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UNIVERSITY OF WISCONSIN-MILWAUKEE. SHELDON B. LUBAR SCHOOLOF BUSINESS
PROGRAM NAME: MBA Career Focused Concentrations: Health Care Management.
COURSE NUMBER: Business Administration 755; Bus Adm 755.
COURSE TITLE: Healthcare Administration and Delivery Systems.
SEMESTER & YEAR: Fall Semester, 2012.
INSTRUCTOR: Alexander Kolker, Ph.D; Adjunct Faculty
SCHEDULE & LOCATION:
Mondays, 5:30 pm – 8:10 pm. First class will be September 10; last class will be December 10.
Final exam will be December 17.
Class meets in LUB N 440.
Office hours: Mondays, after class, 8:10 pm to 9 pm, or by appointment.
Instructor’s emails: alexanderkolker@yahoo.com (primary); kolker@uwm.edu
Mailbox location: the fourth floor of the SBA building, south of the elevators.
Web Site: https://uwm.courses.wisconsin.edu/d2l/home
Materials and Textbooks:
1. A. Kolker. Healthcare Management Engineering: What does this fancy
term really mean? The use of Operations Management Methodology for Quantitative
Decision-Making in Healthcare Settings.
Springer_Briefs Series in Healthcare Management & Economics, 2012
(will be referred as Kolker)
2. Y. Ozcan, Quantitative Methods in Healthcare Management, 2nd
Edition, 2009. Jossey-Bass.
(will be referred as Ozcan)
3. Reid P., D. Compton, J. Grossman, (Eds). Building a Better Delivery System: A New
Engineering / Health Care Partnership. National Academy of Engineering and Institute of
Medicine. Washington, DC, 2005. (will be referred as NAE Report)
4. PowerPoint class presentations. Available before each class from instructor.
Rationale for the Course:
Modern medicine has achieved great progress in treating individual patients. However,
according to the highly publicized report “Building a Better Delivery System: a New Engineering
/ Healthcare Partnership” published jointly by the National Academy of Engineering and the
Institute of Medicine (NAE Report), relatively little material resources and technical talent have
been devoted to the proper functioning of the overall health care delivery as an integrated and
economically sustainable system. This report provides strong convincing arguments that a real
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impact on quality, efficiency and sustainability of the health care delivery systems can be
achieved by the systematic and widespread use of methods and principles of system delivery
analysis and quantitative management of operations.
Management in all industries is moving toward more objective decision making; the
healthcare industry, however, is behind many other industries in this respect. Nonetheless,
some leading healthcare organizations have adopted this area as a strategic priority. For example,
the Mayo Clinic, one of the largest integrated medical centers in the USA, has defined the
Science of Healthcare Delivery as one of its four strategic directions. The Mayo Clinic has also
created the Center for the Science of Healthcare Delivery, a new initiative that will focus on
creating improved approaches to how healthcare is delivered.
One way to promote greater use of quantitative methods in decision making is to include a
quantitative methods sequence in the curricula of graduate programs in hospital and health
administration. This particular course places emphasis on the application of quantitative
techniques to problem solving and decision-making related to the management of health
operations and providers of care, including, but not limited to: hospitals, physician group
practices, clinics.
Program Competencies:
This course provides basic Management and Administration competencies for the program
curriculum. The primary program objectives pursued in this course are as follows:
o Understanding of the application of operations management, quantitative and
scientific techniques in planning, managing and evaluating health care programs
and organizations.
o Ability to apply selected quantitative techniques in addressing problems or
opportunities relating to planning, managing and evaluating health services
programs and health delivery organizations.
o Ability to plan and conduct organizational evaluations and management audits
and ability to design and implement integrated management and planning
systems, and organize and perform re-engineering in healthcare organizations.
o Ability to evaluate alternative planning methods/techniques, and ability to apply
selected quantitative planning methodologies in health care organizations.
Specific Course Objectives:
1. To develop analytical skills in decision-making and problem solving by using quantitative
analytical tools.
2. To develop proficiency in selecting and applying various quantitative techniques which may
be useful in administration of various health care services providers.
3. To identify the concept of decision-making from operational to strategic levels in various
health organization settings.
4. To review and critique the strengths and weaknesses of the above techniques in relation to
their applications in the health care settings.
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5. To identify health services problems or problem types amenable to various quantitative
techniques.
6. To identify the role of Operations Management methodology in organizational decision-
making, strategic planning and control.
Instructional Methodology:
Three modes of instruction will be used:
1. Lectures by instructor to describe and review concepts and techniques and their applications in
the health industry.
2. Discussions to critique the concepts and techniques.
3. Practical training in the use of MS Excel templates and computer simulation software to
analyze problems and develop solutions using various Operations Management techniques.
