Skip to main navigation menu Skip to main content Skip to site footer
FrancoAngeli Journals

Saggi

No. 131 (2024)

Development paths of the operations management function in Italian healthcare organizations: Evidence from the case of Lombardy Region

DOI
https://doi.org/10.3280/mesa2024-131oa20238
Submitted
maggio 23, 2025
Published
2025-07-03

Abstract

The present study examines the diffusion of Operations Management (OM) in healthcare organizations through three perspectives: (i) its role within the organizations, (ii) the tools used, and (iii) the challenges to implementation. Data was collected through a questionnaire administered to healthcare organizations in Lombardy region (target population of 40 units, with a response rate of 65%). It is highlighted that healthcare organizations have established specific offices for OM, but with variations in composition,
objectives, and responsibilities. The use of data-based tools such as Six Sigma and Artificial Intelligence is lacking. Indeed, a primary challenge is the absence of reliable data to manage patient flows.

References

  1. Akinleye Dean D., McNutt L.-A., Lazariu V., McLaughlin C. C. (2019). Correlation between Hospital Finances and Quality and Safety of Patient Care. PLoS ONE, 14(8), e0219124. DOI: 10.1371/journal.pone.0219124.
  2. Barnabè F., Ruggiero P., Guercini J., Bracci L. (2014). Il lean thinking tra efficienza, efficacia e valore nell’azienda pubblica: il caso dell’azienda ospedaliera senese. Azienda Pubblica, 27(4): 347-377.
  3. Berg E., Weightman A. T., Druga D. A. (2020). Emergency Department Operations II: Patient Flow. Emergency Medicine Clinics of North America.
  4. Bredenhoff E., van Lent W. A.M., and van Harten W. H. (2010). Exploring Types of Focused Factories in Hospital Care: A Multiple Case Study. BMC Health Services Research, 10, (June), 154. DOI: 10.1186/1472-6963-10-154.
  5. Buffa E.S. (1980). Research in Operations Management. Journal of Operations Management, 1(1): 1-7.
  6. Carbone C., Lega F., Marsilio M., Mazzocato P. (2013). Lean on lean? Indagine sul perché e come il lean management si sta diffondendo nelle aziende sanitarie italiane. In: CeRGAS-Bocconi, Osservatorio sulle Aziende e sul Sistema Sanitario italiano. Rapporto OASI 2013. Milano: Egea, pp. 394-427.
  7. Carey K, Mitchell J.M. (2018). Specialization and production cost efficiency: evidence from ambulatory surgery centers. Int J Health Econ Manag., Mar, 18(1): 83-98. DOI: 10.1007/s10754-017-9225-9.
  8. Carey K, Mitchell J.M. (2019). Specialization as an Organizing Principle: The Case of Ambulatory Surgery Centers. Med Care Res Rev., Aug, 76(4): 386-402. DOI: 10.1177/1077558717729228.
  9. Chase R., Jacobs R., Aquilano N., Grando A., Sianesi A. (2001). Operations Management nella produzione e nei servizi. Milano: Mc Graw-Hill.
  10. Cook D., Thompson J. E., Habermann E. B., Visscher S. L., Dearani J. A., Roger V. L., and Borah B. J. (2014). From “Solution Shop” Model To “Focused Factory” in Hospital Surgery: Increasing Care Value and Predictability. Health Affairs, 33(5): 746-55. DOI: 10.1377/hlthaff.2013.1266.
  11. D’Andreamatteo A., Ianni L., Lega F., and Sargiacomo M. (2015). Lean in Healthcare: A Comprehensive Review. Health Policy, 119(9): 1197-1209. DOI: 10.1016/j.healthpol.2015.02.002.
  12. Davies C., Walley P. (2000). Clinical Governance and Operations Management Methodologies. International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services, 13(1): 21-26. DOI: 10.1108/09526860010311053.
  13. Day R., Garfinkel R., and Thompson S. (2012). Integrated Block Sharing: A Win-Win Strategy for Hospitals and Surgeons. Manufacturing & Service Operations Management, 14(4): 567-83. DOI: 10.1287/msom.1110.0372.
  14. Del Vecchio M., Roma I. (2012). L’operations management come innovazione gestionale. Mecosan, 21(81): 27-46.
  15. Fenech L., Lega F., Prenestini A. (2017). Il grado di diffusione di una funzione strutturata di gestione operativa nelle aziende sanitarie del SSN: un’analisi empirica. In: CERGAS (a cura di) (2017). Rapporto OASI 2017. Milano: Egea, pp. 615-634.
  16. Fenech L., Lega F., & Prenestini A. (2018). L’Operations Management nelle aziende pubbliche del SSN: da work in progress a work on process. Rapporto OASI.
  17. Forza C. (2002). Survey Research in Operations Management: A Process-Based Perspective. International Journal of Operations & Production Management, 22, (February): 152-94. DOI: 10.1108/01443570210414310.
