browser type, type of computer/device, operating system, internet service provider and IP address. We use this information for support purposes and to monitor the health of the site, identify problems, improve service, detect unauthorized access and fraudulent activity, prevent and respond to security incidents and appropriately scale computing resources.

Web Analytics

Pearson may use third party web trend analytical services, including Google Analytics, to collect visitor information, such as IP addresses, browser types, referring pages, pages visited and time spent on a particular site. While these analytical services collect and report information on an anonymous basis, they may use cookies to gather web trend information. The information gathered may enable Pearson (but not the third party web trend services) to link information with application and system log data. Pearson uses this information for system administration and to identify problems, improve service, detect unauthorized access and fraudulent activity, prevent and respond to security incidents, appropriately scale computing resources and otherwise support and deliver this site and its services.

Cookies and Related Technologies

This site uses cookies and similar technologies to personalize content, measure traffic patterns, control security, track use and access of information on this site, and provide interest-based messages and advertising. Users can manage and block the use of cookies through their browser. Disabling or blocking certain cookies may limit the functionality of this site.

Do Not Track

This site currently does not respond to Do Not Track signals.

Security


Pearson uses appropriate physical, administrative and technical security measures to protect personal information from unauthorized access, use and disclosure.

Children


This site is not directed to children under the age of 13.

Marketing


Pearson may send or direct marketing communications to users, provided that

  • Pearson will not use personal information collected or processed as a K-12 school service provider for the purpose of directed or targeted advertising.
  • Such marketing is consistent with applicable law and Pearson's legal obligations.
  • Pearson will not knowingly direct or send marketing communications to an individual who has expressed a preference not to receive marketing.
  • Where required by applicable law, express or implied consent to marketing exists and has not been withdrawn.

Pearson may provide personal information to a third party service provider on a restricted basis to provide marketing solely on behalf of Pearson or an affiliate or customer for whom Pearson is a service provider. Marketing preferences may be changed at any time.

Correcting/Updating Personal Information


If a user's personally identifiable information changes (such as your postal address or email address), we provide a way to correct or update that user's personal data provided to us. This can be done on the Account page. If a user no longer desires our service and desires to delete his or her account, please contact us at customer-service@informit.com and we will process the deletion of a user's account.

Choice/Opt-out


Users can always make an informed choice as to whether they should proceed with certain services offered by InformIT. If you choose to remove yourself from our mailing list(s) simply visit the following page and uncheck any communication you no longer want to receive: www.informit.com/u.aspx.

Sale of Personal Information


Pearson does not rent or sell personal information in exchange for any payment of money.

While Pearson does not sell personal information, as defined in Nevada law, Nevada residents may email a request for no sale of their personal information to NevadaDesignatedRequest@pearson.com.

Supplemental Privacy Statement for California Residents


California residents should read our Supplemental privacy statement for California residents in conjunction with this Privacy Notice. The Supplemental privacy statement for California residents explains Pearson's commitment to comply with California law and applies to personal information of California residents collected in connection with this site and the Services.

Sharing and Disclosure


Pearson may disclose personal information, as follows:

  • As required by law.
  • With the consent of the individual (or their parent, if the individual is a minor)
  • In response to a subpoena, court order or legal process, to the extent permitted or required by law
  • To protect the security and safety of individuals, data, assets and systems, consistent with applicable law
  • In connection the sale, joint venture or other transfer of some or all of its company or assets, subject to the provisions of this Privacy Notice
  • To investigate or address actual or suspected fraud or other illegal activities
  • To exercise its legal rights, including enforcement of the Terms of Use for this site or another contract
  • To affiliated Pearson companies and other companies and organizations who perform work for Pearson and are obligated to protect the privacy of personal information consistent with this Privacy Notice
  • To a school, organization, company or government agency, where Pearson collects or processes the personal information in a school setting or on behalf of such organization, company or government agency.

Links


This web site contains links to other sites. Please be aware that we are not responsible for the privacy practices of such other sites. We encourage our users to be aware when they leave our site and to read the privacy statements of each and every web site that collects Personal Information. This privacy statement applies solely to information collected by this web site.

Requests and Contact


Please contact us about this Privacy Notice or if you have any requests or questions relating to the privacy of your personal information.

Changes to this Privacy Notice


We may revise this Privacy Notice through an updated posting. We will identify the effective date of the revision in the posting. Often, updates are made to provide greater clarity or to comply with changes in regulatory requirements. If the updates involve material changes to the collection, protection, use or disclosure of Personal Information, Pearson will provide notice of the change through a conspicuous notice on this site or other appropriate way. Continued use of the site after the effective date of a posted revision evidences acceptance. Please contact us if you have questions or concerns about the Privacy Notice or any objection to any revisions.

Last Update: November 17, 2020