The Manager's Guide to Six Sigma in Healthcare

Amy C. Smith, Robert D. Barry

Description

Six Sigma reinforces current developments in healthcare management: evidence based medicine, service line management, and magnet nursing. Six Sigma fits the real healthcare world, dealing with manual tasks and the exceptional needs of patients. This book provides guidance to an organizational strategy that attains and sustains results. It explains how to use in-hand data to improve patient safety, patient service, and patient care for data-informed decision making. A section is also included on finite capacity scheduling models, a key issue in hospital productivity improvement. It is the first book made with strictly management in mind, organized for quick and easy reference. Each topic starts with a check list and follows with additional information in increasing detail. The practical tips and tools included are made to be immediately applicable.

Sujets

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

Informations

• Publié par: ASQ Quality Press
• Date de parution: 30 juin 2005
• Nombre de lectures: 1
• EAN13: 9781636940670
• Langue: English

Extrait

The Manager’s Guide to Six Sigma in Healthcare

Practical Tips and Tools for Improvement

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Nan’s Arsonist: A Six Sigma Mystery Robert Barry

The Six Sigma Book for Healthcare: Improving Outcomes by Reducing Errors Robert Barry, PhD, Amy Murcko, APRN, and Clifford Brubaker, PhD

Lean-Six Sigma for Healthcare: A Senior Leader Guide to Improving Cost and Throughput Chip Caldwell, James Brexler, and Tom Gillem

The Six Sigma Journey from Art to Science Larry Walters

Six Sigma for the Office: A Pocket Guide Roderick A. Munro

Defining and Analyzing a Business Process: A Six Sigma Pocket Guide Jeffrey N. Lowenthal

Customer Centered Six Sigma: Linking Customers, Process Improvement, and Financial Results Earl Naumann and Steven H. Hoisington

Office Kaizen: Transforming Office Operations into a Strategic Competitive Advantage William Lareau

Improving Healthcare with Control Charts: Basic and Advanced SPC Methods and Case Studies Raymond G. Carey

Measuring Quality Improvement in Healthcare: A Guide to Statistical Process Control Applications Raymond G. Carey, PhD and Robert C. Lloyd, PhD

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

The Manager’s Guide to Six Sigma in Healthcare

Practical Tips and Tools for Improvement

Robert Barry Amy C. Smith

ASQ Quality Press Milwaukee, Wisconsin

American Society for Quality, Quality Press, Milwaukee 53203 © 2005 by ASQ All rights reserved. Published 2005 Printed in the United States of America 12 11 10 09 08 07 06 05 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Barry, Robert D., 1938– The manager’s guide to Six Sigma in healthcare : practical tips and tools for improvement / Robert Barry and Amy C. Smith. p. cm. Includes bibliographical references and index. ISBN 0-87389-651-3 (soft cover, perfect bind : alk. paper) 1. Medical care—Quality control. 2. Health facilities—Quality control. 3. Health services administration. I. Smith, Amy C., 1964– II. Title. RA399.A1B366 2005 362.1'068'5—dc22 2005004133 ISBN 0-87389-651-3 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: Annemieke Hytinen Project Editor: Paul O’Mara Production Administrator: Randall Benson ASQ Mission: The American Society for Quality advances individual, organizational, and community excellence worldwide through learning, quality improvement, and knowledge exchange. Attention Bookstores, Wholesalers, Schools, and Corporations: ASQ Quality Press books, videotapes, audiotapes, and software are available at quantity discounts with bulk purchases for business, educational, or instructional use. For information, please contact ASQ Quality Press at 800-248-1946, or write to ASQ Quality Press, P.O. Box 3005, Milwaukee, WI 53201-3005. To place orders or to request a free copy of the ASQ Quality Press Publications Catalog, including ASQ membership information, call 800-248-1946. Visit our Web site at www.asq.org or http://qualitypress.asq.org.

Printed on acid-free paper

Contents

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Acknowledgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Topic

1. Six Sigma Particulars . . . . . . . . . . . . . . . . . . . . . . . . . . . . Six Sigma is a management method based on the use of meaningful internal data, quantitative targets, coherent objectives, and sustainable performance.

