Scalability for supporting the growth of hospitals: application at Thailand hospitals

Public hospitals in Thailand have been forced to serve dramatically increased numbers of patients since the National Health Security Act 2002 gave access to free medical treatment. The challenge to hospitals is to plan for increasing resources and facilities of service processes to serve more patients. A model for analysing the scalability of factors necessary to the growth in hospital size has been developed. In its development, we focused on one part of the hospital, the outpatient department (OPD). The model is an outcome of three-stage study of OPDs. In the first stage, the OPD at a single hospital was investigated for the identification of key factors associated with patient flow. The second stage, the investigation expanded to seven hospitals so to find patterns in performance based on principles of Lean Systems. In the final stage, a descriptive model of 'scalability' was created. The objective of the model is to guide hospitals in planning their growth in size.