Improving healthcare quality and cost with Six Sigma:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Upper Saddle River, NJ
FT Press
2007
|
| Schlagworte: | |
| Online-Zugang: | Table of contents only Inhaltsverzeichnis |
| Beschreibung: | Includes bibliographical references |
| Beschreibung: | XXII, 472 S. Ill., graph. Darst. 25 cm |
| ISBN: | 0131741713 9780131741713 |
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| 264 | 1 | |a Upper Saddle River, NJ |b FT Press |c 2007 | |
| 300 | |a XXII, 472 S. |b Ill., graph. Darst. |c 25 cm | ||
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| 650 | 4 | |a Medical care |x Quality control |z United States |x Statistical methods | |
| 650 | 4 | |a Medical care |z United States |x Cost control |x Statistical methods | |
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| 650 | 4 | |a Delivery of Health Care |x organization & administration | |
| 650 | 4 | |a Quality Assurance, Health Care |x methods | |
| 650 | 4 | |a Cost Control |x methods | |
| 650 | 4 | |a Efficiency, Organizational | |
| 650 | 4 | |a Quality Control | |
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| adam_text | Contents
Foreword xx
Introduction xxi
Part I: The Need for Cutting Costs and
Improving Quality in Healthcare 1
1 Trends in the Healthcare Industry 3
The Quality Crisis in Healthcare 4
Demographics: Financial, Political, Social, and Technological 8
Demographics 9
Other Demographic Considerations JO
Financial 13
The Pluralistic Healthcare Insurance System 14
Political 14
Social 15
Technological 16
The Cost of Healthcare and Six Sigma 16
Healthcare Quality and Error Reduction 18
Why It s Difficult to Deal with Healthcare Errors 18
Conclusion 19
Endnotes 19
vii
vi Contents
2 Excellence (Benchmarks) and Improvement
Challenges in Healthcare System 21
How Do We Define Quality? 21
Cost and Quality 24
Why Is Excellence So Hard? 25
Practice Patterns 26
Not Invented Here 26
Defensive Medicine 27
Failure to Invest in Information Technology 27
Relatively Poor Salaries 27
Incentives for Inefficiency 28
Benchmarks 28
Conclusions 29
Endnotes 30
3 Applicability of Six Sigma in Healthcare
Organizations 31
A Brief Explanation of Six Sigma 33
Why Do You Need Six Sigma? 40
Quality 41
GE 41
Allied Signal 42
Six Sigma Applied to Healthcare 42
Six Sigma at Work in Healthcare 45
Different Views of Healthcare Quality 48
Conclusions 48
Six Sigma Potential in Healthcare 50
Medicine, Measurement, and Science 52
Endnotes 56
Contents ix
Part II Methodology, Tools, and
Measurements 59
4 The Healthcare Opportunity 61
Launching the Six Sigma Initiative 64
Healthcare Scorecard 65
Defining Six Sigma Vision and Mission 66
Virtua s Mission 68
Conducting Business Opportunity Analysis 70
Providing Leadership for Six Sigma 73
Endnotes 75
5 Six Sigma Methodology 77
Six Sigma Defined 78
Six Sigma Readiness 80
Six Sigma Methodology 82
Six Sigma Measurements 84
Six Sigma and Other Quality Systems 87
Making Six Sigma Work 87
6 Understanding Problems: Define, Measure,
and Analyze 89
Define Phase 90
Common Define Tools 90
S1POC 98
Pareto Analysis 100
Force Field Analysis 102
Project Charter 103
x Contents
The Measure Phase 104
The Analyze Phase 112
Key Analyze Tools 772
Multi Vary Analysis 772
Cause and Effect Analysis ] ]3
Constructing the Ishikawa Diagram 775
Regression Analysis 776
Performing Regression Analysis 777
Failure Modes and Effect Analysis (FMEA) 77 S
Concluding Understanding Problems 120
Endnotes 120
Sample Healthcare Excellence Project Forms: Understanding
theProblem 121
7 Solving Problems: Improve and Control 129
Improve Phase 130
Systems Thinking 130
Testing of Hypothesis 131
Conducting Testing of Hypothesis 133
Evaluating Multiple Treatments Using ANOVA 139
Comparative Experiments: Present Versus Modified 140
Full Factorials Experiments 142
Control Phase 146
Control Charts 146
Normal Distribution and Control Charts 146
Documentation 149
Training 150
