With his background in economics and law, and extensive experience as a Lean Six Sigma program manager at PostNL, a career move to healthcare wasn’t immediately obvious for Maarten van Mierlo. However, with family, friends, and his spouse working in healthcare, he decided to make the transition and contribute to healthcare in a more personal way. “The quality of healthcare in the Netherlands is very high. Doctors have always been in charge here, and I love that passion. But these same doctors have also been managing the business side of healthcare, which, in MMC’s case, involves more than 300 million euros in revenue and over 4,000 employees. They aren’t primarily trained for that. There is still a lot of room for improvement.”

"In a process-oriented organization, you follow the patient instead of the doctor."

From silo to process

“One thing that immediately stood out when I arrived here was the number of similarities with my previous work,” says Van Mierlo. “PostNL is also a large organization with a 24-hour dynamic, a production environment, former government ownership, and people who take pride in their work.” Of course, there are differences as well. “Hospitals are naturally organized in silos. It’s all about care, and less attention is paid to the patient’s journey. In a process-oriented organization, you follow the patient instead of the doctor.”

Van Mierlo also noted that aligning staff with patient presence was not as developed as it could be: “Knowing how many patients you can help based on what you do, knowing how many are on the waiting list, knowing how many operating rooms can be opened to keep things moving quickly. Initially, people looked at me like, ‘What kind of questions are these?’ But planning staff based on bed availability is very different from planning based on patient presence. Just because there are 30 beds doesn't mean you need 30 staff members. In pulmonology, there are fewer patients in the summer than in the winter.” “The healthcare sector views itself as a very unique environment that can’t be compared to anything else. It took me a few years to understand healthcare, but also to show that there indeed are multiple other industries that can help advance it.”

Contributing instead of taking away

At companies like PostNL, NS, and Schiphol, everything revolves around planning, says Van Mierlo: “Healthcare can learn a lot from that. I often heard that hospitals are less predictable than packages. That’s not true. Nothing is as predictable as patient flow. At PostNL, for example, rain can reduce production capacity by half on certain days.”

COVID-19 shifted the focus, Van Mierlo believes. “During the pandemic, shortages in healthcare were evident – face masks, ICU beds, people. Now that COVID is gone, the staff shortage remains, highlighting the need for capacity management as a fundamental aspect of healthcare. A good plan ensures staff isn’t there when there’s no work, but that they are when needed. Running a cost-saving program to reduce clinical beds doesn’t win you any support from healthcare staff. But better planning and more effective use of scarce personnel to continue delivering necessary care does. This is exactly the issue hospitals are facing today, and it makes life easier for people like me. Because you’re contributing, not taking away.”

Van Mierlo works with three colleagues in the Integral Capacity Management competence center, alongside two separate departments responsible for personnel and volume planning, all under his management.

"A bit of standardization isn’t a problem, in fact, it aids development."

A testing ground for ORTEC

For its planning, MMC chose ORTEC’s Multi Resource Planning package. “We needed a reliable provider familiar with the healthcare sector. ORTEC could meet most of the required functionalities and was willing to invest in components that were still missing. So now we have ORTEC as a foundation for future developments needed to match supply and demand. Multi-resource planning is on its way, workplace planning is being developed, and we’re making strides in employee self-management.”

Van Mierlo would like to develop a link between personnel planning and volume planning with ORTEC. “Integrating these two areas is where I see real added value. I’m happy for MMC to be ORTEC’s testing ground. We have some good people here who can assess whether something works in practice. It would be great to leverage the expertise of professional partners like ORTEC and Rhythm.”

Companies like ORTEC may need to balance responding to individual customer requests with maintaining control over a standardized model, Van Mierlo notes. “I don’t mind some standardization. On the contrary, it benefits further development. Right now, I have a lot of flexibility, but if 53 hospitals have all chosen their own path, it becomes difficult to bring them back together. It wouldn’t hurt to have an ORTEC Basic Content model alongside those 53 unique models.”

Overall, Van Mierlo is pleased with what MMC has achieved in capacity management so far: “Since 2017, we’ve reduced bed capacity by about 25%, while – and this is what I find most important – our staff hasn’t had to work harder. It’s just become more predictable.” One example is the introduction of “accordion shifts,” which respect employees’ right not to be disturbed during their free time. This right is now part of the collective agreement.

“In winter, five people call in sick every day at the hospital. Each of those people contacts 25 team members: who can cover my shift? That’s 150 people dealing with work when they shouldn’t have to. So, we’ve scheduled three extra day shifts and two extra evening shifts in winter to cover these gaps.”

This is a good example of tight management without putting pressure on staff, Van Mierlo says. “In fact, it boosts employee satisfaction because they’re left alone on their day off. And looking at our absence figures, both in terms of duration and frequency, I can confidently say that good personnel policy and tight planning go hand in hand.”