Applying Lean Six Sigma in Health Care A Practical Guide to Performance Improvement 1st Edition by Thomas K Ross ISBN 9781284170757 1284170756

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ISBN 10: 1284170756
ISBN 13: 9781284170757
Author: Thomas K Ross

Applying Lean Six Sigma in Health Care A Practical Guide to Performance Improvement 1st Edition Table of contents:

Chapter 1 Introduction to Lean Six Sigma

Introduction

The STEEEP Goals of Health Care

The Five Principles of Lean Six Sigma and the Toyota House

Lean Six Sigma Forerunners

Systems, Waste, and Improvement

Systems and SIPOC

Improving System Performance Using 5S

Recognizing and Eliminating Waste: The Eight Wastes

Achieving Continuous Improvement

The Path from Problem Solving to Organizational Transformation

The A3 Report

Lean 6σ and You

Summary

References

Chapter 2 Evaluating the U.S. Healthcare System, Value, and Variation

Introduction

Value

Translating Value into Priorities and Resource Requirements

Natural and Special Cause Variation

Variation in Outcomes

Variation in Use of Healthcare Services

Variation in Use of Healthcare Inputs and Cost

Summary

References

Chapter 3 The Role of Statistics

Introduction

Statistics

Causation and Correlation

Types of Statistics

Measures of Central Tendency and Dispersion

Sampling

Sampling Definitions

Categorical and Numeric Variables

Probability

Probability Definitions

Marginal, Conditional, and Joint Probability

Sensitivity, Specificity, Predictive Value, and Bayes Law

Probability Distributions

Risk Adjustment

Risk Factors

Clinical Patient Inputs

Nonclinical Patient Inputs

Treatment

Random Events

Outcomes

Summary

References

Chapter 4 Overview of the DMAIC Process

Introduction

The Lean Six Sigma Concept

Define, Measure, Analyze, Improve, and Control: DMAIC

Lean Six Sigma Goals

Implementing Change and Achieving Goals

Summary

References

Chapter 5 DMAIC: Define

Introduction

The Define Stage

Identifying an Improvement Project and Stakeholders (Step 1)

Identifying Stakeholders

Building a Stakeholder Management Plan

Assembling a Performance Improvement Team (Step 2)

Developing a Project Charter (Step 3)

Process Mapping

Steps to Lay a Brick

Creating a Project Plan (Step 4)

Gantt Charts

Creating a Voice of the Customer and Voice of the Process Data Collection Plan (Step 5)

Voice of the Customer

Voice of the Process

Concluding the Define Stage

Pain Management Improvement Project

Summary

References

Chapter 6 DMAIC: Measure

Introduction

The Measure Stage

Hearing the Voice of Customer (Step 6)

Hearing the Voice of the Process (Step 7)

Check Sheets

Pareto Charts

Histograms

Run Charts

Creating a Voice of the Process Matrix

Creating Value Stream Maps

Operator Full Work Analysis

Product Process Flow

Benchmarking and Assessing Capability (Step 8)

Assessing Hospital Performance

Assessing Physician Practice Performance

Defining the Cost of Poor Quality and Benefit of Improvement (Step 9)

Concluding the Measure Stage

Pain Management Improvement Project

Summary

References

Chapter 7 DMAIC: Analyze

Introduction

The Analyze Stage

Identifying the Causes of Lower-Than-Desired Performance (Step 10)

The Five Whys

The Why–Why Diagram

Cause and Effect Diagrams

Testing the Identified Causes of Lower-than-Desired Performance and Identifying Root Causes (Step 11)

Scatter Diagrams

Correlation

Regression Analysis

Multiple Regression

Chi-Square Analysis

t-Tests and Analysis of Variance

t-Tests

Analysis of Variance

Determining System Capability (Step 12)

Process Capability

Takt Time and Load Leveling

Concluding the Analyze Stage

Pain Management Improvement Project

Summary

References

Chapter 8 DMAIC: Improve

Introduction

The Improve Stage

Identifying and Selecting Improvements (Step 13)

Identifying Solutions Using PubMed

Performing Cost-Benefit Analysis (Step 14)

Designing the Future State (Step 15)

Establishing Performance Targets (Step 16)

Balanced Scorecards

Dashboards

Obtaining Approval for Change, Training, and Implementing (Step 17)

Project Presentation

Training Plans and Procedures

Implementation

Debriefing

Concluding the Improve Stage

Pain Management Improvement Case

Summary

References

Chapter 9 DMAIC: Control, Part 1: SPC

Introduction

The Control Stage

Why Systems Fail to Produce Desired Outcomes

When Is Corrective Action Needed?

