Lean Healthcare

Dennis R. Delisle

Description

Lean healthcare is not about being better, but rather becoming the best at getting better. Today's challenge in the healthcare environment is your ability to improve at a greater rate than surrounding competitors. This book focuses on the model, strategy, and lessons learned in implementing lean thinking in a practical way. Using real-world case studies, the book provides approaches and tools to facilitate rapid improvements, along with a bonus section on pandemic preparedness. By following this accessible, user-friendly guide, you can achieve meaningful results right away.
Dr. Dennis R. Delisle currently serves as the Executive Director for The Ohio State University Wexner Medical Center's flagship University Hospital. Through the Thomas Jefferson University College of Population Health, Dennis founded and oversees the Master of Science degree program in Operational Excellence, one of the first of its kind in the nation. He is the author of two books about streamlining and transforming healthcare.

Sujets

• Business
• Qualité, hygiène, sécurité, environnement
• Total Quality Management
• Healthcare
• Gestion et management
• FDA
• Health care
• Economics
• CAPA
• Food and Drug Administration

Informations

• Publié par: ASQ Quality Press
• Date de parution: 01 décembre 2020
• Nombre de lectures: 0
• EAN13: 9781951058456
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Lean Healthcare
A Practical Guide for Executing Lean Improvements with Real-World Case Studies
Second Edition
Dennis R. Delisle


ASQ Quality Press
Milwaukee, Wisconsin


American Society for Quality, Quality Press, Milwaukee 53203
© 2020 by Dennis R. Delisle
All rights reserved
Printed in the United States of America
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Publisher’s Cataloging-in-Publication data Names: Delisle, Dennis R., 1984-, author. Title: Lean healthcare, second edition: a practical guide for executing lean improvements with real-world case studies / Dennis R. Delisle. Description: Includes bibliographical references and index. | Milwaukee, WI: Quality Press, 2020. Identifiers: LCCN: 2020948264 | ISBN: 978-1-951058-44-9 (pbk.) | 978-1-951058-45-6 (epub) | 978-1-951058-46-3 (pdf) Subjects: LCSH Health services administration. | Health services administration—Case studies. | Health care management. | Industrial management. | Industrial efficiency. | Business logistics. | Organization. | BISAC BUSINESS & ECONOMICS / Industries / Healthcare Classification: LCC R728 .D45 2020 | DDC 362.1068—dc23
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Printed on acid-free paper

Table of Contents
Cover
H1580_Delisle_Title
H1580_Delisle_CIP
H1580_Delisle_Dedication
H1580_Delisle_Foreword
H1580_Delisle_Introduction
H1580-01_Delisle_Chapter1
H1580-02_Delisle_Chapter2
H1580-03_Delisle_Chapter3
H1580-04_Delisle_Chapter4
H1580-05_Delisle_Chapter5
H1580-06_Delisle_Chapter6
H1580-07_Delisle_Chapter7
H1580-08_Delisle_Chapter8
H1580-09_Delisle_Chapter9
H1580-10_Delisle_Chapter10
H1580-11_Delisle_Chapter11
H1580-12_Delisle_Appendices
H1580-13_Delisle_References
H1580-15_Delisle_AboutAuthor
H1580-16_Delisle_SuppPgs


To my girls: Rachel, Ophelia, and Josephine.


