Improving Healthcare Quality and Cost with Six Sigma

Description

The Definitive Six Sigma Guide for Healthcare: Methodologies, Tools, and Metrics   Rising costs are making healthcare unaffordable for millions, and 100,000 people die every year due to medical error. Healthcare must change―dramatically. Many leading healthcare institutions are discovering a powerful toolset for addressing both quality and cost: Six Sigma. In this hands-on, start-to-finish guidebook, four leading experts introduce Six Sigma from the unique standpoint of the healthcare professional, showing exactly how to implement it in real-world environments.   Drawing on their unsurpassed experience, the authors offer step-by-step methodologies, tools, and metrics―all thoroughly adapted to the unique realities of healthcare. They demonstrate how to utilize Six Sigma’s Define, Measure, Analyze, Improve, and Control (DMAIC) process to address even the most challenging problems. They also offer realistic guidance on rolling out Six Sigma initiatives that deliver rapid and sustainable value.   The authors show Six Sigma at work in every area of the hospital: clinical, radiology, surgery, ICU, cardiovascular, laboratories, emergency, trauma, administrative services, staffing, billing, cafeteria, even central supply. You'll learn why Six Sigma can produce better results than other quality initiatives, how it brings new rigor and discipline to healthcare delivery, and how it can be used to sustain ongoing improvements for the long term.   Coverage includes ·         Adapting Six Sigma methodology, tools, and measurements for healthcare ·         Designing more successful experiments ·         Rolling out your Six Sigma initiative successfully ·         Case studies from every area of the hospital, from the ICU to billing ·         Six Sigma templates modified fully for the healthcare environment   Comprehensive and user-friendly, this book will be indispensable to everyone concerned with quality or cost: administrators, managers, physicians, and quality specialists alike. Where Six Sigma is already in use or being considered, it will serve as a shared blueprint for the entire team.   Contents Foreword  xx Introduction  xxi Part I:   The Need for Cutting Costs and Improving Quality in Healthcare  1 Chapter 1          Trends in the Healthcare Industry  3 Chapter 2          Excellence (Benchmarks) and Improvement Challenges in the Healthcare System  21 Chapter 3          Applicability of Six Sigma in Healthcare Organizations  31   Part II:   Methodology, Tools, and Measurements  59 Chapter 4          The Healthcare Opportunity  61 Chapter 5          Six Sigma Methodology  77 Chapter 6          Understanding Problems: Define, Measure, and Analyze  89 Chapter 7          Solving Problems: Improve and Control  129   Part III:  Benefiting from Six Sigma  161 Chapter 8          Case Study Introduction and Profiles  163 Chapter 9          Clinical Case Studies  181 Chapter 10        Operational Case Studies  203   Part IV:  Rolling Out and Sustaining Six Sigma  239 Chapter 11        Implementing a Six Sigma Culture  241 Chapter 12        Lean Six Sigma in Healthcare  373 Chapter 13        The Road Ahead  401   Part V:   Appendixes  431 Appendix A      PMBOK Tools and Techniques  433 Appendix B       The Six Sigma Body of Knowledge  437 Appendix D      Total Six Sigma Tools Self-Evaluation Form  445 Appendix D      Additional Resources  451 Appendix E       The Man I Want To Be!  453 Index  455     Cover Contents Foreword Introduction PART I: THE NEED FOR CUTTING COSTS AND IMPROVING QUALITY IN HEALTHCARE 1 TRENDS IN THE HEALTHCARE INDUSTRY The Quality Crisis in Healthcare Demographics: Financial, Political, Social, and Technological The Cost of