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Citation

Bowers J & Mould G (2013) Understanding the effects of service redesign on patient-time in an Emergency Department. International Journal of Services Technology and Management, 19 (4/5/6), pp. 254-266. https://doi.org/10.1504/IJSTM.2013.055621

Abstract
Considerable effort has been expended in improving the health service in the United Kingdom through a focus on quantifiable targets. This paper examines the specific experience of the introduction of a new staff rota designed to help reduce the time patients spend in the Emergency Department at one hospital. A simple comparison of the mean times suggested a significant improvement in the service. However, there had been substantial changes in the environment and an analysis of covariance, incorporating the volume of activity and the doctors' experience, suggested that the new staff rota had differential benefits for different categories of patients: some had a reduction of 16 minutes in their mean time though others were unaffected. This example illustrates the challenges of measuring the impact of service redesign in healthcare even when a well defined innovation is considered and the impact is restricted to a readily quantified measure.

Keywords
health; National Health Service; United Kingdom; emergency; service redesign; targets; patient waits; treatment times; staff rota; matching capacity and demand

Journal
International Journal of Services Technology and Management: Volume 19, Issue 4/5/6