Basics of Health Care Performance Improvement A Lean Six Sigma Approach

by Lighter, Donald

• ISBN13: 9780763772147
• ISBN10: 0763772143
• Edition: Revised
• Format: Paperback
• Copyright: 2011-11-29
• Publisher: Jones & Bartlett Learning

Summary

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 Six Sigma Approach, is an ideal first course for students learning the basics of the Six Sigma, and its application in improving health care quality and patient outcomes. Ideal for both undergraduate and graduate level courses, the book also serves as an excellent reference for basic quality improvement approaches for QI professionals. Topic areas include:? 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

Table of Contents

Preface	p. ix
Why Is Performance Improvement the "Big New Thing"?	p. 1
Background	p. 5
Improving the Quality of Care	p. 8
Patient Safety-A Specific Quality Goal	p. 10
Reducing Cost	p. 14
Quality Frameworks	p. 15
When will Quality Become "Job 1"?	p. 17
Discussion Questions	p. 18
References	p. 19
Define Phase Tools	p. 21
Background	p. 21
Project Charter	p. 22
Voice of the Customer	p. 26
CAHPS Surveys and the Voice of the Customer	p. 30
National CAHPS Benchmarking Database	p. 31
Other Methods of Listening to the Voice of the Customer	p. 32
Kano Model	p. 35
Procedure for Kano Model process	p. 37
Tips and tricks	p. 38
Stakeholder Analysis	p. 39
Procedure for stakeholder analysis and diagram	p. 41
Tips and tricks	p. 41
Process Mapping	p. 41
Procedure for creating a process flowchart	p. 42
Tips and tricks	p. 43
SIPOC Process Map	p. 44
Procedure for SIPOC process map	p. 44
Tips and tricks	p. 45
Brainstorming, Brainwriting, and Nominal Group Technique	p. 47
Procedure for brainstorming	p. 47
Variants-brainwriting and nominal group technique (NGT)	p. 48
Multivoting	p. 49
Affinity diagrams	p. 51
Critical-To-Quality (CTQ) Analysis	p. 53
Procedure for creating a CTQ tree	p. 54
Completion of the Define Phase	p. 55
Discussion Questions	p. 56
References	p. 57
Measure Phase Tools	p. 59
The Essence of the Measure Phase	p. 59
Measure Phase Tools	p. 61
Process Maps	p. 61
Performance Evaluation and Review Technique (PERT) Chart	p. 62
Deployment Flowchart	p. 69
Prioritization Matrix	p. 72
Process Cycle Efficiency (Value Added Ratio)	p. 76
Time Value Analysis (TVA)	p. 79
Pareto Charts	p. 80
Run Charts	p. 83
Control Charts	p. 88
Failure Mode and Effects Criticality Analysis (FMECA)	p. 95
Deliverables in the Measure Phase	p. 100
Data Collection and Analysis Plan	p. 100
Measurement System Analysis	p. 103
Baseline Performance-Calculating Process Sigma	p. 105
Finishing the Measure Phase	p. 107
Further Reading	p. 108
Discussion Questions	p. 108
Analyze Phase Tools	p. 111
The Essence of the Analyze Phase	p. 111
Elements of the Analyze Phase	p. 112
Root Cause Analysis (RCA)	p. 113
Cause and Effect (C & E) Diagram	p. 117
Statistical Methods of Establishing Relationships	p. 120
Pearson Correlation Coefficient	p. 121
Hypothesis Testing	p. 125
Confidence Interval	p. 131
Analysis of Variance (ANOVA)	p. 133
Regression Analysis	p. 138
Brainstorming in the Analyze Phase	p. 141
Deliverables of the Analyze Phase	p. 141
Discussion Questions	p. 143
References	p. 144
Improve Phase Tools	p. 145
The Essence of the Improve Phase	p. 145
Elements of the Improve Phase	p. 146
Framework for the Improve Phase	p. 146
Traditional Improvement Tools	p. 148
Change Management	p. 148
Project Plan	p. 150
Failure Mode and Effects Analysis (FMEA)	p. 151
Kaizen	p. 152
6S	p. 158
Prioritization Matrix	p. 163
Deployment Flowchart	p. 163
Pilot Testing	p. 165
Six Sigma Tools	p. 168
Completing the Improve Phase	p. 173
Discussion Questions	p. 173
References	p. 174
Control Phase Tools	p. 175
The Essence of the Control Phase	p. 175
Elements of the Control Phase	p. 176
Framework for the Control Phase	p. 176
Control Phase Tools	p. 181
Flowcharts	p. 181
Standardization and Institutionalization of Process Changes	p. 183
Training Plans and Programs	p. 191
Monitoring Plans	p. 195
Poka Yoke	p. 196
Audit Plans	p. 199
Control Charts	p. 201
Process Sigma Level	p. 209
Control Phase Deliverables	p. 210
Discussion Questions	p. 210
Other Resources	p. 211
Risk Adjustment	p. 212
References	p. 212
LSS Case Studies in Health Care	p. 215
Miami Baptist Hospital	p. 216
Pocono Medical Center (PMC), East Stroudsburg, PA	p. 218
Nebraska Medical Center Peggy D. Cowdery Patient Care Center	p. 221
Radia, Inc	p. 224
Providence St. Joseph Medical Center (PSJMC), Burbank, CA	p. 229
North Shore-Long Island Jewish Health System, New York City	p. 234
Discussion Questions	p. 240
References	p. 241
DMAIC in an Era of Reform	p. 243
Trends in Healthcare Reform	p. 243
New Financial and Quality Realities	p. 250
Financial Models	p. 252
Quality Reporting and Improvement	p. 257
Health Information Technology (HIT)	p. 260
Role of DMAIC as a Quality Improvement Strategy	p. 261
Discussion Questions	p. 262
References	p. 263
Appendix: Quality Measures for Accountable Care Organizations	p. 265
Glossary: DMAIC Terms and Definitions	p. 283
Index	p. 317
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