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E-raamat: Essentials for the Improvement of Healthcare Using Lean & Six Sigma

D.H. Stamatis (Contemporary Consultants, Ypsilanti, Michigan, USA)

Formaat: 463 pages
Ilmumisaeg: 30-Nov-2010
Kirjastus: Productivity Press
Keel: eng
ISBN-13: 9781466500716

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Business & management

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Formaat: 463 pages
Ilmumisaeg: 30-Nov-2010
Kirjastus: Productivity Press
Keel: eng
ISBN-13: 9781466500716

Teised raamatud teemal:

Business & management

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Essentials for the Improvement of Healthcare Using Lean & Six Sigma is all about real and immediate quality improvement. Written by D.H. Stamatis, a renowned expert in organizational development and quality, the book addresses concerns that can be ameliorated with minimal government intervention.

Detailing immediate paths for improvement fundamental to primary care, hospitals, and managed care, the book:

Introduces much-needed mechanics of change, including transitioning from hierarchical groups to interactive inclusionary teams Focuses on customer satisfaction as a key indicator of quality Explains how Lean and Six Sigma tools can be readily applied to healthcare Spotlights primary care, including how to define and redesign its process and develop better metrics Presents IT applications that will improve billing, documentation, and patient care Examines Malcolm Baldrige National Quality Award criteria as it applies to healthcare Illustrates quality improvements and best practices through real world case studies Includes downloadable resources with Six Sigma forms and formulas, Lean improvement tools, and other quality tools and worksheets

Whether you think advances in technology and medicine, coupled with freedom of choice, makes the U.S. healthcare system the best in the world, or whether you believe growing costs, regulatory morass, and a tort-obsessed culture drop it to the bottom; it is evident that the processes currently employed and the subsequent defensive medicine philosophy that has resulted will not be able to meet the future demands of our aging society. Through Six Sigma and Lean, this text moves the focus from reactive controls to the proactive efficiency required to implement real and sustainable quality improvements that will allow us to forge a system that is all about wellness.

Preface

xiii

Acknowledgments

xvii

Introduction

xix

1 The Four Critical Issues in Healthcare

(22)

Introduction

(1)

Occurrence of Errors or Mistakes in the Delivery of Treatment

(3)

Recognition of the Uninsured

(2)

Cost of Delivery of Healthcare

(10)

Doctor's Fee

(5)

Insurance Fee

(1)

Medication (Prescription Drugs)

(1)

Technology

(1)

Hospital Costs

(2)

Efficiency

(2)

Summary

(1)

References

(2)

Selected Bibliography

(2)

2 Directions of Improvement in Healthcare

(16)

Introduction

(1)

Primary Care

(2)

Hospital Care

(4)

Managed Care

(6)

Summary

(1)

References

(1)

Selected Bibliography

(3)

3 The Mechanics of Change

(30)

Introduction

(2)

Typical Participants in a Healthcare Team

(1)

Boundary Conditions

(1)

Sample Roles and Responsibilities of Team Members

(5)

Implementation of the Team

(5)

Decision Making

(1)

Decision-Making Tools

(6)

(1)

When to Use 8D

(1)

The 5 Whys

(1)

IS/IS NOT

(1)

Measuring Effectiveness of a Team

(7)

Relationships between Internal and External Teams

(1)

Summary

(1)

References

(1)

Selected Bibliography

(2)

4 The Transition of Groups to Teams

(10)

Introduction

(4)

Internal Development of the Team

(5)

Stage 1 Forming

(1)

Stage 2 Storming

(1)

Stage 3 Norming

(1)

Stage 4 Performing

(1)

Stage 5 Ending

(2)

Summary

(1)

Selected Bibliography

(1)

5 Logistical Issues of Teams

(22)

Introduction

(1)

To Meet or Not to Meet

(1)

Setting Objectives

(2)

Selecting Participants

(1)

Creating an Agenda

(1)

Establishing Meeting Roles and Ground Rules

(3)

Meeting Leader

(1)

Facilitator

(1)

Participants

(1)

Recorder

(1)

Ground Rules

(1)

Room Setup

(3)

Room

(1)

Other Considerations

(1)

Equipment

(1)

Supplies

(1)

Facility Considerations

(1)

Starting a Meeting

(8)

Establishing Team Strategies and Objectives

(1)

Involving All Team Members and Building Team Consensus

(1)

Applying Active Listening Skills

(1)

Leading a Brainstorming Session

(2)

Handling Difficult Situations

(1)

Keeping the Meeting on Track

(2)

Meeting Minutes

(1)

Summary

(1)

Selected Bibliography

(2)

6 The Effects of Change in Healthcare

101

(8)

Introduction

101

(1)

What Are We Trying to Accomplish?