General Approach:
This course will be taught from the perspectives of decision-making and control systems in
general and their applications in healthcare provider management in particular. The emphasis of
the course will be to learn various concepts and techniques and apply the techniques to diverse
decision-making contexts.
Preliminary knowledge of MS Excel including Add-in is expected.
Attending Policy:
Class members are expected to be prepared for each class by reading the assigned material
before each session, and by attending each class session.
Evaluation:
Class members will be evaluated according to their performance on two examinations, and
computer based exercises.
Assigned exercises/home work are expected to be presented at the beginning of each next class.
An appropriate quality and quantity of in-class discussions relating to sessions subject area is
expected from each class member.
The course grade will be aggregated as follows:
Mid-Term Examination 50%
Final Examination 50%
Total 100%
Exams will be open-book/open-source. Typical exam problems will be covered in the class, but
actual exam problems will not be the same as in the class.
Typical Agenda for Each Class Session:
1. Questions/Answers for previous class session (solutions to assignments, etc.)
2. Lecture on scheduled session.
3. Computational demonstration (via computer) of assigned problems and/or exercises for
scheduled topic.
4. Follow-up (questions/answers) at the course web site or after-hours sessions.
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COURSE OUTLINE SUMMARY
Session Date Topic
01 09/10/12 Course organization. Introduction to Quantitative Decision-Making
in Healthcare Administration and Delivery Systems
02 09/17/12 Introduction to Forecasting for Healthcare Operations
03 09/24/12 Decision-Making in Health Care Settings / Option: Data Envelopment
Analysis for comparing the performance of the hospital nursing units
04 10/1/12 Staffing and Scheduling Using Linear Optimization Models. / Option: Staffing
with variable random demand (“the newsvendor approach framework”)
05 10/8/12 Resource Allocation Using Linear Optimization Models
06 10/15/12 Primary Care Clinics & Managing Physicians’ Patient Panel Size: Advanced
Access and Reducing Delays in Primary Care Clinics
07 10/22/12 Team based approach to care. ‘Fair’ Costs and Payoff Allocation among
cooperating providers. Introduction into the concept of the Shapley Value
08 10/29/12 Mid-Term Examination
09 11/5/12 Introduction into Queuing Analytic Theory: Random Demand and Fixed Supply
10 11/12/12 Introduction into Discrete Event Simulation (DES) Methodology. The Use of
DES for Capacity Analysis and Planning
11 11/19/12 DES Methodology: Staffing Planning
12 11/26/12 DES Methodology: Patient Flow/ DES methodology: Introduction to Healthcare
supply chain management
13 12/3/12 Fundamental Healthcare Operations Management Principles: Summary and
Review
14 12/10/12 Course Review and Reflections. Preparation for Final Examination
15 12/17/12 Final Examination
COURSE OUTLINE
Session: 1 Date: 09/10/12
Topics: Course Organization. Introduction to Quantitative Decision-Making in
Healthcare Administration and Delivery Systems
Objectives:
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1. Recognize the role of quantitative techniques for decision-making in
delivering high quality care
2. The historical background and the development of decision techniques
3. The healthcare manager’s role and responsibilities in decision making
4. The scope of health services and the recent trends in healthcare
5. Health services management and distinct characteristics of health services
Reading Assignments:
NAE Report. Executive Summary.
Ozcan: Chapter 1.
Kolker. Introduction. What is this book about? Who is this book for?
Session: 2 Date: 09/17/12
Topic: Introduction to Forecasting for Healthcare Operations
Objectives:
1. The need for forecasting in healthcare operations
2. Review the various approaches to forecasting
3. Differentiate the data-driven forecasts and opinion or judgment-based
forecasts
4. What type of forecasting approach should be taken for the various health care
forecasting situations?
5. The use of MS Excel, templates and statistical software Minitab for forecasting
Reading Assignments:
Kolker , chapter 4
Ozcan, chapter 2
Assignment: Selected Exercises on forecasting
Session: 3 Date: 09/24/12
Topic: Decision-Making in Health Care Settings/Data Envelopment Analysis (DEA)
for comparing the performance of the business units
Objectives:
1. The decision-making framework in health service organizations
2. The techniques that apply to decision-making under uncertainty and risk
3. Design a decision tree to solve a healthcare problem
4. Analyze sensitivity on outcomes and/or probabilities in analysis
5. Describe the multi-attribute decision-making
6. DEA framework and examples of applications
Reading Assignments:
Ozcan: Chapter 3.
