Lean hospitals: improving quality, patient safety, and employee satisfaction
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Boca Raton
CRC Press
2009
|
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XXIII, 252 S. Ill., graph. Darst. |
| ISBN: | 1420083805 9781420083804 |
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| 650 | 2 | |a Hospital Administration |a methods | |
| 650 | 2 | |a Hospital Administration |a economics | |
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| 650 | 2 | |a Total Quality Management |a organization & administration | |
| 650 | 2 | |a Total Quality Management |a methods | |
| 653 | |a Krankenhaus | ||
| 653 | |a Sicherheit | ||
| 653 | |a Qualitätsmanagement | ||
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Datensatz im Suchindex
| _version_ | 1804143080874442752 |
|---|---|
| adam_text | Contents
Foreword xv
Preface xvii
The Author xxiii
1 The Case for Lean Hospitals 1
Why Do Hospitals Need Lean? 1
Lean Methods Are Not New to Healthcare 2
Toyota s Role in Popularizing Lean 3
Origins of the Term Lean 3
Lean Is Proven to Work Outside of Automotive Factories 4
Lean Is Helping Hospitals Improve 5
Problems in Healthcare 6
Price Pressures and Cost Challenges 7
Coping with Employee Shortages 8
Poor Quality of Care 9
Good Quality Costs Less 10
A Snapshot of Department Success 10
A Snapshot of Hospital Success 12
Conclusion 15
Lean Lessons 16
Points to Ponder 16
Notes 16
2 Overview of Lean for Hospitals 19
What Is Lean? 19
Ohno s Definition of Lean 19
Lean Thinking 20
The Toyota Triangle: Tools, Culture, and Management System 21
Human Development 21
Philosophy.... 22
vii
viii ¦ Contents
Technical Tools 23
Managerial Methods 24
Lean Is about Reducing Waste and Respecting People 24
Elimination of Waste 25
Respect for People 25
Fixing Healthcare from the Inside 27
Capability 1: Work Is Designed as a Series of
Ongoing Experiments That Immediately Reveal Problems 27
Capability 2: Problems Are Addressed Immediately through
Rapid Experimentation 28
Capability 3: Solutions Are Disseminated Adaptively through
Collaborative Experimentation 30
Capability 4: People At All Levels of the Organization Are
Taught to Become Experimentalists 31
Conclusion 31
Lean Lessons 32
Points to Ponder 32
Notes 33
3 Value and Waste 35
What Is Waste? 35
What Is Value? Start with the Customer 36
How Do We Define Value? 38
Rule 1: The Customer Must Be Willing to Pay for the Activity 38
Rule 2: The Activity Must Transform the Product or
Service in Some Way 38
Rule 3: The Activity Must Be Done Right the First Time 39
Examples of Value-Added and Non-Value-Added Activities 40
Learning to Identify and Describe Waste 42
Waste of Defects 42
Waste of Overproduction 44
Waste of Transportation 45
Waste of Waiting 45
Patients and Products Waiting 45
Employees Waiting 46
Waste of Inventory 46
Waste of Motion 47
Waste of Nursing Motion 48
Contents ¦ ix
Waste of Overprocessing 49
Waste of Talent 50
What Non-Value-Added Activities Are Required? 51
Non-Value-Added, Pure Waste 52
Conclusion 53
Lean Lessons 54
Points to Ponder 54
Notes 54
4 Observing the Process and Value Streams 57
How Do We Find Waste? 57
What Is a Value Stream? 58
Value Stream Mapping 58
Creating a Value Stream Map 59
Observing the Process 62
Activity of the Product 62
Activity of the Product—Laboratory 65
Activity of the Employee 66
Activity of the Employee—Nursing 68
Activity of the Employee—Perioperative Services 70
Conclusion 71
Lean Lessons 71
Points to Ponder 72
Notes 72
5 Standardized Work as a Foundation of Lean 73
The Need for Standardized Work 73
The Toyota House Metaphor 74
Overview of the Lean Foundations 74
Lean Foundations: Standardized Work 75
Definition of Standardized Work 75
Current 75
Proper Outcome and the Highest Quality 76
To Safely Complete 77
One Best Way 77
Standardized, Not Identical 78
Written by Those Who Do the Work 79
Considering How Long Tasks Take 80
Types of Standardized Work Documents 81
Standardizing Daily Routines 82