Foreword
by David B. Nash, MD, MBA
D ennis Delisle and our College of Population Health have essentially grown up together on the campus of Thomas Jefferson University in Philadelphia. Let me explain. The nation’s first College of Population Health is now in its early adolescence, celebrating its 12th birthday. There are many new schools and colleges of population health across the nation, including at least 40 departments of population health spread across America’s 150 allopathic medical colleges. Dennis, when I first met him, was a management fellow completing his health administration fellowship at our institution. A few short years later he became the senior administrative leader and vice president of operations for our south Philadelphia division. Jefferson Health itself is now nearly 20 hospitals and more than a $6 billion operation. Today Dennis is the executive administrator for The Ohio State University Wexner Medical Center’s flagship hospital. What has not changed is the burning passion Dennis has for improving the outcomes of medical care, even as a non-clinician.
As I look back on my tenure as the founding dean emeritus, and the celebration of my three decades of service as a faculty member at our university, Dennis continues to stand out as a wonderful colleague. As I wrote in the first Foreword, I was so impressed with Dennis (when I met him) by his fund of knowledge and enthusiasm that it was indeed a great decision to ask him to join our affiliated faculty and charge him with creating some of our most successful online training in lean thinking.
Dennis has evolved into one of our most highly sought-after and most lauded faculty, and the portfolio of courses that he teaches are typically oversubscribed. Therefore, as I wrote in the first Foreword, it does not come as much of a surprise to me that the publisher of the first edition of his successful book has asked him to complete this thoroughly updated second edition. Much has happened in the interim period.
Lean thinking is solidly entrenched in our college curriculum with both a graduate certificate and a master’s degree in operational excellence. Essentially, we believe that clinicians have two jobs to do each and every day: Job #1, which is the clinical job for which they were well trained, and Job #2, which is to improve Job #1. Few clinicians, including doctors, nurses, pharmacists, and others, have the requisite skillset to operationalize Job #2. Dennis Delisle to the rescue!
As I wrote in the first Foreword, from my perch, “lean” means eliminate waste, and after 30 years in academic medicine, I’m convinced that a third of all the procedures my clinical colleagues order, and the money we collectively spend as a society, is probably wasteful. A good portion of what we do is not based on solid scientific evidence but rather on a collection of the opinions of experts and the guild-like nature of our hierarchical training process. In a word, it still seems to me to be a world filled with “see one, do one, and teach one,” with little regard for “Is that the right one in the first place?”
Along comes the second edition of Lean Healthcare , and it is not a clinical guide; rather, it is a new mindset, a paradigm shift, a sea change, a new lens, a disruption. Whichever adjective you choose to use, Dennis has given us a unique view of lean. This book clearly sorts out the differences in our jargon from lean to Six Sigma to business process redesign to continuous quality improvement. At the end of the day, it’s all about improving what we do each day in order to reduce waste, reallocate resources, reduce error, improve outcomes, and, in a word, deliver value in the nation’s largest industry.
With the concomitant expansion of the Jefferson College of Population Health master’s degree in healthcare quality and safety, and the on-campus leadership training programs in high reliability, this book will serve as a cornerstone for our ever-expanding curriculum. It leads me to think about what the future of a truly clinically integrated delivery system—now numbering more than 20 hospitals—might look like. Let me share aspects of that vision.
As I wrote in the first Foreword, “imagine the clinically integrated delivery system of the future.” The chief medical officer makes regular “gemba” walks to see for herself where inefficiencies in the complex process of a hospital might be lurking. Imagine, too, the daily huddle where clinicians, administrators, and others self-reflect about what went on the day before and how they could have made the process safer and more efficient for all our patients. Admittedly, there are some organizations that embrace the gemba walk and the daily huddle for safety, but they remain, 20 years after the publication of To Err is Human , frightfully few and far between. This second edition will go a long way in educating a large number of people who will, in turn, help their organizations to catapult us into such a future vision described herein.
I appreciate how well organized this book is with its ample figures and tables, all of which are clean and easy to grasp. The prose is crisp. The chapter organization makes sense. The definitions of lean principles and kaizen problem-solving are compelling.
It’s now been more than a decade since the passage of the Affordable Care Act, and the nation is struggling with issues including access, disparity in care, inequities in income distribution, and frightful reversal of epidemiologic markers, including a decrease in life expectancy coupled with the diseases of despair (alcoholism, depression, drug abuse, and suicide). The nation seems to have lost its way. As a result, we need lean thinking now more than ever. As I wrote in the first Foreword, lean thinking is not just a destination, it is a new way to view the world. As emeritus dean, I sent faculty members for training in lean and actively promoted enrollment in Dennis’ graduate-level course. Subsequent leaders in our college continue to support Dennis unabashedly, and, as a result, I remain supremely confident that lean thinking will continue to be one of the key tools we need to implement the vision of the Affordable Care Act, now a decade ago. I am equally confident that such implementation will put us on the road to redemption —the road paved with an increased attention to measurement, accountability, transparency, and, of course, closure of the feedback loop.
My 30-year career as a member of the faculty of this great university has taught me many important life lessons. Chief among them is the need for leader­ship training for the emerging class of new leaders forged during a time when our industry has consumed 20 percent of our GDP, and, yet, we continue to be wasteful in our spending and continue to harm patients. As a result, I believe everyone in a leadership role in our increasingly complex delivery system would benefit greatly from at least a rudimentary understanding of lean and, at best, a deep dive into each chapter in this second edition. Once again, kudos to Dennis Delisle for his many accomplishments, most especially the second edition of this important book. The only questions I have are: “Are we courageous enough as practitioners to embrace lean and actually change our thinking to reduce the waste that surrounds so many o