Assignment:Selected Exercises from Chapter 3
Session: 4 Date: 10/1/12
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Topic: Staffing and Scheduling Using Linear Optimization Models
Objectives:
1. Linear programming methodology and its use in healthcare settings
2. The concept of decision variables, parameters, constraints, objective function
3. The use of MS Excel solver
4. Recognize the use of integer linear programming in staff scheduling.
Reading Assignments:
Kolker, chapter 3, sections 3.2 and 3.3;
Ozcan, chapter 10
Assignment: Selected Exercises on staffing & scheduling using Excel Solver
Session 5 Date: 10/8/12
Topic: Resource Allocation Using Linear Optimization Models
Objectives:
1. The concept of resource allocation in healthcare organizations
2. The use of MS Excel solver for resource allocation analysis
3. Introduction into the concept of sensitivity analysis
Reading Assignments:
Kolker, chapter 3, section 3.1
Ozcan, chapter 10
Assignment: Selected Exercises using Excel Solver
Session 6 Date: 10/8/12
Topic: Primary Care Clinics & Managing Physicians’ Patient Panel Size: Advanced Access
and Reducing Delays in Primary Care Clinics
Objectives:
1. The concept of advanced access at a primary care clinics: the patients’ panel
size and physician overflow frequency
2. Uncertainties that should be considered when scheduling patients
3. Decisions that need to be made when designing an appointment system
Reading Assignments:
Green, L., Savin, S., Murray, M., Providing Timely Access to Care: What is the
Right Patient Panel Size? The Joint Commision Journal on Quality and Patient
Safety, 33:211-218, 2007
Savin, S. in “Patient Flow: Reducing Delay in Healthcare Delivery” Ed. Hall, R.,
Springer, 2006. Chapter 5: “Managing Patient Appointments in Primary Care”.
pages 123-150
Assignment: Practice on using the panel size calculator
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Session 7 Date: 10/15/12
Topic: Team based approach to care. ‘Fair’ Costs and Payoff Distributions among
cooperating providers. Introduction into the concept of the Shapley Value.
Objectives:
1. A current trend of value and team based approach to patient care.
2. The issue and effect of cost allocation between providers
3. Introduction into the concept of the Shapley value as a method for providing a
‘fair’ cost (gain) allocation between cooperating providers of care
4. A special case of the Shapley value: application of an ‘airport’ game landing
fees scheme to healthcare organizations
Reading Assignments:
Kolker, chapter 6
Assignment: Selected Exercises
Session 8 Date: 10/29/12
Mid-Term Examination
Session 9 Date: 11/5/12
Topic: Introduction into Queuing Analytic Theory: Random Demand and Fixed
Capacity
Objectives:
1. The queuing systems and their use in healthcare services
2. Queuing concepts and their relationship to capacity planning
3. Some simple healthcare queuing models: their use and limitations
4. Solving some simple queuing problems in health services using Excel
spreadsheet
Reading Assignments:
Kolker, chapter 2, section 2.2; Ozcan, Chapter 14.
Assignment: Selected Exercises
Session 10 Date: 11/12/12
Topic: Introduction into Discrete Event Simulation (DES) Methodology. The Use of
DES for Capacity Analysis and Planning
Objectives:
1. The concept of simulation and its use in healthcare services with random
patient volumes and random service time
2. Demonstrate manually a simple simulation model
3. Review the components of simulation modeling
4. Demonstrate simple simulation models for capacity analysis and planning in
healthcare settings with variable patient volumes and mix.
Reading Assignments:
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Kolker, chapter 2, sections 2.1 and 2.3
Session 11 Date: 11/19/12
Topic: DES Methodology: Staffing Planning and Analysis
Objectives:
1. Demonstrate an effect of the uncertainty and variability of patient volumes
and mix on staffing planning and scheduling
2. Demonstrate the use of the right staff at the right time to minimize the
health organization’s operational costs
Reading Assignments:
Kolker, chapter 2, section 2.4.
Assignment:Selected Exercises
Session: 12 Date: 11/26/12
Topic: DES Methodology: Patient Flow
Objectives:
1. The concept of patient flow and hospital system throughput
2. Principles of surgical capacity and patient flow for operating rooms
3. Demonstrate the entire hospital system patient flow model: effect of
interdependency of ED, ICU, OR and regular nursing units on hospital
patient throughput
Reading Assignments:
Kolker, chapter 2, sections 2.3.9 to 2.3.11
Assignment: Selected Exercises
Session: 13 Date: 12/3/12
Topic: Fundamental Healthcare Operations Management Principles: Summary and
Review
Objectives:
1. Discuss and summarize fundamental Healthcare Operations Management
principles in Healthcare Settings
2. Discuss a similarity of fundamental operations management principles and
the laws of natural sciences
Reading Assignments:
Kolker, chapters 7 and 8
Session 14 Date: 12/10/12
Topic: Course Review. Preparation for Final Examination
Session 15 Date: 12/17/12
Topic: Final Examination