Healthcare Value Proposition
CRC Press (Verlag)
978-1-138-49969-0 (ISBN)
The pursuit of improved performance has driven a host of executives and managers in search of techniques for structuring, rehabilitating, redesigning, and reengineering the organizations they serve. Unfortunately, the narrow-mindedness with which programs are implemented and the discontinuity in their application weaken the promise of success. The process of quality improvement can become an undisciplined search for illusions rather than reality.
For many years, healthcare managers have embraced the narrow definition of performance solely in the context of financial success. Forward-thinking executives now realize that the road to financial success begins with success in quality and service. Quality and service are no longer separate issues – they are the same. Neither one by itself will bring about lasting success. The ultimate measure of performance is in an organization’s ability to create value for its customers, and true performance must be measured in the context of the customers’ total experience.
This book is about how to manage performance in the context of value to the customer or patient. It brings together the many pieces of the performance improvement puzzle – quality, technology, costs, productivity, and customer service. The author also covers process improvement tools including Lean and Six Sigma, and how to create a culture of continuous improvement as well as how to improve the patient experience and productivity improvement strategies. The book is filled with examples, illustrations, and tools for improving key aspects of a healthcare organization’s performance.
Dr. Vincent K. Omachonu is a Professor of Industrial Engineering at the University of Miami, and holds a secondary appointment as Professor in the Department of Health Sector & Policy at the University of Miami. He received his Ph.D. in Industrial Engineering from the New York University Polytechnic, New York. He has two masters degrees one in Operations Research from Columbia University, New York, and the other in Industrial Engineering from the University of Miami, Florida. His B.S. degree is also in Industrial Engineering from the University of Miami. Dr. Omachonu was one of the early contributors to the field of health care quality management. His seminal book titled Total Quality and Productivity Management in Health Care Organizations received the Institute of Industrial Engineers Joint Publishers Book-of-the-Year Award in 1993. Dr. Omachonu is a Master Black Belt in Lean Sigma. Dr. Omachonu’s other books include, Principles of Total Quality (co- authored with J. Ross), Healthcare Performance Improvement, 1999. His most recent book is titled Access to Health Care and Patient Safety (co-authored with M. Taveras Ponce [2013]) His book titled Principles of Total Quality was translated into the Spanish language (Principios de Calidad Total) in 2014. Dr. Omachonu has published several papers in technical and professional journals and has given hundreds of seminars and presentations to professional and management groups all over the United States and South/Central America. He has supervised the implementation of the quality management process in several service organizations. He has successfully conducted industrial engineering efficiency and customer flow studies. Dr. Omachonu has served as the evaluator for federal and State funded projects (SAMHSA, OMH, Department of Health, Ryan White, etc.) He has been featured twice on CNN Business. He has served on the Boards of a number of organizations including Interim Healthcare Services, Fort Lauderdale, Coral Gables Hospital, and Palmetto General Hospital, Miami. His clients include Humana, Leon Medical Centers, Miami, CAC Medical Centers, Miami, Peoples Health in New Orleans, Methodist Health System, Tennessee, Holy Cross Hospital, Fort Lauderdale, Baptist Health Systems, Florida, Bascom Palmer Eye Institute, Miami, Miami Children’s Hospital, Miami, Memorial Hospital System, HCA and Tenet Hospitals. Other clients include Florida Power & Light as well as some Fortune 500 companies. He has conducted educational and training sessions for physicians all over the United States in the areas of Physician-Patient Communication, Improving the Patient Experience, and Improving the HCAPH scores. Dr. Omachonu has facilitated several strategic planning initiatives and senior management retreats for major organizations. He has worked with several Black Belts in Lean Six Sigma. He has served as the Evaluator for all Primary Care projects funded by the Health Foundation of South Florida. He is a renowned speaker/trainer in the areas of Management, organizational development, process re-engineering, and methods improvement. He has published research papers in Health Services Research Journal, European Journal of Operational Research, and Journal of Healthcare Management Science. Dr. Omachonu has been the recipient of University of Miami school-wide teaching awards and multiple awards for teaching excellence in the School of Business (MBA Health Care Sector) program. He is one of 100 world-wide recipients of the IBM 2012 Faculty Award for his work in the field of Health Care. He was recently named the recipient of the Alexander Orr Teacher of the Year Award for the College of Engineering (2013).