  18. Freeman N. K., Melouk S. H., and Mittenthal J. (2016). A Scenario-Based Approach for Operating Theater Scheduling Under Uncertainty. Manufacturing & Service Operations Management, 18(2): 245-61. DOI: 10.1287/msom.2015.0557.
  19. Garrett J. S., Berry C., Wong H., Qin H., and. Kline J. A. (2018). The Effect of Vertical Split-Flow Patient Management on Emergency Department Throughput and Efficiency. The American Journal of Emergency Medicine, 36(9): 1581-84. DOI: 10.1016/j.ajem.2018.01.035.
  20. Heineke D. (2005). Operations Management. New York: McGraw-Hill.
  21. Institute of Medicine (US) Committee on Quality of Health Care in America (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US). -- http://www.ncbi.nlm.nih.gov/books/NBK222274/.
  22. Kayvanfar V., Akbari Jokar M. R., Rafiee M., Sheikh S., and Iranzad R. (2021). A New Model for Operating Room Scheduling with Elective Patient Strategy. INFOR: Information Systems and Operational Research, 59(2): 309-32. DOI: 10.1080/03155986.2021.1881359.
  23. King D. L., Ben-Tovim D. I., Bassham J. (2006). Redesigning Emergency Department Patient Flows: Application of Lean Thinking to Health Care. Emergency Medicine Australasia: EMA, 18(4): 391-97. DOI: 10.1111/j.1742-6723.2006.00872.x.
  24. Kumar S. A., and Suresh N. (2006). Production and Operations Management. New Age International (P) Limited. -- https://books.google.it/books?id=CcZNx668M0wC.
  25. Langabeer J.R. (2008). Health Care Operations Management: A Quantitative Approach to Business and Logistics. Jones & Bartlett Learning. -- https://books.google.it/books?id=qFgZcUDFVDQC.
  26. Langabeer J.R., and Helton J. (2020). Health Care Operations Management: A Systems Perspective. Jones & Bartlett Learning. -- https://books.google.it/books?id=XciAyQEACAAJ.
  27. Lega F., Marsilio M., and Villa S. (2012). An Evaluation Framework for Measuring Supply Chain Performance in the Public Healthcare Sector: Evidence from the Italian NHS. Production Planning & Control, 24, ( January): 1-17. DOI: 10.1080/09537287.2012.666906.
  28. Levine W. C., and Dunn P. F. (2015). Optimizing Operating Room Scheduling. Anesthesiology Clinics, 33(4): 697-711. DOI: 10.1016/j.anclin.2015.07.006.
  29. Leviner S., and Travers D. (2020). Patient Flow within Hospitals: A Conceptual Model. Nursing Science Quarterly, 33(1): 29-34. DOI: 10.1177/0894318419881981.
  30. Li L. X., Benton W.C., and Keong Leong G. (2002). The Impact of Strategic Operations Management Decisions on Community Hospital Performance. Journal of Operations Management, 20(4): 389-408. DOI: 10.1016/S0272-6963(02)00002-5.
  31. Lindner G., and Woitok B. K. (2021). Emergency Department Overcrowding : Analysis and Strategies to Manage an International Phenomenon. Wiener Klinische Wochenschrift, 133(5-6): 229-33. DOI: 10.1007/s00508-019-01596-7.
  32. Litvak E., Buerhaus P. I., Davidoff F., Long M. C., McManus M. L., and Berwick D. M. (2005). Managing Unnecessary Variability in Patient Demand to Reduce Nursing Stress and Improve Patient Safety. The Joint Commission Journal on Quality and Patient Safety, 31(6): 330-38. DOI: 10.1016/S1553-7250(05)31044-0.
  33. Magnoni P., Carnevali D., Cavazzana L., Principi N., Grimoldi L., Marsilio M., and Castaldi S. (2021). Waiting Time for Outpatient Specialist Care in Lombardy Region: Evaluating Accessibility and Quality of Information on Websites of Public Health Agencies and Healthcare Structures. Annali di Igiene: Medicina Preventiva e di Comunità, 33(1): 31-43. DOI: 10.7416/ai.2021.2406.
  34. Marsilio M., and Prenestini A. (2020). Making It Happen: Challenges and Transformations in Health Care Processes, People Management, and Decision-Making. Health Services Management Research, 33(2): 53-54. DOI: 10.1177/0951484820906314.
  35. Marsilio M., and Prenestini A. (2020). La gestione delle operations in tempo di crisi: le prime 10 lezioni apprese dalle Aziende Sanitarie. Mecosan, (113): 155-164.
  36. Marsilio M., Tomas Roldan E., Salmasi L., and Villa S. (2022). Operations Management Solutions to Improve ED Patient Flows: Evidence from the Italian NHS. BMC Health Services Research, 22(1): 974. DOI: 10.1186/s12913-022-08339-x.
  37. Marsh G., Guanciale T., Simon M. (1995). Operations improvement and reengineering at Ohio State University Medical Center. Top Health Inf Manage., Aug, 16(1): 41-6.
  38. Mazzocato P., Savage C., Brommels M., Aronsson H., and Thor J. (2010). Lean Thinking in Healthcare: A Realist Review of the Literature. Quality & Safety in Health Care, 19(5): 376-82. DOI: 10.1136/qshc.2009.037986.
