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Drive Lean Sigma Performance Improvement into Any Hospital or Healthcare Environment
“The Affordable Care Act (ACA) looks like it is around to stay. It will require hospitals and other healthcare organizations to become ruthlessly efficient to survive reimbursement rate reductions. Even if ACA fell, managed care organizations have caught on. They will leverage patient volume to drive reimbursement rates steadily down. Medicare and Medicaid will follow. Lean Sigma may not be the only way healthcare organizations will survive, but it’s a proven solution. In Lean Sigma–Rebuilding Capability in Healthcare, Dr. Wedgwood has presented a roadmap to successful implementation of Lean Sigma.”
–Richard H. Allen, Dr.P.H., Allen & Allen Consulting, LLC
Lean Sigma, widely proven in other industries, can offer even greater value in healthcare. In this guide, Ian Wedgwood walks you through all leadership aspects associated with planning, executing, sustaining, or reinvigorating Lean Sigma in your hospital, system, or clinic.
Drawing on his extensive experience helping healthcare organizations improve, Wedgwood explains Lean Sigma without “stat speak.” Focusing on care providers’ unique challenges, he offers a practical roadmap for making Lean or Six Sigma work. He demonstrates it through real case studies, illuminating key facets of change that are too often ignored.
Coverage includes
• How failure points in conventional change methods prevent performance improvement
• Lean Sigma’s structured change approach: why infrastructure and sequencing matter so much
• Integrating Lean Sigma with strategy and operations
• Elevating individual process performance
• Launching a Lean Sigma program or revitalizing a stalled initiative
• Learning from experience, and increasing program maturity
Whatever your Lean Sigma leadership role–from patient-facing staff to senior executive to performance improvement specialist–this guide gives you an indispensable foundation for success.
Preface xiii
About the Author xix
Chapter 1: Existing Change Models: Why the Traditional Healthcare Models Are Struggling 1
Traditional Change Models 1
Disparate Change Groups 4
Uncontained Change 5
No Standard Change Approach 6
Tools Focus 6
Reliance on Benchmarking 7
Changes Are Not Based on Data, Good Data, or the Right Data 8
Changes Made Based on Symptoms, Not Causes 10
Systems versus Processes 10
Focus on People, Not on Process 11
Lack of Context for Solutions 12
Adding versus Subtracting (Patching) 13
Poor Implementation 13
No Emphasis on Control 14
Management versus Leadership 15
Summary 16
Chapter 2: Structuring Change: Program Infrastructure 17
Lean Sigma: The Program 22
The Steering Group 24
Setting the Program Direction 26
The Fit with Existing Initiatives 29
Shaping Projects 31
Focus on Process 33
Breakthrough Change 35
Project Tiers 35
Identifying Opportunities 40
Characterizing Projects (Preliminary Project Chartering) 43
Setting Goals 46
Prioritizing Action 47
Program and Project Roles 49
Program Tracking, Reporting, and Ongoing Management 52
Summary 53
Chapter 3: Lean Sigma Roadmap: The Anatomy of a Project 55
Lean Sigma Project Roadmap 55
Define 60
Measure 64
Analyze 67
Improve 71
Control 74
The Lean Sigma Roadmap: Why It Works 75
Standardization Projects 79
Kaizen (Accelerated Change) Events 81
Summary 84
Chapter 4: Application to Real Life: Project Case Examples 85
Case 1: CT Capacity and Throughput 85
Case 2: Reduce Discharged, Not Final Billed (DNFB) 88
Case 3: Radiology Denials 91
Case 4: Behavioral Health Discovery 93
Case 5: Medication Delivery 95
Case 6: Registration Standardization 96
Case 7: Inpatient Admission Standardization 98
Case 8: Physician Office Standardization 100
Case 9: Surgery Capacity and Throughput 102
Case 10: Emergency Department Throughput 104
Case 11: Inpatient Placement 106
Case 12: New Emergency Department Design 109
Chapter 5: Commencing the Journey 111
I. Program Vision and Launch 115
II. Creating Program Infrastructure 116
III. Developing Organizational Competence 117
IV. Transforming Processes 120
V. Stabilization and Performance Management 121
VI. Globalization 122
Index 125