Communication 151
Business Review 151
Endnotes 152
Sample Healthcare Excellence Project Forms: Solving
the Problem 153
Contents xi
Part III Benefiting from Six Sigma 161
8 Case Study Introduction and Profiles 163
Commonwealth Health Corporation, Bowling Green, KY 166
Virtua Health, Marlton, NJ 168
Valley Baptist Health System, Harlingen, TX 171
North Shore Long Island Jewish (LIJ) Health System, NY 172
Thibodaux Regional Medical Center, Thibodaux, LA 174
NewYork Presbyterian Hospital, New York, NY 175
Decatur Memorial Hospital, Decatur, IL 177
The Nebraska Medical Center, Omaha, NE 178
9 Clinical Case Studies 181
Cardiac Medication Administration at Virtua Health 182
Analyze and Improve 183
Reducing Surgical Site Infections at Charleston Area
MedicalCenter 185
Define and Measure 186
Reducing CVC Related Bloodstream Infections at
Florida Hospital 188
Define and Measure 189
Analyze Phase 189
Measuring and Maintaining Results 190
Preventing Infections at Decatur Memorial Hospital 190
Reducing the Incidence of Post Operative Infections in Bowel
Cases at Commonwealth Health Corporation 191
Reducing Nosocomial Pressure Ulcers at Thibodaux Regional
Medical Center 193
Results and Recognition 198
Glucose Control in the Adult ICU at Valley Baptist
Health System 199
x Contents
10 Operational Case Studies 203
Timeliness of Self Pay Collections on Commercial Accounts
at Commonwealth Health Corporation 204
Improving and Controlling the Process 207
Reducing Ambulance Diversions at Providence Alaska
Medical Center 208
Better Patient Charge Capture at Yale New Haven Hospital .... 211
Developing and Piloting Solutions 214
New Systems and Fewer Defects 215
Ensuring Accuracy in Managed Care Operating Room
Carve Outs at Virtua Health 215
Addressing Bed Management at The Nebraska Medical
Center 220
Developing Solutions 2267
Project Results and Sustainability 227
The Corporate Advance Directive at Valley Baptist
Health System 229
Cath Lab Utilization of Implantable Devices at Memorial
Hermann Heart Vascular Institute Southwest 231
Optimizing Respiratory Care Services at Valley Baptist
Health System 233
Part IV Rolling Out and Sustaining
Six Sigma 239
11 Implementing a Six Sigma Culture 241
Implementation Process 243
Phase I—Mobilizing 244
Activity 1—Finding and Developing a Six Sigma Advocate 244
Activity 2—Analyzing Six Sigma Fit with the Strategic Plan 245
Activity 3—Defining Six Sigma Improvement Opportunities 250
Contents xifi
Activity 4—Building a Six Sigma Business Case 260
Activity 5—Approving and Organizing for Phase HI Pilot 261
Activity 6—Setting Preliminary Objectives for the Pilot 262
Activity 7—Selecting an External Consultant 263
Phase II—Planning 266
Activity 1—Define the Scope of Each Opportunity 267
Activity 2—Define the SST Members 270
Activity 3—Train the SST Members 273
Activity 4—Organize the SSTs 276
Activity 5—Define the Measurements 288
Activity 6—Prepare a Project Plan 291
Activity 7—Prepare an Organizational Change
Management Plan 293
Phase III—Piloting 295
Phase IV—Implementing the Six Sigma System 299
Activity 1—Organizing 299
Activity 2—Defining the Six Sigma Roles 302
Activity 3—Training the Six Sigma Team 309
Activity 4—Selecting the Six Sigma Projects 327
Activity 5—Forming the SSTs 340
Activity 6—Executing the Projects 342
Activity 7—Internalizing the Six Sigma Culture 344
Conclusion 369
Endnotes 371
12 Lean Six Sigma in Healthcare 373
The Lean Process 375
Lean Six Sigma 375
Principles of Lean Thinking 376
Lean Tools 378
Case Study 1: Combining Lean and Six Sigma to Improve
Throughput in the Emergency Department at
St. John Health 381
Six Sigma Organization at St. John Health 382
Findings from the Analyze Phase 383
Solutions Emerge 384
x v Contents
Case Study 2: Expanding CT Capacity at
North Shore University Hospital 388
Endnotes 399
13 The Road Ahead 401
Does the Healthcare Industry Need Six Sigma? 402
What Is the Problem? , 403
The Government s Problem with Healthcare 404