Healthcare and Six Sigma Healthcare Quality and Error Reduction Conclusion Endnotes 2 EXCELLENCE (BENCHMARKS) AND IMPROVEMENT CHALLENGES IN HEALTHCARE SYSTEM How Do We Define Quality? Cost and Quality Why Is Excellence So Hard? Conclusions Endnotes 3 APPLICABILITY OF SIX SIGMA IN HEALTHCARE ORGANIZATIONS A Brief Explanation of Six Sigma Why Do You Need Six Sigma? Quality Six Sigma Applied to Healthcare Six Sigma at Work in Healthcare Different Views of Healthcare Quality Conclusions Endnotes PART II: METHODOLOGY, TOOLS, AND MEASUREMENTS 4 THE HEALTHCARE OPPORTUNITY Launching the Six Sigma Initiative Defining Six Sigma Vision and Mission Endnotes 5 SIX SIGMA METHODOLOGY Six Sigma Defined Six Sigma Readiness Six Sigma Methodology Six Sigma Measurements Six Sigma and Other Quality Systems Making Six Sigma Work 6 UNDERSTANDING PROBLEMS: DEFINE, MEASURE, AND ANALYZE Define Phase The Measure Phase The Analyze Phase Concluding Understanding Problems Endnotes Sample Healthcare Excellence Project Forms: Understanding the Problem 7 SOLVING PROBLEMS: IMPROVE AND CONTROL Improve Phase Control Phase Endnotes Sample Healthcare Excellence Project Forms: Solving the Problem PART III: BENEFITING FROM SIX SIGMA 8 CASE STUDY INTRODUCTION AND PROFILES Commonwealth Health Corporation, Bowling Green, KY Virtua Health, Marlton, NJ Valley Baptist Health System, Harlingen, TX North Shore-Long Island Jewish (LIJ) Health System, NY Thibodaux Regional Medical Center, Thibodaux, LA NewYork-Presbyterian Hospital, New York, NY Decatur Memorial Hospital, Decatur, IL The Nebraska Medical Center, Omaha, NE 9 CLINICAL CASE STUDIES Cardiac Medication Administration at Virtua Health Reducing Surgical Site Infections at Charleston Area Medical Center Reducing CVC-Related Bloodstream Infections at Florida Hospital Preventing Infections at Decatur Memorial Hospital Reducing the Incidence of Post-Operative Infections in Bowel Cases at Commonwealth Health Corporation Reducing Nosocomial Pressure Ulcers at Thibodaux Regional Medical Center Glucose Control in the Adult ICU at Valley Baptist Health System 10 OPERATIONAL CASE STUDIES Timeliness of Self-Pay Collections on Commercial Accounts at Commonwealth Health Corporation Reducing Ambulance Diversions at Providence Alaska Medical Center Better Patient Charge Capture at Yale-New Haven Hospital Ensuring Accuracy in Managed Care Operating Room Carve-Outs at Virtua Health Addressing Bed Management at The Nebraska Medical Center The Corporate Advance Directive at Valley Baptist Health System Cath Lab Utilization of Implantable Devices at Memorial Hermann Heart & Vascular Institute-Southwest Optimizing Respiratory Care Services at Valley Baptist Health System PART IV: ROLLING OUT AND SUSTAINING SIX SIGMA 11 IMPLEMENTING A SIX SIGMA CULTURE Implementation Process Phase I—Mobilizing Phase II—Planning Phase III—Piloting Phase IV—Implementing the Six Sigma System Conclusion Endnotes 12 LEAN SIX SIGMA IN HEALTHCARE The Lean Process Case Study 1: Combining Lean and Six Sigma to Improve Throughput in the Emergency Department at St. John Health Case Study 2: Expanding CT Capacity at North Shore University Hospital Endnotes 13 THE ROAD AHEAD Does the Healthcare Industry Need Six Sigma? Some Six Sigma Healthcare Results and Lessons Learned Hospital Performance Lessons Learned Six Sigma and the National Quality Awards Why Do Some Six Sigma Systems Fail? Harrington’s Wheel of Fortune Putting It All Together Endnotes PART V: APPENDIXES A: PMBOK TOOLS AND TECHNIQUES B: THE SIX SIGMA BODY OF KNOWLEDGE C: TOTAL SIX SIGMA TOOLS SELF-EVALUATION FORM The 20 Question Six Sigma Status Checklist Student Check list D: Additional Resources E: The Man I Want To Be! Index A B C D E F G H I J K L M N O P Q R S T U V W X–Y–Z