Lean Six Sigma for Healthcare

Nancy Poston, Butler Greg, Chip Caldwell

Description

This book’s unique focus on the role of healthcare leaders and the lessons learned were uncovered during the authors’ research of over 200 U.S. hospitals’ performance. It was written specifically for CEOs, the “C-Suite,” and senior leaders who desire to harness the power of Lean-Six Sigma as their major strategic weapon for progress, as well as those charged to coach them. It is intended for those organizations that operate active Lean-Six Sigma initiatives, but have yet to successfully attack high leverage processes like “In Quality Staffing” and recovering significant Cost of Quality from throughput improvements. It is also intended for senior leaders who have yet to tackle Lean-Six Sigma as their major organization-wide strategic weapon.
However, it is also a must-read for managers at all levels, quality professionals, and Lean-Six Sigma Black Belts who desire to aid in assuring that their organizations’ improvement efforts attack strategically versus the all-to-common tactical, project-by-project approach that suboptimizes the power of Lean-Six Sigma. Further, the book and supporting website is full of electronic checklists, tools, templates, suggestions for additional reading, and many recommended 1-hour and 2-hour learning sessions for senior leaders and managers.
The changes in this second edition include the following:
Many more examples of “In Quality Staffing”, a healthcare translation of one of the seven categories of Lean waste found in the Toyota Production System and one of the most powerful concepts applicable to healthcare. This concept has been described as “the language of nursing” versus a more manufacturing-speak described in other leading Lean-Six Sigma books.
Expanded dialogue of the role of Lean in healthcare.
Additional embedded case examples.

Sujets

• Business
• Qualité, hygiène, sécurité, environnement
• Medical
• Médecine
• Biotechnology

Informations

• Publié par: ASQ Quality Press
• Date de parution: 05 décembre 2008
• Nombre de lectures: 3
• EAN13: 9780873894029
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

LeanSix Sigma for Healthcare

Also available from ASQ Quality Press:

Lean Six Sigma for the Healthcare Practice: A Pocket Guide Roderick A. Munro

A Lean Guide to Transforming Healthcare: How to Implement Lean Principles in Hospitals, Medical Offices, Clinics, and Other Healthcare Organizations Thomas G. Zidel

Improving Healthcare Using Toyota Lean Production Methods: 46 Steps for Improvement, Second Edition Robert Chalice

The Public Health Quality Improvement Handbook Grace L. Duffy and John W. Moran, editors

Solutions to the Healthcare Quality Crisis: Cases and Examples of Lean Six Sigma in Healthcare Soren Bisgaard, editor

On Becoming Exceptional: SSM Health Care’s Journey to Baldrige and Beyond Sister Mary Jean Ryan, FSM

Journey to Excellence: Baldrige Health Care Leaders Speak Out Kathleen Goonan, editor

Benchmarking for Hospitals: Achieving Best-in-Class Performance without Having to Reinvent the Wheel Victor Sower, Jo Ann Duffy, and Gerald Kohers

The Certified Six Sigma Green Belt Handbook Roderick A. Munro, Matthew J. Maio, Mohamed B. Nawaz, Govindarajan Ramu, and Daniel J. Zrymiak

Six Sigma for the New Millennium: A CSSBB Guidebook, Second Edition Kim H. Pries

The Certified Six Sigma Black Belt Handbook, Second Edition T.M. Kubiak and Donald W. Benbow

5S for Service Organizations and Offices: A Lean Look at Improvements Debashis Sarkar

The Executive Guide to Understanding and Implementing Lean Six Sigma: The Financial Impact Robert M. Meisel, Steven J. Babb, Steven F. Marsh, and James P. Schlichting

To request a complimentary catalog of ASQ Quality Press publications, call 800-248-1946, or visit our Web site at http://www.asq.org/quality- press.

LeanSix Sigma for Healthcare

A Senior Leader Guide to Improving Cost and Throughput Second edition

Chip Caldwell, FACHE Greg Butler Nancy Poston, FACHE

ASQ Quality Press Milwaukee, Wisconsin

American Society for Quality, Quality Press, Milwaukee 53203 © 2009 by American Society for Quality All rights reserved. Published 2009 Printed in the United States of America 12 11 10 09 16 15 14 13 5 4 3 2 1 Library of Congress CataloginginPublication Data Butler, Greg. Lean-Six Sigma for healthcare : a senior leader guide to improving cost and throughput / Greg Butler, Chip Caldwell, Nancy Poston.—2nd ed. p. ; cm. Rev. ed. of: Lean-Six Sigma for healthcare / Chip Caldwell, Jim Brexler, Tom Gillem. c2005. Includes bibliographical references and index. ISBN 978-0-87389-759-4 (hardcover : alk. paper) 1. Health services administration—Quality control. 2. Medical care—Cost-effectiveness. 3. Six sigma (Quality control standard) 4. Organizational effectiveness. 5. Performance standards. 6. Strategic planning. 7. Chief executive officers. 8. Hospital administrators. I. Caldwell, Chip. II. Poston, Nancy. III. Caldwell, Chip. Lean-Six Sigma for healthcare. IV. American Society for Quality. V. Title. [DNLM: 1. Hospital Administration. 2. Cost Control—methods. 3. Efficiency, Organizational. 4. Quality Assurance, Health Care. WX 153 B985L 2009] RA399.A1C345 2009 362.1068—dc22 009000927 ISBN 978-0-87389-759-4 No part of this book may be reproduced in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher.