  39. Medicine (US), Institute of (2010). The Future of Emergency Care: Key Findings and Recommendations from 2006 Study. Regionalizing Emergency Care: Workshop Summary. National Academies Press (US). -- https://www.ncbi.nlm.nih.gov/books/NBK220327/.
  40. Nair A., Nicolae M., and Narasimhan R. (2013). Examining the Impact of Clinical Quality and Clinical Flexibility on Cardiology Unit Performance ‒ Does Experiential Quality Act as a Specialized Complementary Asset?. Journal of Operations Management. DOI: 10.1016/j.jom.2013.09.001.
  41. Nguyen O. K., Halm E. A., and Makam A. N. (2016). Relationship Between Hospital Financial Performance and Publicly Reported Outcomes. Journal of Hospital Medicine, 11(7): 481-88. DOI: 10.1002/jhm.2570.
  42. Ozen A., Marmor Y., Rohleder T., Balasubramanian H., Huddleston J., and Huddleston P. (2016). Optimization and Simulation of Orthopedic Spine Surgery Cases at Mayo Clinic. Manufacturing & Service Operations Management, 18(1): 157-75. DOI: 10.1287/msom.2015.0564.
  43. Pakdil F., Beazoglou H. (2022). Monitoring Length of Stay of Acute Myocardial Infarction Patients: A Times Series Analysis Using Statistical Process Control. J Healthc Manag. Sep-Oct 01, 67(5): 353-366. DOI: 10.1097/JHM-D-21-00235.
  44. Porter M. E. (1985). Competitive advantage: creating and sustaining superior performance. New York: Free Press.
  45. Rossum L., van Kjeld H. A., Simons F. E., van der Eng N., and Ten Have W. D. (2016). Lean Healthcare from a Change Management Perspective. Journal of Health Organization and Management, 30(3): 475-93. DOI: 10.1108/JHOM-06-2014-0090.
  46. Soremekun O. A., Terwiesch C., and Pines J. M. (2011). Emergency Medicine: An Operations Management View. Academic Emergency Medicine, 18(12): 1262-68. DOI: 10.1111/j.1553-2712.2011.01226.x.
  47. Stonemetz J., Pham J.C., Necochea A.J., McGready J., Hody R.E., Martinez E.A. (2011). Reduction of regulated medical waste using lean sigma results in financial gains for hospital. Anesthesiol Clin., Mar, 29(1): 145-52. DOI: 10.1016/j.anclin.2010.11.007.
  48. Spector P.E. (2022). Summated Rating Scale Construction. An introduction. SAGE Publications Inc., 11 July. -- https://us.sagepub.com/en-us/nam/summated-rating-scale-construction/book3653.
  49. Twanmoh J.R., Cunningham G.P. (2006). When overcrowding paralyzes an emergency department. Manag Care, Jun, 15(6): 54-9.
  50. Van Dyke K. J., McHugh M., Yonek J., and Moss D. (2011). Facilitators and Barriers to the Implementation of Patient Flow Improvement Strategies. Quality Management in Health Care, 20(3): 223-33. DOI: 10.1097/QMH.0b013e318222a3b0.
  51. Van Looy B., Gemmel P., and Van Dierdonck R. (2013). Service Management. 3rd ed. Pearson. -- https://www.perlego.com/book/811304/service-management-an-integrated-approach-pdf.
  52. Villa S., Giusepi I. L., Lega F. (2012). Gli assetti organizzativi a supporto della gestione operativa: esperienze a confronto. In: Cantu E. (ed.). L’aziendalizzazione della sanità in Italia. Milano: Egea, pp. 439-460.
  53. Villa S., Prenestini A., Giusepi I. (2014). A framework to analyze hospital-wide patient flow logistics: evidence from an Italian comparative study. Health Policy, Apr, 115(2-3): 196-205. DOI: 10.1016/j.healthpol.2013.12.010.
  54. Villa S. (2021). Operations Management for Healthcare Organizations Theory, Models and Cases. Routledge Taylor & Francis Group.
  55. Vissers J., Beech R., (2005). Health Operations Management: Patient Flow Logistics in Health Care. Psychology Press.
  56. Wheelwright S. C., and Hayes R. H. (1985). Competing Through Manufacturing. Harvard Business Review, 1, January. -- https://hbr.org/1985/01/competing-through-manufacturing.
  57. Yau F. F.-F., Tsai T.-C., Lin Y.-R., Wu K.-H., Syue Y.-J., and Li C.-J. (2018). Can Different Physicians Providing Urgent and Non-Urgent Treatment Improve Patient Flow in Emergency Department?. The American Journal of Emergency Medicine, 36(6): 993-97. DOI: 10.1016/j.ajem.2017.11.010.
  58. Zanjiari R., Farahani N., and Davarzani H. (2009). Supply Chain and Logistics in National, International and Governmental Environment. Heidelberg: Physica-Verlag Springer.
  59. Zhu., Fan W., Yang S., Pei J., and Pardalos P. M. (2019). Operating Room Planning and Surgical Case Scheduling: A Review of Literature. Journal of Combinatorial Optimization, 37(3): 757-805. DOI: 10.1007/s10878-018-0322-6.

Metrics

Metrics Loading ...