Verfügbarkeit: Healthcare Kaizen

Healthcare Kaizen: engaging front-line staff in sustainable continuous improvements

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Bibliographische Detailangaben
Hauptverfasser:	Graban, Mark (VerfasserIn), Swartz, Joseph E. (VerfasserIn)
Format:	Buch
Sprache:	English
Veröffentlicht:	Boca Raton [u.a.] CRC Press 2012
Schlagworte:	Kaizen Krankenhaus
Online-Zugang:	Inhaltsverzeichnis Klappentext
Beschreibung:	XXIX, 374 S. Ill.
ISBN:	9781439872963

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Datensatz im Suchindex

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adam_text	Titel: Healthcare Kaizen Autor: Graban, Mark Jahr: 2012 Contents Preface...................................................................................................xix Acknowledgments from Mark Graban..................................................xxi Acknowledgments from Joe Swartz.....................................................xxiii Foreword by Masaaki Imai...................................................................xxv Introduction by Norman Bodek.........................................................xxvii About the Authors...............................................................................xxix SECTION 1 WHAT IS KAIZEN? 1 Kaizen and Continuous Improvement...............................................3 Kaizen = Change for the Better.........................................................................4 Bubbles for Babies.............................................................................................5 Kaizen: A Powerful Word..................................................................................6 Kaizen Is Not Just Change, It Is Improvement..................................................8 We Often Succeed as the Result of Failing More.............................................8 Kaizen, PDSA, and the Scientific Method for Improvement............................9 Changing Back Can Be Better for Babies........................................................11 Kaizen = Continuous Improvement................................................................12 Kaizen Starts with Small Changes...................................................................13 A Small Kaizen with Great Meaning................................................................14 Kaizen = Engaging Everybody in Their Own Change....................................14 Kaizen Upon Kaizen Upon Kaizen..................................................................15 Kaizen Closes Gaps between Staff and Leaders..............................................16 Creativity before Capital...................................................................................17 Expensive Mistakes Made without the Kaizen Mindset.................................20 Kaizen and Lean: Related and Deeply Interconnected Concepts..................20 People Are the Ultimate Competitive Advantage............................................21 High-Level Kaizen Principles—The Kaizen Mindset......................................21 Principle 1: Asking...................................................................................22 Principle 2: Empowering..........................................................................23 Principle 3: Recognizing...........................................................................23 Principle 4: Sharing..................................................................................23 IX Contents This Is Not a Suggestion System—It Is an Improvement System...................24 Kaizen Has an Impact on People and Performance.......................................24 Conclusion........................................................................................................27 Discussion Questions.......................................................................................27 Endnotes...........................................................................................................27 2 The Roots and Evolution of Kaizen.................................................31 Early Suggestion Programs...............................................................................31 Downsides of Suggestion Box Programs........................................................32 Recovering from Taylorism..............................................................................35 The American Roots of Continuous Improvement—TWI and Deming.........37 Kaizen: One of the Two Pillars of The Toyota Way.......................................40 Masaaki Imai and the Spread of Kaizen (1986)..............................................42 Dr. Donald M. Berwick s Call for Kaizen (1989).............................................44 Medicine s Need for Kaizen (1990)...............................................................45 Norman Bodek and American Kaizen............................................................45 Conclusion........................................................................................................46 Discussion Questions.......................................................................................46 Endnotes...........................................................................................................47 3 Types of Kaizen...............................................................................49 The Continuous Improvement of a Lifesaving Innovation.............................50 Three Levels of Kaizen.....................................................................................51 Imai s Three Levels of Kaizen..................................................................55 Complementary Nature of the Levels of Kaizen.....................................55 Three Types of Kaizen at Children s Medical Center Dallas..................56 Events Alone Will Not Make You Lean...........................................................57 The Origins of Kaizen Events..................................................................57 Basic Structure and Format of an Improvement Event...........................58 Additional Challenges with Weeklong Events.........................................59 Impressive Results from Kaizen in Healthcare........................................60 Virginia Mason Medical Center........................................................60 ThedaCare.........................................................................................62 Not All Kaizen Organizations Use Events...............................................64 Avera McKennan Uses System Kaizen and Daily Kaizen.......................64 Kaizen Leads to Innovation at Franciscan...............................................65 Conclusion........................................................................................................66 Discussion Questions........................................................................................67 Endnotes............................................................................................................67 4 Moving Toward a Kaizen Culture....................................................71 The Real Goal—Cultural Transformation........................................................71 What a Kaizen Culture Feels Like...................................................................73 Everyone Is Engaged................................................................................73 Drivers of Engagement.....................................................................75 Contents ¦ xi Everyone Is Relentlessly Searching for Opportunities to Improve.........76 The Two Parents of Transformation: Pain and Possibility......................78 Pain...................................................................................................78 Possibilities........................................................................................79 You Have Control over Your