Streamlining Health Care Operations How Lean Logistics Can Transform Health Care Organizations

by Lewis, Audie G.

• ISBN13: 9780787955038
• ISBN10: 0787955035
• Edition: 1st
• Format: Hardcover
• Copyright: 2001-05-29
• Publisher: Jossey-Bass

Summary

Using the success of other industries as a model, this book promotes methodologies, indicators, and ideas that health care organizations can use to streamline their practices and maintain strong profit margins. Based on the core principles embodied in lean logistics-the systematic process of removing waste and inefficiency throughout the purchasing, supply, distribution, and business operations chain-Streamlining Health Care Operations shows health care leaders how to fundamentally restructure their organizations and effectively balance costs, quality, and patient access to excellent care.

Author Biography

AUDIE G. LEWIS is president and chief executive officer of Audie Lewis Consulting, Inc., a national research and consulting firm specializing in cost cutting, business improvement, supply chain analysis, and Internet projection and growth for the health care industry. He is the author of the best-seller The Year 2000 Health Care Survival Guide

Table of Contents

Preface	xi
Acknowledgments	xiii
About the Author	xv
Introduction	1	(8)
Resistance to Change	3	(1)
Accountability Needed	4	(2)
Why Benchmarks Don't Always Work	6	(1)
What Is Needed for Growth	7	(1)
Summary	8	(1)
The Value of the Employee	9	(14)
The Cost of Employee Layoffs	9	(3)
Morale and Motivation	12	(2)
Internal Versus External Motivation	14	(2)
Emphasis on Creativity	16	(1)
Lessons from Vietnam	17	(1)
Communication and Change	18	(2)
Summary	20	(1)
Questions to Ponder	21	(2)
Access: An Elusive Paradox	23	(14)
Defining the Customer	23	(2)
Mixed Customer Groups	25	(1)
Patient Scheduling	26	(1)
Lessons from a Cab Driver	27	(2)
Technology as an Access Point	29	(1)
Innovative Approaches to Access	30	(4)
Summary	34	(2)
Questions to Ponder	36	(1)
Quality: A Systematic Approach	37	(16)
Quality and Cost: An Alliance for Long-Term Success	38	(1)
Quantitative Analysis: Testing for Quality in Health Care	39	(3)
Education and Training: The ``Enabling'' Arm of Quality	42	(4)
Process and Procedure: The Key to Cutting Cost	46	(2)
Lessons from GE: An Example of Strategic Quality	48	(1)
Summary	49	(1)
Questions to Ponder	50	(3)
Creativity: An Environment for Exponential Growth	53	(14)
Canvas Innovative Ideas Through Interviews	54	(1)
Train Project Teams in Research Methods	55	(2)
Solicit Ideas Electronically and Traditionally	57	(2)
Reward Excellence in Creative Low-Cost Solutions	59	(1)
Use Education and Training Resources to Expand Horizons	59	(1)
Consider Innovative Practices for Research and Development	60	(1)
Encourage Bottom-Up Solutions Through Executive Interaction	61	(1)
Summary	62	(2)
Questions to Ponder	64	(3)
Human Resources: The Critical Component	67	(16)
Create the Best	67	(3)
Hire the Best	70	(2)
Keep the Best	72	(1)
Pay the Best	73	(1)
Educate, Train, and Redeploy	74	(1)
Create a Customer-Driven Culture	75	(4)
Lessons from Southwest Airlines	79	(1)
Summary	80	(1)
Questions to Ponder	81	(2)
Purchasing: A Dynamic Model	83	(28)
The Health Care Purchasing Dilemma	84	(2)
Implement for Comparative Analysis	86	(2)
Elevate Purchases to a New Plane	88	(2)
Lessons from Wal-Mart	90	(2)
Use Zero-Base Purchasing	92	(1)