Publisher: William A. Tony Acquisitions Editor: Matt Meinholz Project Editor: Paul O’Mara Production Administrator: Randall Benson

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ASQ Mission: The American Society for Quality advances individual, organizational, and community excellence worldwide through learning, quality improvement, and knowledge exchange.

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Printed on acid-free paper

The authors dedicate this work to:

Chip Caldwell—To the love of my life, Nancy Poston, who was a great inspiration for this second edition, and for my daughters, Kali and Morgan, and my grandchildren, Jack and Davis, who have added much joy to my life.

Greg Butler—To my wife, Susan, for her encouragement and support, which has been a true inspiration and blessing from God, and to Chip, who has been both a friend and a mentor.

Nancy Posten—To my parents, McCracken and Barbara Poston who taught me the importance of doing it right the first time.

Contents

CD Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi List of Figures and Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxv Chapter 1 The Role of Senior Leaders: Raising the Performance Bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 So, What Is Lean-Six Sigma? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Lean-Six Sigma as a Strategic Deployment Approach . . . . . . . . . 5 Lean-Six Sigma as a Belief System . . . . . . . . . . . . . . . . . . . . . . . . 7 Lean-Six Sigma as a Statistical Calculation . . . . . . . . . . . . . . . . . 9 Lean-Six Sigma as a Suite of Project Methodologies . . . . . . . . . . 11 Checklists and Tools Accessible Electronically . . . . . . . . . . . . . . . 13 Recommended Learning Sessions . . . . . . . . . . . . . . . . . . . . . . . . . 13 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Chapter 2 The Role of Senior Leaders: Coaching Cost of Quality Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 How Can Lean-Six Sigma Serve as a Cost Recovery Concept? . . 16 Coaching the Seven Categories of Waste . . . . . . . . . . . . . . . . . . . . 22 How Can Senior Leaders Reduce This Waste? . . . . . . . . . . . . . . . 42 What Is the Impact of Lean Thinking on Throughput and Cost? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 How Can We Reduce Worked Hours? . . . . . . . . . . . . . . . . . . . . . . 49 Eight Lean-Six Sigma Solution Sets . . . . . . . . . . . . . . . . . . . . . . . 52 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Checklists and Tools Accessible Electronically . . . . . . . . . . . . . . . 53 Recommended Learning Sessions . . . . . . . . . . . . . . . . . . . . . . . . . 55 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Additional Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

vii

viii

Contents

Chapter 3 The Role of Senior Leaders: Organizing LeanSix Sigma Project Methodologies to Drive Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 DMAIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 PDCA-Type Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 100–Day Workout Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Manager Project . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Assessing Current Improvement Methods . . . . . . . . . . . . . . . . . . . 75 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Checklists and Tools Accessible Electronically . . . . . . . . . . . . . . . 78 Recommended Learning Sessions . . . . . . . . . . . . . . . . . . . . . . . . . 78 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Additional Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Chapter 4 The Role of Senior Leaders: Managing the Organization Accountable Change Model . . . . . . . . 81 Achieving the Magic Moment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Measuring Strategic Magic Moment Results . . . . . . . . . . . . . . . . . 101 Establish Monthly Project Milestone Tracking . . . . . . . . . . . . . . . 107 Senior Leader Missteps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Checklists and Tools Accessible Electronically . . . . . . . . . . . . . . . 112 Recommended Learning Session . . . . . . . . . . . . . . . . . . . . . . . . . . 112 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Additional Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Chapter 5 The Role of Senior Leaders: Simulation, Experimentation, and the Cost of Not Getting It Right the First Time . . . . . . . . . . . . . . . . . 115 Emergency Department Case Study . . . . . . . . . . . . . . . . . . . . . . . . 118 Operating Room Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Recommended Learning Session . . . . . . . . . . . . . . . . . . . . . . . . . . 133 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Chapter 6 The Role of Senior Leaders: Driving Sustainable Organizational Change . . . . . . . . . . . . . 135 Behavioral Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Change Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 Checklists and Tools Accessible Electronically . . . . . . . . . . . . . . . 140 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Additional Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

Contents

ix

Chapter 7 The Role of Senior Leaders: Engaging Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Communication with Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . 145 Case in Point: Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Chapter 8 The Role of Senior Leaders: Achieving Sustainable Results (Magic Moment Example) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Morton Plant Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Additional Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Chapter 9 Summation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

Glossary

Appendix A

Appendix B

Appendix C

Appendix D

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

Waste Walk Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

DMAIC Project Charter Template . . . . . . . . . . . . . . 177

LeanSix Sigma Solution Set . . . . . . . . . . . . . . . . . . . 181

PDCA Project Method Assessment Workpaper . . . . 195

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207