Workplace.................................................80 Patients and Families Are Happy.............................................................81 Staff and Physicians Are Happy...............................................................84 Work and Patient Care Flow Like Clockwork.........................................86 The Workspace Is Clean, Orderly, and Safe............................................86 Everyone Works Together........................................................................87 Everything Gets Questioned....................................................................90 Small Successes Lead to Bigger Successes..............................................90 Imai s Three Stages of Kaizen.........................................................................93 Conclusion........................................................................................................94 Discussion Questions.......................................................................................94 Endnotes...........................................................................................................95 SECTION 2 KAIZEN METHODOLOGIES 5 Quick and Easy Kaizen....................................................................99 How to Do Kaizen...........................................................................................99 Quick and Easy Kaizen.................................................................................100 Starting the Franciscan Kaizen Journey.........................................................102 The Quick and Easy Kaizen Process.............................................................102 Step 1—Find............................................................................................103 Start Small........................................................................................103 Start with You..................................................................................103 Make Your Work Easier...................................................................103 Make Your Work Safer.....................................................................105 Make Your Work More Interesting..................................................105 Build Your Skills, Your Capabilities, and Your Knowledge..........106 See an Opportunity or a Problem.................................................106 Step 2—Discuss.......................................................................................112 Discuss with Your Direct Supervisor..............................................112 Discuss with Your Team Members.................................................115 Step 3—Implement.................................................................................123 Enrolling Others to Help.................................................................123 Implement the Improvement Idea..................................................124 Seven Days Grace............................................................................124 Step 4—Document..................................................................................125 Finalize the Kaizen Report.............................................................126 Submit Report for Approval............................................................129 Step 5—Share.........................................................................................130 Leveraging Improvement Ideas from Others.................................130 Sharing Kaizens...............................................................................131 xii ¦ Contents Conclusion.......................................................................................................133 Discussion Questions.....................................................................................134 Endnotes..........................................................................................................135 Visual Idea Boards.........................................................................137 Making the Improvement Process Visible.....................................................138 Setting up a Visual Idea Board.......................................................................140 Boards Should Be Highly Visible in the Workplace..............................141 Boards in Public Settings........................................................................142 Communication before the Visual Idea Board Is Up....................................143 What Happened to Our Suggestion Box?...............................................143 What Employees Can Expect..................................................................143 A Communication Example....................................................................144 Formats for Idea Cards...................................................................................144 Sticky Notes versus Structured Cards.....................................................144 Idea Cards versus Suggestion Cards.......................................................146 Modeling the Kaizen and PDSA Process in Writing..............................147 Visual Idea Cards............................................................................................148 Problem....................................................................................................148 Suggestion or Idea...................................................................................149 Date Originated.......................................................................................150 Created by...............................................................................................150 Expected Benefits....................................................................................150 Input Needed from..................................................................................153 Implementation Steps..............................................................................153 Results Verified?.......................................................................................154 New Method Standardized?....................................................................155 Completion Date......................................................................................155 Idea Card Examples........................................................................................155 Staff and Patient Annoyances.................................................................155 Asking for Help.......................................................................................155 Addressing Patient Needs........................................................................157 Getting Input from Others......................................................................159 Other Formats of Idea Boards and Cards......................................................l60 Park Nicollet s KEEP Form......................................................................160 Akron Children s Hospital.......................................................................163 Seattle Children s Hospital Pharmacy.....................................................163 Visual Management of the Idea Boards.........................................................165 Using Idea Cards to Coach People on Kaizen...............................................169 The Suggestion to Be More Careful .....................................................170 Something s Not Happening—So Don t Forget......................................171 Easier for Us, but Not Best for the Whole System?................................171 Tracking Completed Cards.............................................................................172 Contents ¦ xiii Conclusion.......................................................................................................174 Discussion