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Summary
Summary
DELIVER FASTER, BETTER, AND CHEAPER HEALTHCARE IN AS FEW AS FIVE DAYS
A Doody's Core Title for 2015!
"The main purpose is to present simple steps to help hospitals start getting faster, better, and cheaper in five days or less while achieving the goal of fast, affordable, and flawless healthcare. Healthcare has many opportunities for improvement and the use of Lean Six Sigma concepts can make a dramatic impact. This book provides the basic information to do that."-- Doody's Review Service
Lean Six Sigma for Hospitals: Simple Steps to Fast, Affordable, Flawless Healthcare explains how to use tested Lean Six Sigma methods and tools to rapidly improve hospital operations and quality of care and reduce costs. These proven strategies follow the patient from the front door of the hospital or emergency room all the way through discharge, examining key aspects of patient flow and quality. The trail of billing and collections is also followed to discover and eliminate cash flow leaks. This practical guide emphasizes both the clinical and operational sides to reduce the "three demons of quality"--delay, defects, and deviation. Real-world case studies from major hospitals illustrate successful implementations of Lean Six Sigma.
Coverage Includes:
Achieving a faster, better hospital in five days--emergency department, door-to-balloon time, operating room, medical imaging, lab, nursing unit, clinical staff, pharmacy, order accuracy, diagnosis, ICU Lean for accelerated patient flow Reducing medical errors with Six Sigma Creating a more profitable hospital in five days by reducing denied, rejected, and appealed claims Six Sigma for hospitals Excel power tools for Lean Six Sigma Identifying improvement projects through data mining and analysis Sustaining improvement using control charts Laser-focused process innovation Statistical tools for Lean Six Sigma Implementing Lean Six SigmaAuthor Notes
Jay Arthur , The KnowWare Man, works with companies that want to fire up their profits using Lean Six Sigma. He is the author of Lean Six Sigma Demystified and the QI Macros SPC software for Excel. The QI Macros is used by over 3,000 hospitals to meet the accreditation needs of the Joint Commission. Jay has worked with Tenet Healthcare, Kindred Healthcare, Centura Healthcare, and Christus Healthcare on projects to improve patient flow and to reduce clinical and operational errors. Besides consulting with healthcare companies, Jay has been researching what works and what doesn't work in healthcare for over a decade. He will backup his writing with examples and case studies from all aspects of healthcare.
Table of Contents
Preface | p. xi |
Chapter 1 Simple Steps to a Faster Hospital | p. 1 |
Goal: Accelerate the Patient's Experience of Healthcare | p. 1 |
A Faster Emergency Department in Five Days | p. 3 |
Faster Door-to-Balloon (D2B or DTB) Time in Five Days | p. 6 |
A Faster Operating Room in Five Days | p. 7 |
Faster Medical Imaging in Five Days | p. 8 |
A Faster Lab in Five Days | p. 9 |
A Faster Nursing Unit in Five Days | p. 13 |
The Problem Isn't Where You Think It Is | p. 13 |
Take the Domino's Challenge | p. 15 |
How to Get a Faster Hospital in Five Days | p. 15 |
Chapter 2 Lean for Accelerated Patient Flow | p. 19 |
Mind the Gap | p. 20 |
Value-Stream Mapping | p. 20 |
If They Can Do It in Botswana | p. 21 |
The Fast Eat the Slow | p. 23 |
Core Score | p. 24 |
Speed Saves Lives | p. 25 |
You Already Understand Lean | p. 28 |
The Power Laws of Speed | p. 29 |
Economies of Speed | p. 30 |
The Toyota Production System | p. 30 |
Core Ideas of Lean | p. 30 |
The Lean Mindset | p. 33 |
The Seven Speed Bumps of Lean | p. 34 |
The Five S's | p. 36 |
Value-Stream Mapping | p. 37 |
Pull versus Push | p. 38 |
Redesign for One-Piece Flow | p. 38 |
Lean Tools | p. 41 |
Walking Is Waste | p. 45 |
Lean Principle-Load Leveling | p. 48 |
Lean Principle-Minimize Inventory | p. 48 |
Theory of Constraints (TOC) | p. 49 |
Get the Idea? | p. 52 |
Chapter 3 Simple Steps to a Better Hospital | p. 53 |
A Better Emergency Department (ED) in Five Days | p. 54 |
A Better Clinical Staff in Five Days | p. 54 |
A Better Operating Room (OR) in Five Days | p. 55 |
A Better Pharmacy | p. 63 |
Better Order Accuracy in Five Days | p. 64 |
Better Medical Imaging in Five Days | p. 68 |
A Better Lab in Five Days | p. 68 |