Six Sigma Is Part of the Answer 406
Poor Quality Cost and Six Sigma 406
Customer Loyalty—Customers/Patients for Life 407
Some Six Sigma Healthcare Results and Lessons Learned 410
Hospital Performance 413
Lessons Learned 415
Six Sigma and the National Quality Awards 417
Why Do Some Six Sigma Systems Fail? 419
Too Many Black Belts 421
Harrington s Wheel of Fortune 421
Putting It All Together 424
Endnotes 428
Part V Appendixes 431
A PMBOK Tools and Techniques 433
B The Six Sigma Body of Knowledge 437
Contents XV
C Total Six Sigma Tools Self Evaluation Form 445
The 20 Question Six Sigma Status Checklist 445
Student Check list 447
D Additional Resources 451
E The Man I Want To Be! 453
Index 455
|
| adam_txt |
Contents
Foreword xx
Introduction xxi
Part I: The Need for Cutting Costs and
Improving Quality in Healthcare 1
1 Trends in the Healthcare Industry 3
The Quality Crisis in Healthcare 4
Demographics: Financial, Political, Social, and Technological 8
Demographics 9
Other Demographic Considerations JO
Financial 13
The Pluralistic Healthcare Insurance System 14
Political 14
Social 15
Technological 16
The Cost of Healthcare and Six Sigma 16
Healthcare Quality and Error Reduction 18
Why It's Difficult to Deal with Healthcare Errors 18
Conclusion 19
Endnotes 19
vii
vi" Contents
2 Excellence (Benchmarks) and Improvement
Challenges in Healthcare System 21
How Do We Define Quality? 21
Cost and Quality 24
Why Is Excellence So Hard? 25
Practice Patterns 26
Not Invented Here 26
Defensive Medicine 27
Failure to Invest in Information Technology 27
Relatively Poor Salaries 27
Incentives for Inefficiency 28
Benchmarks 28
Conclusions 29
Endnotes 30
3 Applicability of Six Sigma in Healthcare
Organizations 31
A Brief Explanation of Six Sigma 33
Why Do You Need Six Sigma? 40
Quality 41
GE 41
Allied Signal 42
Six Sigma Applied to Healthcare 42
Six Sigma at Work in Healthcare 45
Different Views of Healthcare Quality 48
Conclusions 48
Six Sigma Potential in Healthcare 50
Medicine, Measurement, and Science 52
Endnotes 56
Contents ix
Part II Methodology, Tools, and
Measurements 59
4 The Healthcare Opportunity 61
Launching the Six Sigma Initiative 64
Healthcare Scorecard 65
Defining Six Sigma Vision and Mission 66
Virtua 's Mission 68
Conducting Business Opportunity Analysis 70
Providing Leadership for Six Sigma 73
Endnotes 75
5 Six Sigma Methodology 77
Six Sigma Defined 78
Six Sigma Readiness 80
Six Sigma Methodology 82
Six Sigma Measurements 84
Six Sigma and Other Quality Systems 87
Making Six Sigma Work 87
6 Understanding Problems: Define, Measure,
and Analyze 89
Define Phase 90
Common Define Tools 90
S1POC 98
Pareto Analysis 100
Force Field Analysis 102
Project Charter 103
x Contents
The Measure Phase 104
The Analyze Phase 112
Key Analyze Tools 772
Multi Vary Analysis 772
Cause and Effect Analysis ] ]3
Constructing the Ishikawa Diagram 775
Regression Analysis 776
Performing Regression Analysis 777
Failure Modes and Effect Analysis (FMEA) 77 S
Concluding Understanding Problems 120
Endnotes 120
Sample Healthcare Excellence Project Forms: Understanding
theProblem 121
7 Solving Problems: Improve and Control 129
Improve Phase 130
Systems Thinking 130
Testing of Hypothesis 131
Conducting Testing of Hypothesis 133
Evaluating Multiple Treatments Using ANOVA 139
Comparative Experiments: Present Versus Modified 140
Full Factorials Experiments 142
Control Phase 146
Control Charts 146
Normal Distribution and Control Charts 146
Documentation 149
Training 150
Communication 151
Business Review 151
Endnotes 152
Sample Healthcare Excellence Project Forms: Solving
the Problem 153
Contents xi
Part III Benefiting from Six Sigma 161
8 Case Study Introduction and Profiles 163
Commonwealth Health Corporation, Bowling Green, KY 166
Virtua Health, Marlton, NJ 168
Valley Baptist Health System, Harlingen, TX 171
North Shore Long Island Jewish (LIJ) Health System, NY 172
Thibodaux Regional Medical Center, Thibodaux, LA 174