Questions......................................................................................174 Endnotes..........................................................................................................174 7 Sharing Kaizen...............................................................................175 Different Formats for Sharing.........................................................................175 The Kaizen Wall of Fame Format..................................................................176 Kaizen Sharing Examples...............................................................................178 Making Things Better for Patients..........................................................179 Supplies for Patients.......................................................................180 Improving Meal Rounds..................................................................181 Easier to Get DVDs..........................................................................182 Little Details for Patients..................................................................183 Preventing Mistakes or Harm..................................................................183 Ensuring Proper Bed Cleaning......................................................184 Preventing Pressure Ulcers..............................................................185 More Accurate Lab Results through Standardized Work...............186 Proper X-Ray Ordering....................................................................187 Ensuring Equipment Is Ready........................................................188 Eye Protection for Lab Staff.............................................................190 Preventing Aerosolized Specimens.................................................191 Making Work Easier for Staff..................................................................192 Easier to Plug In Carts.....................................................................192 Improved Ergonomics and Specimen Quality................................193 Saving Sore Feet...............................................................................194 Better Phone Ergonomics and Productivity....................................195 Combining Two Forms into One....................................................196 Preventing Delays....................................................................................197 Faster Code STEMI Heart Attack Care............................................197 Meds for Discharged Patients..........................................................198 Getting Patients to Rooms with Less Delay....................................199 More Timely Test Results for Rounding.........................................200 Fewer Supply Chain Delays...........................................................200 Better Access to Endocrinology.....................................................200 Saving Space or Cost..............................................................................203 Creativity over Capital in the Lab...................................................203 Company Medical Clinic Costs......................................................204 Rethinking Freezer Use..................................................................206 Conclusion......................................................................................................207 Discussion Questions.....................................................................................207 8 The Art of Kaizen..........................................................................209 Barriers to Kaizen...........................................................................................210 Resistance to Change..............................................................................211 Lack of Time—We re Too Busy..............................................................212 xiv ¦ Contents A Model for Mobilizing Support.....................................................................213 Tenet 1: Respect Others..........................................................................214 Tenet 2: Create a Vision That Matters.....................................................215 Tenet 3: Convey the Why........................................................................216 Tenet 4: Connect to the Mission.............................................................219 Is This about Me or Is This about the Mission?....................................220 Working with Others Based on Their Willingness to Invest........................220 Strategy 1: Co-create with Those Eager for Opportunity......................221 Seek Their Ideas.............................................................................222 Play Kaizen Catch Ball...................................................................222 Reigniting Everyone s Creativity.....................................................223 Strategy 2: Sell Opportunity to Those Who Are Cautious....................224 Encourage........................................................................................225 Seven Days Grace...........................................................................225 Measure Progress.............................................................................225 Strategy 3: Find Common Meaning and Negotiate with Opposers......226 Include Opposing Viewpoints.......................................................226 Find Common Meaning..................................................................227 Negotiate.........................................................................................227 Use Demands as a Last Resort.......................................................228 Kaizen and Positive Deviance.......................................................................228 Rules for Leaders....................................................................................229 Conclusion......................................................................................................230 Discussion Questions.....................................................................................230 Endnotes.........................................................................................................230 SECTION 3 KAIZEN LESSONS LEARNED 9 The Role of Leaders in Kaizen.......................................................235 Leading to Create the Culture........................................................................236 Key Actions for Leaders at All Levels............................................................236 Key Action 1: Believe In the Power of Kaizen.......................................237 Key Action 2: Participate in Kaizen........................................................237 Key Action 3: Just Ask............................................................................238 Ask, Don t Tell................................................................................238 Key Action 4: Use Kaizen to Develop People.......................................239 Key Action 5: Ensure Staff Members Are Recognized and Rewarded. 