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Table 5 Cataract care

From: Exploring types of focused factories in hospital care: a multiple case study

Unit 11 12 13
Organizational context    
Focusing decisions/operations strategy Strategy pursuing efficiency Strategy to reduce the no. of visits in order to realize lead time ≤ 18 weeks Strategy pursuing open access, prevent medical liability
Standardized procedures Yes Yes Yes
Dedicated lay-out Cataract clinic with dedicated day-surgery operating rooms Cataract clinic with dedicated day-surgery operating rooms Clinic applied general operating rooms
Planning routine One stop diagnostics and scheduling of surgery Preoperative assessments according to open access model One stop diagnosis, preoperative assessment and scheduling of surgery One stop diagnosis, preoperative assessment and scheduling of surgery for clinic patients Most diagnostics (91% of the patients) take place outside the hospital at the practice of affiliated ophthalmologists
Team composition Extensive division of labor allocating tasks to nurses Extensive division of labor allocating tasks to nurses MDs perform most tasks
Degrees of focus    
Product focus 94% 94% 94%
Process focus 84% 84% 84%
Operational performance    
Visits/patient 3.2 3.0 3.6
Lead time (days) 91.0 109.2 15.0
   - Access time to outpatient clinic 25.0 31.5 0.0
   - Waiting time for surgery 66.0 77.7 15.0
  1. The organizational outcomes for unit 13 exclude diagnostics (as these take place outside the hospital). If these outside diagnostics were taken into account, the degree of focus score on process focus could deteriorate to 78% or 72%