NewYork Presbyterian Hospital, New York, NY 175
Decatur Memorial Hospital, Decatur, IL 177
The Nebraska Medical Center, Omaha, NE 178
9 Clinical Case Studies 181
Cardiac Medication Administration at Virtua Health 182
Analyze and Improve 183
Reducing Surgical Site Infections at Charleston Area
MedicalCenter 185
Define and Measure 186
Reducing CVC Related Bloodstream Infections at
Florida Hospital 188
Define and Measure 189
Analyze Phase 189
Measuring and Maintaining Results 190
Preventing Infections at Decatur Memorial Hospital 190
Reducing the Incidence of Post Operative Infections in Bowel
Cases at Commonwealth Health Corporation 191
Reducing Nosocomial Pressure Ulcers at Thibodaux Regional
Medical Center 193
Results and Recognition 198
Glucose Control in the Adult ICU at Valley Baptist
Health System 199
x" Contents
10 Operational Case Studies 203
Timeliness of Self Pay Collections on Commercial Accounts
at Commonwealth Health Corporation 204
Improving and Controlling the Process 207
Reducing Ambulance Diversions at Providence Alaska
Medical Center 208
Better Patient Charge Capture at Yale New Haven Hospital . 211
Developing and Piloting Solutions 214
New Systems and Fewer Defects 215
Ensuring Accuracy in Managed Care Operating Room
Carve Outs at Virtua Health 215
Addressing Bed Management at The Nebraska Medical
Center 220
Developing Solutions 2267
Project Results and Sustainability 227
The Corporate Advance Directive at Valley Baptist
Health System 229
Cath Lab Utilization of Implantable Devices at Memorial
Hermann Heart Vascular Institute Southwest 231
Optimizing Respiratory Care Services at Valley Baptist
Health System 233
Part IV Rolling Out and Sustaining
Six Sigma 239
11 Implementing a Six Sigma Culture 241
Implementation Process 243
Phase I—Mobilizing 244
Activity 1—Finding and Developing a Six Sigma Advocate 244
Activity 2—Analyzing Six Sigma Fit with the Strategic Plan 245
Activity 3—Defining Six Sigma Improvement Opportunities 250
Contents xifi
Activity 4—Building a Six Sigma Business Case 260
Activity 5—Approving and Organizing for Phase HI Pilot 261
Activity 6—Setting Preliminary Objectives for the Pilot 262
Activity 7—Selecting an External Consultant 263
Phase II—Planning 266
Activity 1—Define the Scope of Each Opportunity 267
Activity 2—Define the SST Members 270
Activity 3—Train the SST Members 273
Activity 4—Organize the SSTs 276
Activity 5—Define the Measurements 288
Activity 6—Prepare a Project Plan 291
Activity 7—Prepare an Organizational Change
Management Plan 293
Phase III—Piloting 295
Phase IV—Implementing the Six Sigma System 299
Activity 1—Organizing 299
Activity 2—Defining the Six Sigma Roles 302
Activity 3—Training the Six Sigma Team 309
Activity 4—Selecting the Six Sigma Projects 327
Activity 5—Forming the SSTs 340
Activity 6—Executing the Projects 342
Activity 7—Internalizing the Six Sigma Culture 344
Conclusion 369
Endnotes 371
12 Lean Six Sigma in Healthcare 373
The Lean Process 375
Lean Six Sigma 375
Principles of Lean Thinking 376
Lean Tools 378
Case Study 1: Combining Lean and Six Sigma to Improve
Throughput in the Emergency Department at
St. John Health 381
Six Sigma Organization at St. John Health 382
Findings from the Analyze Phase 383
Solutions Emerge 384
x'v Contents
Case Study 2: Expanding CT Capacity at
North Shore University Hospital 388
Endnotes 399
13 The Road Ahead 401
Does the Healthcare Industry Need Six Sigma? 402
What Is the Problem? , 403
The Government's Problem with Healthcare 404
Six Sigma Is Part of the Answer 406
Poor Quality Cost and Six Sigma 406
Customer Loyalty—Customers/Patients for Life 407
Some Six Sigma Healthcare Results and Lessons Learned 410
Hospital Performance 413
Lessons Learned 415
Six Sigma and the National Quality Awards 417
Why Do Some Six Sigma Systems Fail? 419
Too Many Black Belts 421
Harrington's Wheel of Fortune 421
Putting It All Together 424
Endnotes 428
Part V Appendixes 431
