Verena Lindenau-Stockfisch wurde 1976 in Meißen geboren und wuchs in den heutigen neuen Bundesländern auf. Seit ihrem Abschluss zur Internationalen Managementassistentin im Frühjahr 2003 arbeitet Frau Lindenau-Stockfisch bei einem Exportunternehmen für Medizintechnik, welches auf die Komplettausstattung von Krankenhäusern, hauptsächlich im Mittleren Osten, spezialisiert ist. Um ihre fachlichen Qualifikationen im Bereich der Betriebswirtschaft weiter auszubauen, entschied sie sich für ein berufsbegleitendes Vollzeitstudium, welches sie 2009 erfolgreich abschloss. Ihre sprachlichen Kenntnisse optimierte sie bei verschiedenen Auslandsaufenthalten, u. a. in Großbritannien und Südafrika, und durch das hauptsächlich englischsprachige BA-Studium. Bereits während ihrer Arbeit als Projektleiterin sammelte die Autorin umfangreiche praktische Erfahrungen hinsichtlich der Strukturierung, Ausarbeitung und Budgetierung internationaler Krankenhausprojekte. In Zusammenarbeit mit Medizinplanern, Architekten und Ingenieuren steuert sie das Projektteam bei der Ausarbeitung der Ausschreibungsunterlagen, um die optimale Strukturierung der Prozessabläufe im Krankenhaus von Anfang an zu gewährleisten. Während eines Aufenthalts beim Deutsch-Arabischen Wirtschaftsforum 2006 kam sie erstmals mit dem Begriff Lean Healthcare in Kontakt und verfolgt seither mit regem Interesse das Thema Lean Management in Krankenhäusern. In einem weiterführenden Masterstudium der Gesundheitsökonomie mit Schwerpunkt Patientenversorgung wird sich Frau Lindenau-Stockfisch weiter intensiv einer Teilthematik ihres Buches widmen. Verena Lindenau-Stockfisch was born in 1976 in Meißen (Saxony) and grew up in the today’s known New Laender in Germany. Since her graduation as an International Management Assistant in 2003, she has been working in an export company, specialised on turn-key hospital projects mainly in the Middle East. In 2009, she graduated from her extra-occupational but full-time BA studies that were important to improve her professional skills in the fields of Business Administration. Various stays abroad, among others in Great Britain and South Africa, as well as the BA studies mainly held in English, contributed to her language skills and enabled her to work on an academic level. Already during her work as a Project Manager, she gained comprehensive experience with regard to structuring, elaboration and budgeting of international hospital projects. Above all, her position demands the ability of leading a project team and cooperation with engineers, medical planners and architects and to ensure optimal process structuring in a hospital from the very beginning. At a German-Arabic Health & Economy Congress in 2006, she became first acquainted with the definition Lean Healthcare. Since that day, she has been fascinated and intensively studied the topic Lean Management in Hospitals.

