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Lean Six Sigma for Hospitals: Simple Steps to Fast, Affordable, and Flawless Healthcare

Book Description


"The main purpose is to present simple steps to help hospitals start getting faster, better, and cheaper in five days or less while achieving the goal of fast, affordable, and flawless healthcare. Healthcare has many opportunities for improvement and the use of Lean Six Sigma concepts can make a dramatic impact. This book provides the basic information to do that."--Doody's Review Service

Lean Six Sigma for Hospitals: Simple Steps to Fast, Affordable, Flawless Healthcare explains how to use tested Lean Six Sigma methods and tools to rapidly improve hospital operations and quality of care and reduce costs. These proven strategies follow the patient from the front door of the hospital or emergency room all the way through discharge, examining key aspects of patient flow and quality. The trail of billing and collections is also followed to discover and eliminate cash flow leaks. This practical guide emphasizes both the clinical and operational sides to reduce the "three demons of quality"--delay, defects, and deviation. Real-world case studies from major hospitals illustrate successful implementations of Lean Six Sigma.

Coverage Includes:

  • Achieving a faster, better hospital in five days--emergency department, door-to-balloon time, operating room, medical imaging, lab, nursing unit, clinical staff, pharmacy, order accuracy, diagnosis, ICU
  • Lean for accelerated patient flow
  • Reducing medical errors with Six Sigma
  • Creating a more profitable hospital in five days by reducing denied, rejected, and appealed claims
  • Six Sigma for hospitals
  • Excel power tools for Lean Six Sigma
  • Identifying improvement projects through data mining and analysis
  • Sustaining improvement using control charts
  • Laser-focused process innovation
  • Statistical tools for Lean Six Sigma
  • Implementing Lean Six Sigma