x ¦ Contents
Defining Roles and Responsibilities 83
Explaining Why through Standardized Work 84
Standardized Work Documents and the Standardized Work System 85
Measuring and Observing for Standardized Work Adherence 86
Resistance to Standardized Work 88
Asking Why When Standardized Work Is Not Being Followed 88
Standardized Work Can Apply to Physicians 90
Another Example of Having to Ask Why 92
Training through Standardized Work 93
Conclusion o /
Lean Lessons nc
Points to Ponder 05
Notes gr
6 Lean Methods: Visual Management, 5S, and Kanban 97
Lean Is More Than Tools, but Tools Can Help 97
Reducing Waste through Visual Management 97
Examples of Visual Management 98
5S: Sort, Store, Shine, Standardize, and Sustain 99
First S: Sort 100
Second S: Store joi
Third S: Shine 102
FourthS: Standardize 103
Fifth S: Sustain 207
Safety as a Sixth S? 108
Kanban: A Lean Approach to Managing Materials 108
Problems with Traditional Materials Systems 109
Trade-offs with Inventory 109
Using Kanban within a Department HI
A Kanban Case Study ll4
Conclusion ^,
Lean Lessons ^
Points to Ponder ^
Notes.... ,
116
7 Proactive Root Cause Problem Solving 119
Improving Quality and Patient Safety H9
Cultural Obstacles to Quality Improvement ZZ. 120
Why Do Errors Occur? m
Examples of Quality Improvement ~ZZZ ZZ .122
Contents ¦ xi
Finding Root Causes and Preventing Errors 123
Workarounds and the Need for Fixing Root Causes 123
Asking Why? Instead of Who? 125
Start at the Gemba 126
The Five Whys Method 127
Example of the Five Whys: Hand Hygiene 127
Be Proactive and Use FMEA 130
Proactive Resolution of Near-Miss Problems 131
The Safety Pyramid 132
Conclusion 133
Lean Lessons 134
Points to Ponder 134
Notes 134
8 Preventing Errors 137
Creating Quality at the Source through Error Proofing 137
Being Careful Is Not Enough 137
Why 100% Inspection Is Not 100% Effective 138
Types of Error Proofing 139
Make It Impossible to Create the Error 139
Make It Harder to Create the Error 140
Make It Obvious the Error Has Occurred 142
Make the System Robust, So It Tolerates the Error 142
Error Proofing, Not Dummy Proofing 143
Examples of Error Proofing in Hospitals 143
Banned Abbreviations as Error Proofing 144
Computer Systems as Error Proofing 145
Preventing Surgery Errors through Error Proofing 146
Stopping the Line (Andon) 147
Error Proofing the Error Proofing 148
Conclusion 149
Lean Lessons 150
Points to Ponder 150
Notes 150
9 Improving Flow 153
Processes Should Flow Like a River 153
Uneven Workloads as a Barrier to Flow 154
Naturally Occurring Unevenness 155
Mura Caused by Morning Rounds 155
xii ¦ Contents
Mura Caused by Suboptimizing Courier Routes %
Mura Created by Clinic Scheduling 157
Mura in the Patient Discharge Process 158
Addressing Mura by Matching Staffing to Workloads 160
Improving Patient Flow ^
Improving Patient Flow in the Emergency Department 162
Improving Patient Flow in Outpatient Cancer Treatment... 164
Improving Flow for Patient Care and Support !67
Improving Flow in Clinical Laboratories l67
Reducing Delays in Specimen Collection l67
Reducing Delays in the Lab s Receiving Areas.... !68
Improving Flow Also Improves Quality and Teamwork 169
Reducing Delays Inside the Lab s Testing Areas 170
Improving Flow in Pharmacies 172
Conclusion
Lean Lessons
Points to Ponder
Notes... 175
176
10 Engaging and Leading Employees 177
Changing How We Manage 177
What Is a Manager s Role? 17g
Common Management Problems 179
Lean as a Management System and Philosophy 181
A Daily Lean Management System 181
Process Audits or Rounding 181
Standardized Audits of the Standardized Work 181
A Hierarchy of Audits 183
Performance Measures lg4
Timely Measures Drive Improvement 185
A Balanced Scorecard Focuses on All Stakeholders . . . . . . . . . . . . . .186
Metncs Should Be Visible, Visual and
Statistically Meaningful
Daily Stand-up Team Meetings. ZL
Kaizen and Suggestion Management 01
Problems with Suggestion Boxes L
The.Role of Supervisors in Kaizen. L
Fmdmg a Better Method for Managing Kaizen. 194
