Basics of Health Care Performance Improvement: A Lean Six Sigma Approach / Edition 1

by Donald Lighter

Overview

While quality improvement methods and approaches have become well accepted in American Industry, they have been slower to catch on in the largest American industry—and arguably the most important: the health care services. A clear understanding of basic quality improvement methods, applications, and approaches is critical foundation for a successful career in health care administration. Building on the success of his previous text, Quality Management in Health Care: Principles and Methods, Dr. Lighter’s new book, Basics of Performance Improvement; A Lean Six Sigma Approach, is an ideal first course for students learning the basics of Lean Six Sigma, and its application in improving health care quality and patient outcomes. DMAIC Phase Tools: Define, Measure, Analyze, Improve, Control Creating the business case for improving healthcare performance Group Processes in healthcare PI Process tools in QI Medical informatics and data resources Process control Advanced statistical applications Approaches to improvement - standardization Integration of care systems Alignment and integration of performance improvement systems – the Malcolm Baldrige National Quality Award Accreditation and certification programs Lean Six Sigma Case Studies Ideal for both undergraduate and graduate level courses, the book also serves as an excellent reference for basic quality improvement approaches for QI professionals. © 2013 | 342 pages

Product Details

ISBN-13:	9780763772147
Publisher:	Jones & Bartlett Learning
Publication date:	11/29/2011
Edition description:	1
Pages:	342
Product dimensions:	6.00(w) x 8.90(h) x 0.90(d)

About the Author

Dr. Donald E. Lighter currently serves as the Associate Medical Director for Clinical Outcomes Programs for the Shriners Hospitals for Children, where he is responsible for leading the design and implementation of programs to evaluate and improve the care of children in the Shriners system. Shriners' unique hospital system provides free care for children with serious orthopaedic abnormalities and burns. After finishing his medical degree at St. Louis University Medical School, Dr. Lighter completed a pediatric residency and practiced general pediatrics in both private practice and academic settings for over twenty-five years. Dr. Lighter's experience in managed care has spanned nearly twenty years, having led the formation of two IPAs and three HMOs. Over the past ten years, Dr. Lighter has worked both with commercial and Medicaid HMOs, and presently he is Director at The Institute for Healthcare Research and Education and a founder of CyberCE, Inc., an online educational consulting company. Additionally, Dr. Lighter is a professor and a member of the core faculty for The University of Tennessee's Physicians' Executive MBA program, an innovative curriculum that relies heavily on the Internet to provide didactic material for physicians working toward a Masters in Business Administration degree. He also serves as a Senior Examiner in the Malcolm Baldrige National Quality Award Program.

Table of Contents

Preface ix

Chapter 1 Why Is Performance Improvement the "Big New Thing"? 1

Background 5

Improving the Quality of Care 8

Patient Safety-A Specific Quality Goal 10

Reducing Cost 14

Quality Frameworks 15

When will Quality Become "Job 1"? 17

Discussion Questions 18

References 19

Chapter 2 Define Phase Tools 21

Background 21

Project Charter 22

Voice of the Customer 26

CAHPS Surveys and the Voice of the Customer 30

National CAHPS Benchmarking Database 31

Other Methods of Listening to the Voice of the Customer 32

Kano Model 35

Procedure for Kano Model process 37

Tips and tricks 38

Stakeholder Analysis 39

Procedure for stakeholder analysis and diagram 41

Tips and tricks 41

Process Mapping 41

Procedure for creating a process flowchart 42

Tips and tricks 43

SIPOC Process Map 44

Procedure for SIPOC process map 44

Tips and tricks 45

Brainstorming, Brainwriting, and Nominal Group Technique 47

Procedure for brainstorming 47

Variants-brainwriting and nominal group technique (NGT) 48

Multivoting 49

Affinity diagrams 51

Critical-To-Quality (CTQ) Analysis 53

Procedure for creating a CTQ tree 54

Completion of the Define Phase 55

Discussion Questions 56

References 57

Chapter 3 Measure Phase Tools 59

The Essence of the Measure Phase 59

Measure Phase Tools 61

Process Maps 61

Performance Evaluation and Review Technique (PERT) Chart 62

Deployment Flowchart 69

Prioritization Matrix 72

Process Cycle Efficiency (Value Added Ratio) 76

Time Value Analysis (TVA) 79

Pareto Charts 80

Run Charts 83

Control Charts 88

Failure Mode and Effects Criticality Analysis (FMECA) 95

Deliverables in the Measure Phase 100

Data Collection and Analysis Plan 100

Measurement System Analysis 103

Baseline Performance-Calculating Process Sigma 105

Finishing the Measure Phase 107

Further Reading 108

Discussion Questions 108

Chapter 4 Analyze Phase Tools 111

The Essence of the Analyze Phase 111

Elements of the Analyze Phase 112

Root Cause Analysis (RCA) 113

Cause and Effect (C & E) Diagram 117

Statistical Methods of Establishing Relationships 120

Pearson Correlation Coefficient 121

Hypothesis Testing 125

Confidence Interval 131

Analysis of Variance (ANOVA) 133

Regression Analysis 138

Brainstorming in the Analyze Phase 141

Deliverables of the Analyze Phase 141

Discussion Questions 143

References 144

Chapter 5 Improve Phase Tools 145

The Essence of the Improve Phase 145

Elements of the Improve Phase 146

Framework for the Improve Phase 146

Traditional Improvement Tools 148

Change Management 148

Project Plan 150

Failure Mode and Effects Analysis (FMEA) 151

Kaizen 152

6S 158

Prioritization Matrix 163

Deployment Flowchart 163

Pilot Testing 165

Six Sigma Tools 168

Completing the Improve Phase 173

Discussion Questions 173

References 174

Chapter 6 Control Phase Tools 175

The Essence of the Control Phase 175

Elements of the Control Phase 176

Framework for the Control Phase 176

Control Phase Tools 181

Flowcharts 181

Standardization and Institutionalization of Process Changes 183

Training Plans and Programs 191

Monitoring Plans 195

Poka Yoke 196

Audit Plans 199

Control Charts 201

Process Sigma Level 209

Control Phase Deliverables 210

Discussion Questions 210

Other Resources 211

Risk Adjustment 212

References 212

Chapter 7 LSS Case Studies in Health Care 215

Miami Baptist Hospital 216

Pocono Medical Center (PMC), East Stroudsburg, PA 218

Nebraska Medical Center Peggy D. Cowdery Patient Care Center 221

Radia, Inc 224

Providence St. Joseph Medical Center (PSJMC), Burbank, CA 229

North Shore-Long Island Jewish Health System, New York City 234

Discussion Questions 240

References 241

Chapter 8 DMAIC in an Era of Reform 243

Trends in Healthcare Reform 243

New Financial and Quality Realities 250

Financial Models 252

Quality Reporting and Improvement 257

Health Information Technology (HIT) 260

Role of DMAIC as a Quality Improvement Strategy 261

Discussion Questions 262

References 263

Appendix: Quality Measures for Accountable Care Organizations 265

Glossary: DMAIC Terms and Definitions 283

Index 317