Contents
About the Author .......................................................................................xi
Introduction.............................................................................................xiii
1 The Healthcare Industry: Challenges and Opportunities............1
Healthcare Cost and Sustainability..............................................................1
The Aging Population in the United States.................................................3
The Growing Trend of Retail Healthcare....................................................4
Telemedicine and Virtual Healthcare..........................................................6
Population Health Management..................................................................7
Price Transparency in Healthcare...............................................................8
Behavioral Healthcare................................................................................10
Data Security..............................................................................................12
Healthcare Technology and Electronic Medical Records System.............13
Data and Insights in Healthcare................................................................16
Preventive Care..........................................................................................17
Empathy and Compassion.........................................................................19
Transition from Volume-Based Healthcare to Value-Based Healthcare........22
Questions for Discussion...........................................................................23
References..................................................................................................23
2 Determinants of Value: Patients’ Perspective.............................27
Privacy, Confidentiality, and Security........................................................30
Timeliness...................................................................................................31
Patient Safety..............................................................................................32
Care for the “Whole Person”......................................................................33
The Hassle Factor in Healthcare...............................................................34
Chief Complaint.........................................................................................35
Empathy, Sensitivity, and Compassion......................................................36
Post-Discharge Follow-Up..........................................................................37
Care Coordination......................................................................................37
Attention to Detail (ATD)..........................................................................39
Availability of Information.........................................................................39
True Cost and Value..................................................................................40
Clinical Outcomes as a Measure of Value.................................................41
Value Proposition: Health Outcomes Divided by Costs...........................42
The Patient Experience Value Manifesto...................................................43
Questions for Discussion...........................................................................46
References..................................................................................................47
3 The Patient Experience...............................................................51
Measuring Patient Experience: HCAHPS Surveys.....................................54
Tactics and Strategies for Improving HCAHPS Scores..............................57
HCAHPS and Health Plans........................................................................66
Questions for Discussion...........................................................................66
References..................................................................................................67
4 Value Is in the Attention to Detail..............................................71
Attentiveness—The Gold Standard............................................................76
The Power of Details.................................................................................79
Culture of Attention to Detail....................................................................80
Today’s Culture of Distraction...................................................................81
Core Value Principles of ATD....................................................................83
Questions for Discussion...........................................................................85
References..................................................................................................85
Additional Reading.....................................................................................85
5 Data and Information.................................................................87
Why Collect Data?......................................................................................88
Data Collection Methods...........................................................................89
Observation................................................................................................90
Focus Groups and Interviews....................................................................91
Conducting Focus Groups: Group Composition and Size....................91
Surveys.......................................................................................................93
Documents and Records............................................................................94
Experiments...............................................................................................94
Stratifying Data..........................................................................................94
Data Variations...........................................................................................95
Types of Data.............................................................................................96
Attribute or Discrete Data......................................................................96
Variable or Continuous Data.................................................................97
Distinguishing Data Types.........................................................................97
Summary....................................................................................................98
Questions for Discussion...........................................................................98
References..................................................................................................99
6 Lean Management System.........................................................101
The Lean Process.....................................................................................104
Lean Tools and Their Applications..........................................................107
Value Stream Mapping.............................................................................107
What Is Value Stream Mapping?..............................................................108
Defining Waste......................................................................................... 110
The Process.............................................................................................. 111
Poka-Yoke................................................................................................. 113
Kaizen....................................................................................................... 115
Kaizen Events........................................................................................... 116
Day 1—Current State Documentation................................................. 117
Day 2—Current State Evaluation......................................................... 117
Day 3—Characterize the Future State; Plan Its Implementation........ 118
Day 4—Implement the Future State.................................................... 118
Day 5—Operationalize the Future State and Debrief........................ 119
The Five S Method................................................................................... 119
Planning for 5S.........................................................................................121
The Steps for Implementing 5S Methodology.........................................122
Benefits of 5S...........................................................................................125
SMED........................................................................................................125
Examples of SMED Healthcare Applications..........................................127
Five Whys.................................................................................................129
Kanban.....................................................................................................130