Variation Within Systems

Measuring and Reporting Results (Step 18)

Statistical Process Control for Continuous Data: and R Charts

Step 1: Data Collection

Step 2: Summarize Historical Performance and Calculate Control Limits

Step 3: Graph Actual Performance and Control Limits

Step 4: Interpret Performance

Step 5: Investigate Instability and Improve As Needed

Statistical Process Control for Binomial Data: p and np Charts

Step 1: Data Collection

Step 2: Summarize Historical Performance and Calculate Control Limits

Step 3: Graph Performance and Control Limits

Step 4: Interpret Performance

Step 5: Investigate Instability and Improve As Needed

Pancreatectomy Mortality Rates Example

Step 1: Collect Data

Step 2: Calculate Descriptive Statistics and Control Limits

Step 3: Graphing Performance

Step 5: Investigate Instability and Improve as Needed

Statistical Process Control for Counts: c and u Charts

Step 1: Collect Data

Step 2: Summarize Historical Performance and Calculate Control Limits

Step 3: Graph Actual and Expected Performance

Step 4: Interpret Performance

Step 5: Investigate Instability and Improve as Needed

Hospital-Acquired Infection Example

Step 1: Collect Data

Step 2: Summarize Performance and Calculate Control Limits

Step 3: Graph Actual and Expected Performance

Step 4: Interpret Performance

Step 5: Investigate Instability and Improve as Needed

Medicare Hospital Quality Initiative

Step 1: Collect Data

Step 2: Summarize Historical Performance and Calculate Control Limits

Step 3: Graph Actual and Expected Performance

Step 4: Interpret Performance

Step 5: Investigate Instability and Improve as Needed

Selecting a Control Chart

Improving Performance Using SPC

Pain Management Improvement Project

Steps 1 and 2: Collect Data, Summarize Historical Performance, and Calculate Control Limits

Step 3: Graph Performance and Control Limits

Step 4: Interpret Performance

Step 5: Investigate Instability and Improve as Needed

Summary

References

Chapter 10 DMAIC: Control, Part 2: Reporting, Managing, and Replicating

Introduction

Measuring and Reporting Results (Step 18, Part 2)

Visual Management Systems

Managing Change (Step 19)

Safeguards and Mistake Proofing

Standardizing Care

Audits

Plan-Do-Check-Act Cycles

Identifying Replication Opportunities (Step 20)

Embedding Continuous Improvement Across the Organization (Step 21)

Concluding a Performance Improvement Project

Pain Management Improvement Project: A3 Summation

Summary

References

Chapter 11 Developing a Culture to Embrace Change

Introduction

Disruptive Change

Creating a Climate for Change

Maintaining Change

Jidoka, Delegating Stop-the-Line Authority

Leadership and Management

Summary

References

Chapter 12 Lean Six Sigma Projects and Practice Case

Introduction

Outcome-Improving Projects

Reducing Bacterial Infections

Reducing Inpatient Length of Stay

Process-Improving Projects

Improving Efficiency and Turnaround Times in a Clinical Laboratory

Improving Efficiency in a Cardiac Catheterization Laboratory

Practice Case: An Emergency Department Improvement Project

A Primer on Pivot Tables

Summarizing the Improvement Project on an A3 Report

Summary

References

Chapter 13 Lean Six Sigma and Healthcare Practice

Introduction

The Evolution of Lean Six Sigma

Insights Provided by Lean Six Sigma

Bringing It All Together

Lean Six Sigma and Finance

The Opportunities and Challenges of Lean Six Sigma

Lean Six Sigma and Interprofessional Practice

Interprofessional Practice

Interprofessional Practice and Lean Six Sigma

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Tags: Thomas K Ross, Lean Six Sigma, Health Care, Performance Improvement