A PMBOK Tools and Techniques 433
B The Six Sigma Body of Knowledge 437
Contents XV
C Total Six Sigma Tools Self Evaluation Form 445
The 20 Question Six Sigma Status Checklist 445
Student Check list 447
D Additional Resources 451
E The Man I Want To Be! 453
Index 455 |
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| id | DE-604.BV022761057 |
| illustrated | Illustrated |
| index_date | 2024-07-02T18:34:34Z |
| indexdate | 2024-07-09T21:05:29Z |
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| isbn | 0131741713 9780131741713 |
| language | English |
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| spelling | Improving healthcare quality and cost with Six Sigma Brett E. Trusko ... Upper Saddle River, NJ FT Press 2007 XXII, 472 S. Ill., graph. Darst. 25 cm txt rdacontent n rdamedia nc rdacarrier Includes bibliographical references zdravstvena oskrba - finance - finančna učinkovitost - stroški - obvladovanje stroškov - kakovost - organizacijska učinkovitost Medical care Quality control United States Statistical methods Medical care United States Cost control Statistical methods Medical care United States Cost effectiveness Delivery of Health Care organization & administration Quality Assurance, Health Care methods Cost Control methods Efficiency, Organizational Quality Control USA Trusko, Brett E. Sonstige oth http://www.loc.gov/catdir/toc/ecip074/2006036533.html Table of contents only HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015966612&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Improving healthcare quality and cost with Six Sigma zdravstvena oskrba - finance - finančna učinkovitost - stroški - obvladovanje stroškov - kakovost - organizacijska učinkovitost Medical care Quality control United States Statistical methods Medical care United States Cost control Statistical methods Medical care United States Cost effectiveness Delivery of Health Care organization & administration Quality Assurance, Health Care methods Cost Control methods Efficiency, Organizational Quality Control |
| title | Improving healthcare quality and cost with Six Sigma |
| title_auth | Improving healthcare quality and cost with Six Sigma |
| title_exact_search | Improving healthcare quality and cost with Six Sigma |
| title_exact_search_txtP | Improving healthcare quality and cost with Six Sigma |
| title_full | Improving healthcare quality and cost with Six Sigma Brett E. Trusko ... |
| title_fullStr | Improving healthcare quality and cost with Six Sigma Brett E. Trusko ... |
| title_full_unstemmed | Improving healthcare quality and cost with Six Sigma Brett E. Trusko ... |
| title_short | Improving healthcare quality and cost with Six Sigma |
| title_sort | improving healthcare quality and cost with six sigma |
| topic | zdravstvena oskrba - finance - finančna učinkovitost - stroški - obvladovanje stroškov - kakovost - organizacijska učinkovitost Medical care Quality control United States Statistical methods Medical care United States Cost control Statistical methods Medical care United States Cost effectiveness Delivery of Health Care organization & administration Quality Assurance, Health Care methods Cost Control methods Efficiency, Organizational Quality Control |
| topic_facet | zdravstvena oskrba - finance - finančna učinkovitost - stroški - obvladovanje stroškov - kakovost - organizacijska učinkovitost Medical care Quality control United States Statistical methods Medical care United States Cost control Statistical methods Medical care United States Cost effectiveness Delivery of Health Care organization & administration Quality Assurance, Health Care methods Cost Control methods Efficiency, Organizational Quality Control USA |
| url | http://www.loc.gov/catdir/toc/ecip074/2006036533.html http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015966612&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT truskobrette improvinghealthcarequalityandcostwithsixsigma |