A Better Nursing Unit in Five Days | p. 70 |
Better Diagnoses | p. 72 |
A Better Intensive-Care Unit (ICU) in Five Days | p. 72 |
Misuse of Antibiotics | p. 74 |
Bar Codes Bust Medication Errors | p. 75 |
The Problem Isn't Where You Think It Is | p. 75 |
I Pledge Allegiance to Science and Evidence | p. 77 |
Simple Steps to a Better Hospital in Five Days | p. 79 |
Chapter 4 Reducing Defects with Six Sigma | p. 81 |
Invisible Low-Hanging Fruit | p. 82 |
Six Sigma's Problem-Solving Process | p. 83 |
Getting to Lean Six Sigma | p. 84 |
Key Tools for Defect Reduction | p. 84 |
Problem-Solving Process | p. 85 |
The 4-50 Rule | p. 104 |
Six Sigma Tar Pits | p. 104 |
Become a Lean Six Sigma Detective | p. 108 |
Mistakes, Defects, and Errors | p. 111 |
Measurement Simplicity | p. 113 |
Accidents Don't Just Happen | p. 115 |
Analysis Is Easy ... If You Know What to Look For | p. 115 |
Chapter 5 Simple Steps to a Cheaper (More Profitable) Hospital | p. 117 |
Faster + Better = Cheaper and More Profitable! | p. 117 |
Reducing Denied Claims in Five Days | p. 120 |
Reducing Rejected Claims in Five Days | p. 122 |
Reducing Appealed Claims in Five Days | p. 127 |
How to Get a Cheaper (More Profitable) Hospital in Five Days | p. 131 |
Insights | p. 132 |
Conclusion | p. 133 |
Chapter 6 Six Sigma for Hospitals | p. 135 |
Double Your Profits | p. 135 |
Manufacturing and Service | p. 137 |
Tricks of the Trade | p. 138 |
The Faster, Better, Cheaper Toolkit | p. 140 |
Every Business Has Two Sources of Cash Row | p. 141 |
Every Business Process Has Three Big Leaks | p. 142 |
Every Business Has Two Improvement Focuses | p. 143 |
The Universal Improvement Method | p. 148 |
Lean Six Sigma | p. 152 |
Chapter 7 Excel Power Tools for Lean Six Sigma | p. 155 |
The QI Macros for Excel | p. 156 |
The QI Macros Are Easy to Use | p. 156 |
QI Macros Introduction | p. 157 |
Power Tools for Lean Six Sigma | p. 168 |
Analyzing Customer Service Data Hidden in Trouble-Reporting Systems | p. 169 |
Setting Up Your Data in Excel | p. 172 |
Data Collection and Measurement for Six Sigma | p. 175 |
Mistake-Proof Data Collection | p. 178 |
Troubleshooting Problems | p. 185 |
Technical Support | p. 186 |
Chartjunk | p. 186 |
Get the Idea? | p. 188 |
Chapter 8 Is There an Improvement Project in My Data? | p. 189 |
Data Mining with Excel and the QI Macros PivotTable Wizard | p. 189 |
Word Count | p. 195 |
PivotTable Wizard | p. 196 |
Get the Idea? | p. 202 |
Chapter 9 Sustaining Improvement | p. 205 |
Process Flowchart | p. 206 |
Control Charts for Sustaining the Improvement | p. 208 |
Control Plan | p. 219 |
Chapter 10 Laser-Focused Process Innovation | p. 221 |
Focusing the Improvement Effort | p. 221 |
Critical-to-Quality Indicators (CTQs) | p. 228 |
SIPOC | p. 228 |
Balanced Scorecard | p. 230 |
Quality Management Systems | p. 232 |
Chapter 11 Statistical Tools for Lean Six Sigma | p. 235 |
Hypothesis Testing | p. 235 |
Hypothesis Testing for Variation | p. 236 |
Hypothesis Testing for Means | p. 239 |
Analysis of Variance | p. 249 |
Are Your Data Normal? | p. 251 |
Tests of Proportion | p. 256 |
Chi-Square Tests in Excel | p. 257 |
Determining Sample Sizes | p. 261 |
Conclusion | p. 267 |
Chapter 12 Implementing Lean Six Sigma in Hospitals | p. 269 |
Excuses, Excuses, Excuses | p. 270 |
Decisive Force | p. 271 |
Crisis Junkies | p. 273 |
Minor in Major Things | p. 274 |
Getting the Right People Involved with Lean Six Sigma | p. 275 |
The Improvement Mindset | p. 275 |
Talent versus Process | p. 279 |
New CEOs Can Kill Lean Six sigma | p. 280 |
Be a Money Belt | p. 281 |
Our Reward Systems Are Broken | p. 282 |
Barriers to Lean Six Sigma | p. 283 |
Here's My Point | p. 284 |
Management by Quality (MBQ) | p. 285 |
Why Do Six Sigma Teams Fail? | p. 288 |
ôBridezillaö Meets Lean Six Sigma | p. 292 |
Here's My Point | p. 293 |
Making Lean Six Sigma Successful | p. 293 |
What's Wrong with Most Lean Sue Sigma Training? | p. 300 |
Are You a Lean Six Sigma Salmon? | p. 304 |
Risk-Free Way to Implement Lean Six Sigma | p. 310 |
Can Lean Six Sigma Kill Your Hospital? | p. 319 |
Assets and Liabilities | p. 320 |
Innovation Rules | p. 323 |
Religion of Reuse | p. 325 |
Conflicting Goals | p. 326 |
Honor Your Progress | p. 328 |
The Hard Work Is Soft | p. 329 |
Lean Six Sigma Roles | p. 329 |
Get a Faster, Better, Cheaper Hospital | p. 330 |
Bibliography | p. 333 |
Index | p. 337 |