240 Key Action 6: Share and Spread Ideas..................................................240 Key Action 7: Sell the Benefits................................................................241 It Is Not Always about Cost.............................................................241 Role of Top-Level Managers..........................................................................242 Leadership and Kaizen Participation Starts at the Top.........................242 Dr. John Toussaint s Participation..................................................242 Going to the Gemba.......................................................................244 Contents ¦ xv Kaizen Reports Are for Everybody........................................................244 Key Actions for Top-Level Managers.....................................................244 Key Action 1 : Communicate Expectations and Prioritize.............244 Key Action 2: Resource Adequately...............................................246 Key Action 3: Sponsor a Recognition and Incentives Program.....247 Key Action 4: Share Notable Kaizens.............................................247 Key Action 5: Thank People Personally.........................................249 Role of Middle-level Managers.......................................................................249 Paula s Baby Steps Lead the Way............................................................250 The Great Big Pile of Problems ....................................................250 Leaders Drive Kaizen Success.................................................................251 The Kaizen Difference............................................................................252 Key Actions for Middle-level Managers..................................................253 Key Action 1: Be the Departmental Owner and Develop Co-Owners or Coordinators............................................................253 Key Action 2: Use Departmental Meetings....................................254 Key Action 3: Encourage Staff to Participate by Asking for Their Ideas.......................................................................................255 Key Action 4: Create a Departmental Recognition System............255 Key Action 5: Put a Tracking System in Place, if One Does Not Exist..........................................................................................258 Key Action 6: Tie to Performance Evaluations...............................259 Role of First-Level Managers..........................................................................260 A First-Level Manager Is a Coach..........................................................260 Key Actions for First-Level Managers......................................................26l Key Action 1: Coach........................................................................261 Key Action 2: Empower Staff—Do Not Do the Kaizen for Them...262 Key Action 3: Use Rounding to Coach...........................................262 Key Action 4: Help Set Expectations.............................................263 Key Action 5: Review and Approve Kaizen Reports.....................263 Key Action 6: Help Document Benefits.........................................265 Key Action 7: Make Kaizen Fun.....................................................265 Key Action 8: Recognize and Reward............................................266 Key Action 9: Share and Spread Ideas...........................................266 Key Action 10: Be a Cheerleader....................................................267 Conclusion......................................................................................................268 Discussion Questions.....................................................................................268 Endnotes.........................................................................................................268 10 Organization-Wide Kaizen Programs............................................271 Getting Started................................................................................................271 When Will You See Results?..................................................................272 Tying Kaizen to the Organization s Strategy..........................................273 The Kaizen Promotion Office.........................................................................274 Staffing the KPO......................................................................................274 xvi ¦ Contents Activities of the Kaizen Promotion Office......................................................275 Activity 1: Facilitates the Practice of Kaizen...........................................275 Activity 2: Reports Kaizen Metrics..........................................................276 Activity 3: Coordinates Rewards and Recognition................................277 Activity 4: Facilitates Kaizen Sharing across the Organization.............278 Activity 5: Develops Kaizen Standardized Work...................................278 Activity 6: Develops and Delivers Staff Education................................279 Activity 7: Facilitates the Documentation and Tracking of Kaizens.....279 Sustaining a Kaizen Program—Incentives and Rewards..............................279 Pros and Cons of Financial Incentives..................................................280 Electronic Kaizen Systems.............................................................................281 Advantages of an Electronic Online Database......................................282 Quick Entry.....................................................................................282 Automatic Routing and Electronic Approval..................................284 Ideas to Hold for Later....................................................................285 Quick Search and Retrieval............................................................285 Electronic Kaizen within Intermountain Healthcare.............................285 Electronic Kaizen at Park Nicollet.........................................................286 Electronic Kaizen at Vanderbilt..............................................................287 Conclusion......................................................................................................289 Discussion Questions.....................................................................................290 Endnotes.........................................................................................................290 11 Lean Methods for Kaizen...............................................................293 Technique 1: Add Value.................................................................................293 The Internal Customer s Point of View.................................................294 Different Forms of Patient Value............................................................295 Technique 2: Eliminate Waste.......................................................................297 Waste 1: Transportation..........................................................................298 Waste 2: Overproduction.......................................................................298 Waste 3: Motion......................................................................................299 Waste 4: Defects (Errors and Rework)...................................................300 Waste 5: Waiting.....................................................................................300 Waste 6: Inventory..................................................................................300 Waste 7: Overprocessing.........................................................................301 Waste 8: Lost Human Potential, Creativity, and Opportunities.............301 Seeing Waste through Process Observation..........................................302 Go See ..........................................................................................302 Spaghetti Diagrams.........................................................................303 Technique 3: Visual Workplace.....................................................................303 Color Coding..........................................................................................306 Home Locations......................................................................................308 Kitchen Example.............................................................................308 Borders...................................................................................................309 Contents ¦ xvii Technique 4: 5S—Workplace Organization...................................................310 SI: Sort.....................................................................................................310 S2: Set in Order.......................................................................................311 S3: Shine..................................................................................................312 S4: Standardize........................................................................................312 S5: Sustain................................................................................................313 Technique 5: Workstation Design...................................................................315 Technique 6: Problem Solving........................................................................316 A3 Problem-Solving Technique..............................................................317 Problem-Solving Methods Used with A3................................................319 Find the Point of the Cause.............................................................319 Identify the Root Cause...................................................................321 Technique 7: Error Proofing...........................................................................322 Fatal and Preventable Healthcare Errors................................................324 Four Elements of a Zero Defect Quality System...................................326 Element 1: Self-Check and Successive Check................................326 Element 2: Immediate Feedback and Corrective Action...............326 Element 3: Source Inspection.........................................................326 Element 4: 100% Inspection...........................................................330 Conclusion.......................................................................................................331 Discussion Questions......................................................................................332 Endnotes..........................................................................................................332 12 Kaizen At Home.............................................................................335 Kaizen Tips from an Actress...........................................................................335 Kaizen Tips from a Behavioral Scientist.......................................................336 Kaizen at Home..............................................................................................337 Kaizen before Work........................................................................................337 Kaizen for Breakfast................................................................................337 Kaizen to Get Ready for Work...............................................................338 Kaizen with Your Coffee........................................................................338 Kaizen to Get Dressed...........................................................................340 Kaizen to Reduce Cup Clutter................................................................346 Kaizen on the Way to Work..................................................................346 Kaizen in the Home Office.............................................................................347 Kaizen on the Computer.........................................................................347 Kaizen on the Physical Desktop............................................................348 Kaizen after Work..........................................................................................349 Kaizen for Dinner...................................................................................349 Kaizen in the Backyard...........................................................................351 Improvements..................................................................................351 Kaizen for Home Repair.........................................................................351 Kaizen for the Earth................................................................................352 Kaizen in the Bathroom..........................................................................352 xviii ¦ Contents Kaizen and Your Kids.............................................................................353 A Vacation from Kaizen?.........................................................................354 Kaizen for Repetitive Tasks.....................................................................354 Kaizen for the Kaizen Process................................................................355 Conclusion.......................................................................................................355 Discussion Questions......................................................................................356 Endnotes..........................................................................................................356 Conclusion............................................................................................359 A Minute to Learn, a Lifetime to Master.......................................................360 Your Next Steps.............................................................................................360 Building a Kaizen Community.......................................................................36l Endnotes..........................................................................................................36l Index....................................................................................................363 Healthcare Kaizen focuses on the principles and methods of daily continuous improvement, or “Kaizen,” for healthcare professionals and organizations. This book shares the experiences of numerous hospitals around the world, including Franciscan St. Francis Health, and the management mindsets required to make Kaizen work effectively in a hospital department or as an organization-wide program. All of the examples in the book were shared by leading healthcare organizations, with over 200 full-color pictures and visual illustrations of Kaizen-based improvements that were initiated by nurses, physicians, housekeepers, senior executives, and other staff members at all levels. Offering templates that are available for download on the authors’ website (www.HCkaizen.com), this is the ideal reference for healthcare organizations that want to go beyond just doing weeklong improvement events and are ready to move into a more complete Lean management system.
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title	Healthcare Kaizen engaging front-line staff in sustainable continuous improvements
title_auth	Healthcare Kaizen engaging front-line staff in sustainable continuous improvements
title_exact_search	Healthcare Kaizen engaging front-line staff in sustainable continuous improvements
title_full	Healthcare Kaizen engaging front-line staff in sustainable continuous improvements Mark Graban and Joseph E. Swartz
title_fullStr	Healthcare Kaizen engaging front-line staff in sustainable continuous improvements Mark Graban and Joseph E. Swartz
title_full_unstemmed	Healthcare Kaizen engaging front-line staff in sustainable continuous improvements Mark Graban and Joseph E. Swartz
title_short	Healthcare Kaizen
title_sort	healthcare kaizen engaging front line staff in sustainable continuous improvements
title_sub	engaging front-line staff in sustainable continuous improvements
topic	Kaizen (DE-588)4429179-6 gnd Krankenhaus (DE-588)4032786-3 gnd
topic_facet	Kaizen Krankenhaus
url	http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025205837&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025205837&sequence=000003&line_number=0002&func_code=DB_RECORDS&service_type=MEDIA
work_keys_str_mv	AT grabanmark healthcarekaizenengagingfrontlinestaffinsustainablecontinuousimprovements AT swartzjosephe healthcarekaizenengagingfrontlinestaffinsustainablecontinuousimprovements

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