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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, LLCLean 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 maturityWhatever 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.
Contents
Preface xiiiAbout the Author xixChapter 1: Existing Change Models: Why the Traditional Healthcare Models Are Struggling 1Traditional Change Models 1Disparate Change Groups 4Uncontained Change 5No Standard Change Approach 6Tools Focus 6Reliance on Benchmarking 7Changes Are Not Based on Data, Good Data, or the Right Data 8Changes Made Based on Symptoms, Not Causes 10Systems versus Processes 10Focus on People, Not on Process 11Lack of Context for Solutions 12Adding versus Subtracting (Patching) 13Poor Implementation 13No Emphasis on Control 14Management versus Leadership 15Summary 16Chapter 2: Structuring Change: Program Infrastructure 17Lean Sigma: The Program 22The Steering Group 24Setting the Program Direction 26The Fit with Existing Initiatives 29Shaping Projects 31Focus on Process 33Breakthrough Change 35Project Tiers 35Identifying Opportunities 40Characterizing Projects (Preliminary Project Chartering) 43Setting Goals 46Prioritizing Action 47Program and Project Roles 49Program Tracking, Reporting, and Ongoing Management 52Summary 53Chapter 3: Lean Sigma Roadmap: The Anatomy of a Project 55Lean Sigma Project Roadmap 55Define 60Measure 64Analyze 67Improve 71Control 74The Lean Sigma Roadmap: Why It Works 75Standardization Projects 79Kaizen (Accelerated Change) Events 81Summary 84Chapter 4: Application to Real Life: Project Case Examples 85Case 1: CT Capacity and Throughput 85Case 2: Reduce Discharged, Not Final Billed (DNFB) 88Case 3: Radiology Denials 91Case 4: Behavioral Health Discovery 93Case 5: Medication Delivery 95Case 6: Registration Standardization 96Case 7: Inpatient Admission Standardization 98Case 8: Physician Office Standardization 100Case 9: Surgery Capacity and Throughput 102Case 10: Emergency Department Throughput 104Case 11: Inpatient Placement 106Case 12: New Emergency Department Design 109Chapter 5: Commencing the Journey 111I. Program Vision and Launch 115II. Creating Program Infrastructure 116III. Developing Organizational Competence 117IV. Transforming Processes 120V. Stabilization and Performance Management 121VI. Globalization 122Index 125