Patient Care

2. Patients’ Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . What does the patient want? What does the organization need to do in order to serve the patient population?

3. Patient Populations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Medical care is required for populations of patients sharing a diagnosis. Then, medical care is required for each patient as an individual. The population deserves national standard protocols. The individual deserves individualized attention.

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4. Patients As Individuals . . . . . . . . . . . . . . . . . . . . . . . . . . .

Start with a standardized protocol and care plan for each patient. Track patient response. Intercede if the patient shows other than the expected response. Take charge of com- munications with the patient and family.

5. Patient Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Protect patients from being harmed by any credible single failure.

Patient Service

6. Service Fundamentals . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Patients want attentive care. All the lessons learned in other service industries are available for application to healthcare. Think through the business issues, set standards, track per- formance. Encourage attainment.

7. Serving Impatient Patients . . . . . . . . . . . . . . . . . . . . . . . .

Patients who have immediate alternatives do not wait in queue. The only way to get their business is to have capacity to serve them, right now.

8. Serving Patient Patients . . . . . . . . . . . . . . . . . . . . . . . . . .

Unscheduled patients who are willing to wait in queue for a reasonable period of time decide for themselves how long they are willing to wait.

9. Serving Scheduled Patients . . . . . . . . . . . . . . . . . . . . . . . .

Scheduling services reduces capacity. Scheduling is for the benefit of the patient. Make sure the patient appreciates it by working on the total patient experience.

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Topic

Table of Contents

10. Bottlenecks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

A bottleneck is the part of the system that has limited capac- ity, compared to demand; that cannot easily or economically be expanded; and that limits overall production in an impor- tant way. In multistep processes, effective production plan- ning means getting upstream planning right so the bottleneck stays busy.

Operations

11. Global Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . .

The service line manager identifies with a population of patients served in order to have the global perspective. The service line manager has financial responsibility or else no one will pay any attention to him or her.

12. Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Getting high utilization rates requires continual attention by expediters charged with clearing away encumbrances that arise spontaneously in any organization.

13. Magnet Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Attract nurses by adopting the management practices known to attract nurses like a magnet.

14. Training and Retraining . . . . . . . . . . . . . . . . . . . . . . . . .

Training and retraining are essential to the attainment of high and consistent performance. Everybody needs training. Everybody needs retraining.

15. Autoremediation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Posting tracking charts does wonders for self-improvement. It applies to physicians, technicians, laborers, individuals, and groups. And it’s free!

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16. Make or Buy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Medical transcription service is an example of how to set standards and measure performance for support groups.

17. Effectiveness versus Efficiency . . . . . . . . . . . . . . . . . . . .

The goal is to promote effective use of resources for the benefit of the patient. Efficiency comes as a result of effectiveness and should not be pursued separately.

18. Lean Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

“Lean” operations that reduce cycle time are fine and are integral to Six Sigma. “Lean” operations aimed at inventory and stocking-level control usually make things worse.

Systems

19. Six Sigma Design Principles . . . . . . . . . . . . . . . . . . . . . .

There are design principles for producing trustworthy systems. These are distilled from centuries of experience and can be applied directly to healthcare, manual operations included.

20. Defense in Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Because errors and mistakes cannot be excluded, particu- larly in manual operations, the patient must be protected in depth from any hazard.

21. Communications Systems Design . . . . . . . . . . . . . . . . . .

Robust communications include confirmation that the message got through and was understood.

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22. Tasks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

There are three rules for effective task design: make the task more likely to produce the right result than the wrong one, make it possible to detect error on the spot, and make it pos- sible to correct any error on the spot.

23. Gates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Gates are points in the process that stop action until upstream conditions are validated. Gates block the propa- gation of error.

24. Buffers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Buffers are waiting times built into processes just upstream of irreversible actions to provide time to take stock.

25. Centrality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Six Sigma does not accept go/no-go system design, but rather insists on targeting the center of the target range.

Methods and Tools

26. Visualization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Charts provide management information and self- management information. Charts are a key tool for organi- zational performance.

27. DMAIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Six Sigma process improvement goes through specific stages: define the objective, measure the baseline, analyze the base- line, implement trials, and control the results to be certain that improvements abide. These are commonly stated as DMAIC.

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