Optimizing Your Capacity to Care: A Systems Approach to Hospital and Population Health Management, 1st Edition (Hardback) book cover

Optimizing Your Capacity to Care

A Systems Approach to Hospital and Population Health Management, 1st Edition

By Pierce Story, MPHM

Productivity Press

232 pages | 28 B/W Illus.

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Hardback: 9781466593961
pub: 2016-06-14
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Our nation's capacity to care is becoming increasingly stressed as an aging and increasingly unhealthy population collides with a relative reduction in the numbers of clinicians and ever-tightening financial resources. If even the mildest of future-state predictions are to be believed, we need a significant restructuring of our entire healthcare system and its total Capacity to Care, such that we can simultaneously improve care capacity, cost, quality, accessibility, and resource gratification.

Optimizing Your Capacity to Care: A Systems Approach to Hospital and Population Health Management provides comprehensive guidance to a new way to optimize and manage community-wide Care Capacity via a unique, holistic approach to healthcare operations. Through clear examples and actual project results, the book demonstrates the outcomes of a systems-level way of thinking about a community's Capacity to Care that incorporates and integrates the full spectrum of available clinical and communal resources into the care of patients, including hospitals, physicians, emergency departments, surgical services, local churches, civic organizations, pharmacies, and volunteers.

The book details operational models for each major department of the hospital and a fully integrated communal resource pool to demonstrate how the optimization of capacity, resource utilization, cost, and clinical outcomes can be attained. And by providing healthcare leaders with a deeper understanding of key elements missing from the most common process improvement methodologies and approaches, this book offers fresh perspectives and bold alternatives for hospitals, health systems, and entire communities.

Table of Contents


Why This Topic?

Goals of This Book

A Caveat to the Claim of "Holistic"

Healthcare Cost: An Overview of the Issues

A Frank Conversation about the Cost of the U.S. Healthcare System



The 80–15–5 and the Population’s View

Relative Health

End of Life


Introduction to the Section on Workplace Culture

Making the Transition from a Culture of Accountability to a Culture of Ownership, by Joe Tye


The Journey from Accountability to Ownership

Culture Eats Strategy for Lunch

Fostering a More Positive Healthcare Culture

Key Lessons for Fostering a Culture of Ownership


Terminology of This Book

Care Circle Networks


Dynamic Capacity Analysis, Matching, and Management


Health Ownership



Hour of Day, Day of Week, Week of Month, and Season of Year

The Five Pillars of Healthcare Capacity Optimization

Introduction to Section on Hospital Capacity Optimization

Dynamic Capacity Management: An Approach to Capacity Optimization

Healthcare Is Different

Variability and Interdependencies

Demand Patterns and the Relevance of Ranges

Making Capacity Dynamic

DCAMM and Other PI Methodologies


The Blocking and Tackling of Hospital Capacity Management: An Overview

Blocking and Tackling of Capacity Management in the Emergency Department

Breaking Down the Arrival Data

Blocking and Tackling of ED Capacity

Other ED Performance Improvement Concepts


Blocking and Tackling of Capacity Management in Surgical Services

Block-Scheduling Overview

OR Data Analytics for Optimization

Surgeon Utilization

Other Analytics

Additional Analytics and Tips

Creating the New Schedule

Review of the Blocking and Tackling of Block Scheduling


Blocking and Tackling of Inpatient Capacity Management

Capacity Variance

Essential Elements

Managing Inpatient Capacity Patterns


Physicians and Their Role in Optimization

Until Then, What Now?

Final Thoughts: Legal Protections


Preparing for Coming Change: Forming a PHO, by Peter Wood


Culture and Behavior

Getting Started

What Does the Operational Structure Look Like?

Funding the PHO Operations

Pulling It All Together: A Real Case Model of a PHO

Is This All for Real? Does It Exist Elsewhere?

Care Circle Networks: An Introduction


Achilles’ Heels


The Care Circle Network Concept

CCN Description

Application Overview

An Engineered Approach

CCN Components

Managing Communal Resources

Technology Infrastructure

Palliative and End-of-Life Care

Assimilation and Passion

Capacity as Strategy

Other Important Attributes of the CCN

An Additive Solution

A Caveat to the Contents of This Book

A Missing Element


Assessing the Community and the Patient Population

Selecting Patients

Size, Scope, and Scale of Your CCN

"Assimilation Propensity"


Building the Communal Resource Pool


Resource and Capacity Variance

Resource Options

Resource Selection

Selecting Physicians

Creating a Care Circle Team

Using the Care Strategies

Personalizing the Resource Pool

Resource Assimilation

Resources for the Resources

Resource Education for Assimilation

Leadership and Core Values

Group Dynamics™ for Resources

Outcomes and Incentives

Challenges and Obstacles


CCNs, Palliative Care, and End-of-Life Planning

Palliative Care: Definition and History

EOL Planning and Care

Integrating EOL and Palliative Care into the CCN Model

The Payor Role

Government and EOL Planning


Final Thoughts



About the Author

Pierce Story is the co-founder of Capacity Strategies, Inc., a firm dedicated to the optimization of the "Capacity to Care" in hospitals and communities. His unique expertise lies in "Dynamic Care Capacity Management" (a concept he has developed over the past 15 years); process and systems optimization; resource utilization; and the application of systems dynamics and process simulation to healthcare environments.

During his 25-plus-year healthcare career, Story has developed several innovative care and business models to improve health system operations and promote population health outcomes. His passion lies in creating holistic, systemic responses to key constraints facing healthcare, especially in low-income and at-risk communities. He has worked extensively in departmental and hospital-wide performance and capacity optimization as well as new facility planning throughout the care continuum, including work in Emergency Departments, Surgical Services, inpatient units, and community-based health clinics.

Subject Categories

BISAC Subject Codes/Headings:
BUSINESS & ECONOMICS / Quality Control
BUSINESS & ECONOMICS / Industries / Service Industries
MEDICAL / Administration