Table of Contents

  1. Cover Page
  2. Lean Six Sigma for Hospitals
  3. Copyright Page
  4. Contents
  5. Preface
  6. CHAPTER 1 Simple Steps to a Faster Hospital
    1. Goal: Accelerate the Patient’s Experience of Healthcare
    2. A Faster Emergency Department in Five Days
    3. Faster Door-to-Balloon (D2B or DTB) Time in Five Days
    4. A Faster Operating Room in Five Days
    5. Faster Medical Imaging in Five Days
    6. A Faster Lab in Five Days
    7. A Faster Nursing Unit in Five Days
    8. The Problem Isn’t Where You Think It Is
    9. Take the Domino’s Challenge
    10. How to Get a Faster Hospital in Five Days
  7. CHAPTER 2 Lean for Accelerated Patient Flow
    1. Mind the Gap
    2. Value-Stream Mapping
    3. If They Can Do It in Botswana
    4. The Fast Eat the Slow
    5. Core Score
    6. Speed Saves Lives
    7. You Already Understand Lean
    8. The Power Laws of Speed
    9. Economies of Speed
    10. The Toyota Production System
    11. Core Ideas of Lean
    12. The Lean Mindset
    13. The Seven Speed Bumps of Lean
    14. The Five S’s
    15. Value-Stream Mapping
    16. Pull versus Push
    17. Redesign for One-Piece Flow
    18. Lean Tools
    19. Walking Is Waste
    20. Lean Principle—Load Leveling
    21. Lean Principle—Minimize Inventory
    22. Theory of Constraints (TOC)
    23. Get the Idea?
  8. CHAPTER 3 Simple Steps to a Better Hospital
    1. A Better Emergency Department (ED) in Five Days
    2. A Better Clinical Staff in Five Days
    3. A Better Operating Room (OR) in Five Days
    4. A Better Pharmacy
    5. Better Order Accuracy in Five Days
    6. Better Medical Imaging in Five Days
    7. A Better Lab in Five Days
    8. A Better Nursing Unit in Five Days
    9. Better Diagnoses
    10. A Better Intensive-Care Unit (ICU) in Five Days
    11. Misuse of Antibiotics
    12. Bar Codes Bust Medication Errors
    13. The Problem Isn’t Where You Think It Is
    14. I Pledge Allegiance to Science and Evidence
    15. Simple Steps to a Better Hospital in Five Days
  9. CHAPTER 4 Reducing Defects with Six Sigma
    1. Invisible Low-Hanging Fruit
    2. Six Sigma’s Problem-Solving Process
    3. Getting to Lean Six Sigma
    4. Key Tools for Defect Reduction
    5. Problem-Solving Process
    6. The 4-50 Rule
    7. Six Sigma Tar Pits
    8. Become a Lean Six Sigma Detective
    9. Mistakes, Defects, and Errors
    10. Measurement Simplicity
    11. Accidents Don’t Just Happen
    12. Analysis Is Easy . . . If You Know What to Look For
  10. CHAPTER 5 Simple Steps to a Cheaper (More Profitable) Hospital
    1. Faster + Better = Cheaper and More Profitable!
    2. Reducing Denied Claims in Five Days
    3. Reducing Rejected Claims in Five Days
    4. Reducing Appealed Claims in Five Days
    5. How to Get a Cheaper (More Profitable) Hospital in Five Days
    6. Insights
    7. Conclusion
  11. CHAPTER 6 Six Sigma for Hospitals
    1. Double Your Profits
    2. Manufacturing and Service
    3. Tricks of the Trade
    4. The Faster, Better, Cheaper Toolkit
    5. Every Business Has Two Sources of Cash Flow
    6. Every Business Process Has Three Big Leaks
    7. Every Business Has Two Improvement Focuses
    8. The Universal Improvement Method
    9. Lean Six Sigma
  12. CHAPTER 7 Excel Power Tools for Lean Six Sigma
    1. The QI Macros for Excel
    2. The QI Macros Are Easy to Use
    3. QI Macros Introduction
    4. Power Tools for Lean Six Sigma
    5. Analyzing Customer Service Data Hidden in Trouble-Reporting Systems
    6. Setting Up Your Data in Excel
    7. Data Collection and Measurement for Six Sigma
    8. Mistake-Proof Data Collection
    9. Troubleshooting Problems
    10. Technical Support
    11. Chartjunk
    12. Get the Idea?
  13. CHAPTER 8 Is There an Improvement Project in My Data?
    1. Data Mining with Excel and the QI Macros PivotTable Wizard
    2. Word Count
    3. PivotTable Wizard
    4. Get the Idea?
  14. CHAPTER 9 Sustaining Improvement
    1. Process Flowchart
    2. Control Charts for Sustaining the Improvement
    3. Control Plan
  15. CHAPTER 10 Laser-Focused Process Innovation
    1. Focusing the Improvement Effort
    2. Critical-to-Quality Indicators (CTQs)
    3. SIPOC
    4. Balanced Scorecard
    5. Quality Management Systems
  16. CHAPTER 11 Statistical Tools for Lean Six Sigma
    1. Hypothesis Testing
    2. Hypothesis Testing for Variation
    3. Hypothesis Testing for Means
    4. Analysis of Variance
    5. Are Your Data Normal?
    6. Tests of Proportion
    7. Chi-Square Tests in Excel
    8. Determining Sample Sizes
    9. Conclusion
  17. CHAPTER 12 Implementing Lean Six Sigma in Hospitals
    1. Excuses, Excuses, Excuses
    2. Decisive Force
    3. Crisis Junkies
    4. Minor in Major Things
    5. Getting the Right People Involved with Lean Six Sigma
    6. The Improvement Mindset
    7. Talent versus Process
    8. New CEOs Can Kill Lean Six Sigma
    9. Be a Money Belt
    10. Our Reward Systems Are Broken
    11. Barriers to Lean Six Sigma
    12. Here’s My Point
    13. Management by Quality (MBQ)
    14. Why Do Six Sigma Teams Fail?
    15. “Bridezilla” Meets Lean Six Sigma
    16. Here’s My Point
    17. Making Lean Six Sigma Successful
    18. What’s Wrong with Most Lean Six Sigma Training?
    19. Are You a Lean Six Sigma Salmon?
    20. Risk-Free Way to Implement Lean Six Sigma
    21. Can Lean Six Sigma Kill Your Hospital?
    22. Assets and Liabilities
    23. Innovation Rules
    24. Religion of Reuse
    25. Conflicting Goals
    26. Honor Your Progress
    27. The Hard Work Is Soft
    28. Lean Six Sigma Roles
    29. Get a Faster, Better, Cheaper Hospital
    30. Bibliography
  18. Index