Contents ¦ xiii
Visual Tracking of Suggestions 198
Communicating Kaizen Changes 198
Conclusion 199
Lean Lessons 200
Points to Ponder 201
Notes 201
11 Getting Started with Lean 203
Where Do We Start? 203
Types of Kaizen 206
Kaizen Events 207
Pitfalls of Kaizen Events 207
Lean Transformation 209
Executive Sponsorship and Leadership 210
Starting from the Middle 212
Establishing a Model Line and a Roadmap 213
Chartering a Project 214
Dedicating Internal Resources: The Lean Team 215
The Importance of Change Management 217
The Beginnings of a Lean Enterprise 218
Starting in the Lab 219
Moving to Other Areas 220
Designing a Hospital for Lean 221
Designing a New ED Process for the New Space 222
The Future Roadmap 226
Conclusion 228
Lean Lessons 228
Points to Ponder 228
Notes 229
12 A Vision for a Lean Hospital 231
When Is a Hospital Lean? 232
What Would a Lean Hospital Look Like? 232
What Would a Patient Experience in a Lean Hospital? 233
What Would It Be Like to Work in a Lean Hospital? 234
How Would We Describe a Lean Hospital? 235
Strategy and Management System 235
Patients 236
Employees 236
xiv ¦ Contents
Waste and Kaizen 236
Technology and Infrastructure 237
Final Thought 237
Notes 238
Glossary Terms 239
Index 245
|
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| id | DE-604.BV036512181 |
| illustrated | Illustrated |
| indexdate | 2024-07-09T22:41:59Z |
| institution | BVB |
| isbn | 1420083805 9781420083804 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-020434365 |
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| physical | XXIII, 252 S. Ill., graph. Darst. |
| publishDate | 2009 |
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| publisher | CRC Press |
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| spelling | Graban, Mark Verfasser aut Lean hospitals improving quality, patient safety, and employee satisfaction Mark Graban Boca Raton CRC Press 2009 XXIII, 252 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Hospital Administration methods Hospital Administration economics Efficiency, Organizational Total Quality Management organization & administration Total Quality Management methods Krankenhaus Sicherheit Qualitätsmanagement Arbeitszufriedenheit HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=020434365&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Graban, Mark Lean hospitals improving quality, patient safety, and employee satisfaction Hospital Administration methods Hospital Administration economics Efficiency, Organizational Total Quality Management organization & administration Total Quality Management methods |
| title | Lean hospitals improving quality, patient safety, and employee satisfaction |
| title_auth | Lean hospitals improving quality, patient safety, and employee satisfaction |
| title_exact_search | Lean hospitals improving quality, patient safety, and employee satisfaction |
| title_full | Lean hospitals improving quality, patient safety, and employee satisfaction Mark Graban |
| title_fullStr | Lean hospitals improving quality, patient safety, and employee satisfaction Mark Graban |
| title_full_unstemmed | Lean hospitals improving quality, patient safety, and employee satisfaction Mark Graban |
| title_short | Lean hospitals |
| title_sort | lean hospitals improving quality patient safety and employee satisfaction |
| title_sub | improving quality, patient safety, and employee satisfaction |
| topic | Hospital Administration methods Hospital Administration economics Efficiency, Organizational Total Quality Management organization & administration Total Quality Management methods |
| topic_facet | Hospital Administration methods Hospital Administration economics Efficiency, Organizational Total Quality Management organization & administration Total Quality Management methods |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=020434365&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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