101

(2)

How Do We Know Whether the Change Is Indeed an Improvement?

103

(1)

What Are the Changes That Will Result in Expected Improvement?

104

(3)

Testing Changes

107

(1)

Summary

107

(1)

References

108

(1)

Selected Bibliography

108

(1)

7 Customer Satisfaction

109

(40)

Introduction

109

(6)

Customer Service Attributes

115

(2)

Approach for Healthcare Service Quality Improvement

117

(1)

Develop Feedback Systems for Customer Service Quality

117

(1)

Implementation

118

(1)

Measurement

118

(5)

Competition

119

(1)

Management Leadership

119

(3)

Employee Empowerment

122

(1)

Six Ps and S Model

123

(1)

Considerations in Defining the Customer (Patient) for Healthcare

123

(22)

Developing a Patient Satisfaction Instrument

134

(3)

Preliminary Steps to an Effective Survey

137

(1)

Healthcare Concerns about Customer Satisfaction (CSat)

138

(1)

Insubstantial Theory

139

(1)

Haphazard Execution

139

(2)

Measurement Confiscation

141

(1)

Inappropriate Application

142

(3)

Summary

145

(1)

References

145

(2)

Selected Bibliography

147

(2)

8 Understanding the Process

149

(30)

Introduction

149

(5)

Failure Mode and Effect Analysis (FMEA)

154

(2)

Systems Thinking

156

(1)

Poka-Yoke (Mistake Proofing/Error Proofing)

157

(2)

Advance Practice Quality Planning (APQP)

159

(4)

Measurement

163

(1)

Project Management

164

(8)

Process of Project Management

167

(1)

Key Integrative Processes

168

(1)

Project Management and Quality

168

(2)

Generic Seven-Step Approach to Project Management

170

(1)

Phase 1 Define the Project

170

(1)

Phase 2 Plan the Project

171

(1)

Phase 3 Implement the Plan

171

(1)

Phase 4 Track Progress and Complete the Project

172

(1)

Process Flowchart

172

(4)

Value Process Mapping

176

(1)

Summary

176

(1)

References

177

(1)

Selected Bibliography

178

(1)

9 Using Six Sigma Methodology for Improvement

179

(40)

Introduction

179

(8)

Define

187

(2)

Measure

189

(2)

Analyze

191

(2)

Improve

193

(1)

Control

194

(1)

Design for Six Sigma

195

(14)

Define

205

(1)

Characterize

206

(1)

Optimize

207

(1)

Verify

208

(1)

Special Note

209

(1)

Synthesis of Lean Thinking and Six Sigma

210

(1)

Lean Six Sigma Healthcare

211

(2)

Conclusions

213

(1)

Summary

214

(1)

Note

214

(1)

References

214

(2)

Selected Bibliography

216

(3)

10 Using Lean Methodology for Improvement

219

(48)

Introduction

219

(4)

Lean Enterprise versus Lean Organization

223

(6)

Applying the Hoshin Method

229

(5)

Lean Is Not a Toolbox. It Is a Way of Thinking about Work

234

(3)

Tools Used in Lean

237

(25)

237

(3)

Value Stream Mapping

240

(1)

Construction of a VSM

241

(9)

The Seven VSM Tools

250

(3)

Quick Changeover---SMED Setup Reduction

253

(2)

SMED Example

255

(4)

Theory of Constraints

259

(1)

Kanban

259

(1)

Push versus Pull

259

(3)

Kaizen

262

(1)

A Final Note for the Lean Discussion

262

(2)

Summary

264

(1)

References

264

(1)

Selected Bibliography

264

(3)

11 Understanding Measurement

267

(14)

Introduction

267

(2)

Level I (System or Hospital)

269

(1)

Level II (Departments)

269

(1)

Level III (Operational Issues)

270

(2)

Monitoring Measurements

272

(1)

Investigative Measurements

272

(4)

