Queuing theory does not work for it. It must be eliminated by conventional management reforms. But worse, it adds variability to the entire hospital by feeding more cases to the floors on some days than others. In recent years, many hospitals have attracted more patients, often operating at 70 to 80 percent capacity. This is where Litvak and Long believe that excessive variability can set caregivers up to make mistakes.
Block booking remains in place at most large hospitals.
The changes MGH has made in OR allocation are working, the authors say. Yet as long as there is no research in this area, hospital leaders cannot draw on a body of knowledge to convince medical staff that this approach will benefit all. The authors worry that some leaders at hospitals and HMOs agree with their approach but take no action. If we are able to engage the issue they are challenging us to, then the potential for creating lots of winners is huge because we will be able to mobilize resources that can be reinvested where they are needed.