When ‘operations’ doesn’t mean surgery

It took me a little while to understand that we were talking about different things.  I thought ‘operations’ meant surgical procedures; managers thought it meant ‘everything’, i.e. how we do what we do. 

If you’re not sure what the ‘operations’ of your organisation is, ask yourself, why does this organisation exist?  What does it do?  What is its purpose, its raison d’être?   This is its operations function.  It should also be what most of the organisation’s resources are spent on. 

You can quantify it by the 4 ‘Vs’: 

  • 1. Volume: how much?
  • 2. Variety: what type?
  • 3. Variation: when?
  • 4. Visibility: Who sees what we do? 

How do we arrange our resources?  In most hospitals, the patient has to fit in around the staff (lots of patients moving around between areas).  This shows that the process is more important than the patient.  On the other hand, if patients are too sick to be moved, ‘Safari’ ward rounds occur, with groups of doctors journeying through the hospital in search of ‘their’ patients!  Sometimes, specific areas deal with specific patients (Cell Layout); rarely, an idealised pathway of care is followed (Product Layout). 

For as long as I can remember, the central issue in the NHS has been how much money to spend on it.  In other words, the focus has been on inputs.  However, due to the lack of dramatic improvement in the service despite year-on-year increases in funding, there is a growing realisation that scrutiny of outputs may be more enlightening.  Thus, not so much asking “How much are we spending?” but rather, “How well are we performing?”  This would be a great ‘operations philosophy’!


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