Improving Healthcare Quality and Cost with Six SIGMA

by Trusko, Brett E.; Pexton, Carolyn; Harrington, Jim; Gupta, Praveen

• ISBN13: 9780131741713
• ISBN10: 0131741713
• Edition: 1st
• Format: Hardcover
• Copyright: 2007-01-01
• Publisher: FT Press

Summary

Rising costs are making healthcare unaffordable for millions of individuals and employers. Meanwhile, 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. But, until now, most discussions of Six Sigma have focused on fields far distant from healthcare. In this book four leading experts introduce Six Sigma from the standpoint of the healthcare professional, showing exactly how to implement it successfully in real-world environments. This hands-on, start-to-finish guidebook covers every facet of Six Sigma in healthcare, demonstrating its use through examples and case studies. 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. 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.

Table of Contents

Foreword	p. xx
Introduction	p. xxi
The Need for Cutting Costs and Improving Quality in Healthcare	p. 1
Trends in the Healthcare Industry	p. 3
Excellence (Benchmarks) and Improvement Challenges in the Healthcare System	p. 21
Applicability of Six Sigma in Healthcare Organizations	p. 31
Methodology, Tools, and Measurements	p. 59
The Healthcare Opportunity	p. 61
Six Sigma Methodology	p. 77
Understanding Problems: Define, Measure, and Analyze	p. 89
Solving Problems: Improve and Control	p. 129
Benefiting from Six Sigma	p. 161
Case Study Introduction and Profiles	p. 163
Clinical Case Studies	p. 181
Operational Case Studies	p. 203
Rolling Out and Sustaining Six Sigma	p. 239
Implementing a Six Sigma Culture	p. 241
Lean Six Sigma in Healthcare	p. 373
The Road Ahead	p. 401
Appendixes	p. 431
PMBOK Tools and Techniques	p. 433
The Six Sigma Body of Knowledge	p. 437
Total Six Sigma Tools Self-Evaluation Form	p. 445
Additional Resources	p. 451
The Man I Want To Be!	p. 453
Index	p. 455
Table of Contents provided by Publisher. All Rights Reserved.

Excerpts

Introduction INTRODUCTION This book is an introduction to quality methods, Six Sigma, and healthcare. No doubt, if you purchase this book you are concerned about the quality issue and the future of healthcare. You have probably tried TQM (Total Quality Management), CQI (Continuous/Clinical Quality Improvement), and a number of other approaches to improving quality in your organization. We too have thought about this long and hard throughout the years as consultants, speakers, and writers in the healthcare field. You might be familiar with Dr. Brett Trusko's work as a futurist who collaborated with the late Russell Coile Jr. Little did he know some 20 years ago that most of our work in healthcare would boil down to quality issues. We have spoken and written about quality, organizational development, motivation, teamwork, information technology, and finance in healthcare with a Pollyanna perspective that with enough caring and hard work we can solve the problems of healthcare. Only recently did we really begin to understand that all these issues were reflective of a dysfunctional system that works against excellence in healthcare. For example, our healthcare system in the U.S. systematically rewards heroics and intervention while penalizing planning, quality, management, and effectiveness. For years we have reimbursed providers based upon costs while efficiency has generally resulted in lower reimbursements. In our capitalist economy, we usually find that the best provider of a good or service is the one that is the most efficient, not the least. But this is precisely how we handle healthcare in the U.S. The more healthcare resources we consume as providers of healthcare, the more reimbursements we receive. How would we feel about paying a mechanic more for replacing parts that our car doesn't even need? How about rewarding grocery stores for finding the most expensive method of shipping groceries to the store? Of course, healthcare providers aren't mechanics, and hospitals aren't grocery stores. Hospitals are hospitals and physicians are physicians. Healthcare is generally an imprecise science. However, using the excuse of an imprecise science as a reason not to improve healthcare is irresponsible. In fact, healthcare is an imprecise science, but at the same time there is much in healthcare that can and should be improved. The authors have worked in healthcare for more than 60 years. We have been unit secretaries, surgical scrub technicians, and administrators. We have seen healthcare finances from the inside out and worked in the clinical setting. Healthcare is not an easy business. Healthcare professionals are some of the most dedicated and caring people on earth. When publications such as the May 1, 2006, edition ofTimemagazine (Gibbs, 2006) and morning news shows likeThe Today Showand others prominently feature stories about how to protect yourself from medical errors in a hospital, we would expect to see more healthcare professionals expressing outrage against the system. Dedicated, caring professionals are and should be outraged at the shallow investigative reporting. But the fact is that healthcare professionals usually don't have a very good defense against attacks, because in most cases, they don't really know what happened. They don't know what happened because they don't understand their processes, and they don't understand their processes because the processes tend to be complicated and fluid. As professionals who have worked in healthcare for so many years, we the authors can personally vouch for the fact that most healthcare providers strive for delivery excellence. These providers have witnessed miracles, such as the snaking of wires from the leg to the brain to clear a clot and save a life. They have seen two-pound premature babies live, and peop