The McKinsey Quarterly

close Visitor Edition

McKinsey Quarterly is the business journal of McKinsey & Company.

Upgrade to Premium Membership to read this article

  • Recommendations
  • Text Size
  • Print
  • Download PDF
  • Link to This

Hospitals get serious about operations Premium

The income statements of hospitals have been ailing. The cure? Serious attention to operating efficiency.

Walk into most hospitals in the United States today, and you observe a true logistical anachronism. Patients arrive in the admissions area at 5:00 in the morning, only to wait two hours before they are checked in and two more before someone preps them for surgery. At lunchtime, the traffic jam spills over into the operating rooms, where patients routinely arrive late because of the admissions delays. The surgeons, anticipating this, come later than scheduled for operations in order to avoid wasting time. By midafternoon the bottleneck has shifted to the recovery area and the intensive care unit (ICU), forcing groggy patients to wait back in the operating rooms. Frederick Winslow Taylor was worrying about inefficiencies of this kind in factories a century ago.

To understand why such problems persist in health care, you must go back at least to the mid-1980s. In those days, insurers still paid whatever fee hospitals demanded, and federal and state governments still subsidized the expansion of capacity by adding a "capital pass-through" term to their Medicaid and Medicare payments. Although much of US industry was applying modern logistics techniques, hospitals—like many service providers—felt no competitive pressure to do so.

Hospital care becomes a...

Premium Membership

Already a Quarterly member? Log in now.
Are you a Firm member or alumnus?

Premium Membership benefits:

  • Access to the entire Quarterly archive
  • Subscription to the collector’s edition print journal
  • Downloadable PDFs of all articles for offline use
  • Premium Membership FAQs 

Start by filling in this form

  • Membership Information
  • Shipping, Billing, & Payment
  • Review & Complete

Country & Membership Term

Shipping & Handling covers all charges for your membership term.

You may pay with Visa, MasterCard, Discover, or American Express.

Member Information

View our privacy policy.

We will not share your e-mail.
See details.

Newsletter Sign-up

View sample.

* Required

Embed E-mail