Eliminate Biased Attractions	93	(2)
Educate Buyers for Long-Term Success	95	(2)
Retain Control in the Buying Decision	97	(1)
Understand Total Purchase Cost	97	(1)
Link Directly to Manufacturers	98	(2)
Consider New and Emerging Distribution Models	100	(3)
Track Transportation-Related Cost	103	(2)
Eliminate Returns, Damaged Goods, and Liability	105	(1)
Install Proactive Payment Procedures	106	(1)
Summary	107	(1)
Questions to Ponder	108	(3)
Strategic Technology Assessment: Not Just an Acquisition	111	(16)
A Critical Step in Cost Avoidance	111	(2)
Create an Objective Economic Evaluation Model	113	(2)
Make Market-Driven Purchases	115	(2)
Standardize Acquisition Practices	117	(2)
Do a Total Life-Cycle Analysis	119	(3)
Use Review Committees Effectively	122	(2)
Summary	124	(1)
Questions to Ponder	125	(2)
Utilization Management Within Technology Assessment	127	(16)
Minimizing the Impact of Past and Future Mistakes	128	(4)
Process Reengineering as a Purchase-Avoidance Tool	132	(2)
Hidden Capital-Purchase Dollars	134	(2)
Assessing the Value of Options	136	(2)
Asset Management Redefined	138	(1)
Summary	139	(1)
Questions to Ponder	140	(3)
Equipment Service: Balancing Quality and Control	143	(24)
Create a Macro Approach	144	(2)
Eliminate Little Pockets of Great Loss	146	(1)
Drive Out Cost with Project Teams	147	(2)
Outsourcing Versus Insourcing	149	(3)
Train for Savings	152	(1)
Purchase Repair Parts Effectively	153	(3)
Prevent Losing Money in Backup Systems	156	(3)
Implement Strategic and Procedural Changes for Cost Avoidance	159	(2)
Maintain Fleets Appropriately	161	(1)
Summary	162	(3)
Questions to Ponder	165	(2)
Major Projects: Cost-Effective Expansion and Growth	167	(20)
Manage the Scope of the Project	167	(3)
Use Budget Control Mechanisms	170	(4)
Index Costs to Other Industries	174	(1)
Consider ``Highest and Best'' Use	175	(2)
Allow for Growth: Don't Build for Growth	177	(1)
Compare Off-Site and On-Site Cost	177	(1)
Examples of Construction Cost Variables	178	(3)
Equipment Planning Issues	181	(3)
Summary	184	(1)
Questions to Ponder	185	(2)
Reimbursement and the Business Office: Functions for Success	187	(16)
Time for a Paradigm Shift	188	(4)
Cash Value Versus Procedure Value	192	(1)
Test Outcomes Against ``Raw'' Net Income	193	(1)
Align Functions for Strategic Growth	194	(1)
Lead the Way in Reimbursement Training	195	(2)
Excel at Preregistration	197	(1)
Create an Audit Trail for Success	198	(1)
Summary	199	(1)
Questions to Ponder	200	(3)
Consultants: Less Is More	203	(12)
Exhaust Internal Resources First	204	(2)
Outsource if Benefits Are Clearly Evident	206	(1)
Know Who and What You Are Getting	207	(1)
Manage the Process to Ensure Expected Results	208	(1)
Avoid Long-Term Encumbrances	209	(1)
Consider Train-the-Trainer Services	210	(1)
Niche Consulting	211	(1)
Summary	212	(2)
Questions to Ponder	214	(1)
Special Concerns: Drive Out Waste	215	(22)
Utility and Phone Service Cost	215	(4)
Housekeeping	219	(1)
Security	220	(1)
Physical Plant Equipment	221	(1)
Environmental, Waste, and Recyclables Management	222	(1)
Linen Distribution	223	(1)
Office Supplies	224	(2)
Vending Services	226	(1)
Mail and Courier Cost	226	(1)
Physician and Other Professional Education	227	(1)
Medical Records	228	(2)
Contracts	230	(1)
Bureaucratic Waste	231	(1)
Summary	232	(2)
Questions to Ponder	234	(3)
Recommended Readings	237	(2)
Index	239