Steps for the Implementation of a Two-Bin Kanban System.................132
Benefits of Kanban in Hospitals and Clinics..........................................134
Standardized and Standard Work............................................................134
The Process..............................................................................................135
Benefits of Standardized Work................................................................136
Questions for Discussion.........................................................................137
References................................................................................................137
Additional Readings.................................................................................138
7 Six Sigma..................................................................................139
Key Concepts of Six Sigma...................................................................... 142
Examples of Defects................................................................................ 142
Control Charts.......................................................................................... 143
Control Charts for Attribute Data............................................................ 143
Attribute Data Chart Categories...............................................................146
Attribute Charts for Non-Conforming Items...........................................146
Attribute Charts for Non-Conformities....................................................146
P Chart Example...................................................................................... 147
Procedure for Constructing a P Chart..................................................... 147
Results...................................................................................................... 150
An NP Chart Example............................................................................. 150
Results...................................................................................................... 153
Variable Sample Size................................................................................ 153
Results...................................................................................................... 153
A C Chart Example.................................................................................. 154
Results...................................................................................................... 156
A U Chart Example.................................................................................. 156
Results...................................................................................................... 159
Bringing the Process Under Control....................................................... 159
Evidence of an Unstable Process............................................................. 159
The Meaning of a Stable Process............................................................160
Control Charts for Variable Data.............................................................160
Variable Data........................................................................................160
Judging Process Stability.......................................................................... 162
Example of an X - R Chart.................................................................... 162
Procedure for Constructing an R Chart................................................... 162
Results......................................................................................................166
Procedure for Constructing an X Bar Chart............................................ 167
Results...................................................................................................... 167
An X - S Chart........................................................................................ 167
Process Improvement Tools.....................................................................168
Tools for Managing Ideas........................................................................ 170
Brainstorming........................................................................................... 171
The Creativity Phase............................................................................ 173
The Clarification Phase........................................................................ 173
The Assessment Phase......................................................................... 174
Multi-Voting.............................................................................................. 174
Tools for Gathering and Analyzing Data................................................ 175
Flow Charts.............................................................................................. 175
Process for Creating Flow Charts........................................................ 175
Pareto Analysis.........................................................................................177
An Example..........................................................................................177
Cause and Effect Diagrams (Ishikawa or Fishbone Diagrams).............. 178
Process for Creating a Cause and Effect Diagram.............................. 179
Scatter Diagrams............................................................................... 179
An Example......................................................................................180
Coefficient of Correlation (R)...........................................................181
Discussion Questions and Problems.......................................................183
References................................................................................................187
Additional Readings.................................................................................187
8 Creating Value Through Digital Transformation......................189
The Meaning of Digital............................................................................190
Digital Health Applications...................................................................... 191
Impact on Employees.............................................................................. 193
Role of Leadership................................................................................... 194
Important First Steps in Implementing a Digital Strategy...................... 195
Questions for Discussion.........................................................................196
References................................................................................................196
9 Telemedicine: The Quest for Quality and Value.......................199
What Is Telemedicine?.............................................................................199
Structure-Related Measures of Quality....................................................204
Process of Care Measures........................................................................204
The Institute of Medicine (IOM) Model..............................................205
Dimensions of Quality Measurement in Telemedicine.......................206
Effectiveness and Process................................................................ 211
Patient-Centeredness and Structure.................................................212
Patient-Centeredness and Process...................................................213
Timeliness and Structure..................................................................213
Timeliness and Process.................................................................... 214
Efficiency and Structure................................................................... 214
Efficiency and Process..................................................................... 215
Equitability and Structure................................................................ 216
Equitability and Process................................................................... 216
Implications for Outcomes....................................................................... 217
Questions for Discussions....................................................................... 219
References................................................................................................ 219
Index........................................................................................................ 223
Erscheinungsdatum | 16.11.2018 |
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Zusatzinfo | 17 Tables, black and white |
Verlagsort | London |
Sprache | englisch |
Maße | 178 x 254 mm |
Gewicht | 620 g |
Themenwelt | Medizin / Pharmazie ► Gesundheitswesen |
Studium ► 1. Studienabschnitt (Vorklinik) ► Med. Psychologie / Soziologie | |
Wirtschaft ► Betriebswirtschaft / Management ► Logistik / Produktion | |
ISBN-10 | 1-138-49969-2 / 1138499692 |
ISBN-13 | 978-1-138-49969-0 / 9781138499690 |
Zustand | Neuware |
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