Understanding Variation

276

(3)

Summary

279

(1)

Reference

279

(1)

Selected Bibliography

280

(1)

12 Primary Care

281

(56)

Introduction

281

(1)

Understanding the Process

282

(6)

Practice Redesign

288

(11)

Step 1 Select a Registry

294

(1)

Step 2 Identify a Template

295

(1)

Step 3 Protocols (Standardize the System of Care)

296

(1)

Step 4 Self-Management Support (Using Diabetes as a Model)

297

(2)

Patient-Centered Medical Home (PCMH)

299

(5)

Lean Strategy for Primary Care

304

(4)

Facilitate the Project Using Leadership Skills

304

(1)

"Lean" the Practice

305

(1)

Using Lean Six Sigma

306

(2)

Special Note on Measurement

308

(5)

Note 1 Understanding the Customer and the Process

308

(1)

Note 2 Chronic Model

308

(5)

Note 3 Medical Home

313

(1)

Primary Care Example

313

(21)

Concerns and Comments

333

(1)

Secondary Concerns

333

(1)

Summary

334

(1)

References

334

(1)

Selected Bibliography

334

(3)

13 Immediate Applications for Information Technology (IT) in Healthcare

337

(24)

Introduction

337

(1)

Billing and Administration

338

(1)

Electronic Documentation

338

(1)

Patient Care

339

(1)

Health IT Focused on Improving Patient Care

339

(3)

Population (Proactive) Care

342

(3)

Whole-Patient (Planned) Care

345

(2)

Measurement

347

(3)

Change Concepts

350

(3)

Use of Models, Including Models of the Desired Care System and Models of Improvement

350

(2)

Focus on a Practical, Patient-Oriented View of Functionality and What It Should Be Able to Accomplish

352

(1)

Use of Learning Strategies to Accelerate Progress in Testing and Applying Change Ideas

352

(1)

Specific Change Ideas

353

(1)

Implications for Spread

353

(5)

Data Structures to Support Improvement

355

(1)

Dense Display of Data

356

(1)

Transferability of Data

356

(1)

Customization

357

(1)

Optimal Design of Alerts and Reminders

358

(1)

Designs That Are Patient-Centric (Patient-Controlled) Personal Health Records (PHRs), Communications, Home as Hub

358

(1)

Summary

358

(1)

References

359

(1)

Selected Bibliography

359

(2)

14 Project Selection

361

(16)

Introduction

361

(1)

Link between Quality Function Needs and Overall Strategic Plan

362

(1)

Link between Strategic Plan and Quality Plan

363

(1)

Theory of Variation (Common and Special Causes)

363

(1)

Quality Function Mission Is Very Important in Strategic Planning

364

(1)

Metrics and Goals That Drive Organizational Performance

365

(2)

Resource Requirements to Manage the Quality Function

367

(1)

How Is Robustness Incorporated into Six Sigma and Lean Methodologies?

367

(1)

What Is the Significance of the Project?

367

(1)

What Is the Cost of Poor Quality?

368

(1)

What Is Customer and CTQ Identification?

369

(1)

What Is the Significance of a Data Collection Plan?

369

(1)

Measurement for Projects

369

(1)

What Are Some of the Common Formulas Used in Six Sigma?

370

(1)

Specific Project Expectations of the DMAIC Model for Each Phase

371

(3)

Summary

374

(1)

References

375

(1)

Selected Bibliography

375

(2)

15 Understanding and Utilizing ISO 9000 Standards

377

(18)

Introduction

377

(7)

New Accreditation Option for Hospitals: National Integrated Accreditation for Healthcare Organizations (NIAHO)

384

(5)

Medical Devices

389

(2)

Certification Process

391

(2)

Summary

393

(1)

References

393

(1)

Selected Bibliography

394

(1)

16 Understanding and Utilizing the Malcolm Baldrige National Quality Program

395

(14)

References

407

(1)

Selected Bibliography

407

(2)

Epilogue

409

(10)

Bibliography

419

(8)

Index

427

Dr.Stamatis is a specialist in Management Consulting, Organizational Development and Quality Science. He has taught Project Management, Operations Management, Logistics, Mathematical Modeling and Statistics for both graduate and undergraduate levels at Central Michigan University, University of Michigan, and Florida Institute of Technology.

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