Lean Management in Hospitals Principles and Key Factors for Successful Implementation 1
Table of Content 3
List of Abbreviations 5
1. Introduction 7
2. Process Optimisation – Principles & Tools
2.1 Lean Methodology 9
2.1.1 Cycle Muda 9
2.1.2 Kanban 11
2.1.3 Kaizen 12
2.1.4 Value Stream Mapping 14
2.2 Lean Sigma 15
2.2.1 Poka Yoke – Error Proofing in Hospitals 16
2.2.2 Defining Six Sigma 16
2.2.3 DMAIC Methodology 18
2.2.4 Performance Measurements 22
2.3 Telemedicine & E-Health
2.3.1 Defining Telemedicine & E-Health
2.3.2 Types of Telemedicine 24
2.3.3 Benefits and Limitations of Telemedicine 26
3. Patient-Oriented Management 29
3.1 Patient Satisfaction & Loyalty
3.1.1 Patient Satisfaction – Distinctive Features and Drivers 29
3.1.2 Patient Loyalty – How Patients Differ from Common Customers 30
3.1.3 Shouldice Hospital – One Pioneer Example of Patient Orientation 32
3.1.4 Improvement of Patient Satisfaction 33
3.2 Strategic Alliances in the Healthcare Environment 36
3.2.1 Relevance of Strategic Alliances for Hospitals 36
3.2.2 Advantages, Risks and Challenges 37
3.2.3 Types of Strategic Alliances in the Healthcare Environment 38
3.3 Hospital Marketing 39
3.3.1 The Market 39
3.3.2 Marketing Plan 41
3.3.3 Marketing Mix 42
3.3.4 Control & Evaluation Plans
4. Engaging & Leading Employees
4.1 Employee Satisfaction & Motivation
4.1.1 Role of Employee Satisfaction & Motivation
4.1.2 Requirements for Managers 49
4.1.3 Motivation Methods 49
4.1.4 Conflict Resolution 52
4.2 Employee Attitude Surveys 53
4.2.1 Setting the Right Target 53
4.2.2 Designing the Questionnaire 54
4.2.3 Communicating Objectives 56
4.3 Auditing 58
4.3.1 Hospital Environment 58
4.3.2 The 6-Level-Model 59
5. Conclusion 63
6. Appendices 65
7. Bibliography 67

Textprobe: Kapitel 3.3 Hospital Marketing: Marketing has become a central issue for the existence of hospitals and healthcare organisations. In general, marketing includes all activities of distribution of a product or service. In a healthcare environment, marketing first of all means a philosophy or concept to focus the hospital's attention on its customers - mainly the patients - by using all resources, skills, products and thinking to understand and meet customer needs. With professional and correctly implemented marketing, interior and exterior hospital activities are streamlined and contribute to lean management. In fact, understanding the marketplace and designing a professional marketing plan will help to avoid inefficient and ineffective activities. Instead, valued resources (e. g. time, money) are identified and can be used in a more reasonable way. The Market: The healthcare sector is subject to a variety of difficulties and restrictions and can therefore not be regarded a common service industry. This is true, just because of the following reasons: first of all, the healthcare market itself does not offer homogenous goods due to local, personal, temporal or objective preferences of the patients. Second, 'hospitals and health systems are affected by political upheaval; changes in government regulations; declines in reimbursement; the growth of alternative medicine; the rise of consumerism; an increase in competition from physician-owned specialty hospitals, retail clinics, and other business models; and a host of other complications'. In an international context, these factors must also be well-considered regarding socio-economic, cultural and legal conditions of the respective nation. In the following, the framework of the Federal Republic of Germany will provide an example. In the 21st century, two trends can be seen in the German healthcare market. On the one hand, there is a fast-growing development of a private market for healthcare services. On the other hand, progressive liberalisation of the public healthcare sector can be noticed. Both sectors have to cope with difficult market conditions. In recent years, the German government has enacted various healthcare regulations and reforms with the main aim to increase transparency and to identify inefficient sectors. For hospitals, this results in important consequences regarding their market orientation. According to Mayer, these consequences are mainly: cutbacks in public capital spending, decrease of overcapacities, deregulation of primary costs' coverage, intensive interconnection of ambulant and stationary treatment, enlarged reporting obligation and the introduction of a total quality system with publishing duties. Furthermore, especially the public healthcare sector is restricted due to institutional interdependencies that originate from the German healthcare system itself. In general, patients are admitted to hospitals by physicians (either family doctor or specialist). The German association of health insurance companies controls and coordinates the compensation package and bills the provided performance to physicians, ambulant providers, clinics and hospitals. These procedures result in two disadvantages: first of all, hospitals have to cope with inflexible billing procedures and, furthermore, patients lack transparency of the cost-performance ratio. The Euro Healthcare Index 2007, carried out by the Health Consumer Powerhouse, underlines that lack of transparency regarding patient rights and information (please see appendix 2, page 61). The index represents survey results from the patients' view carried out in several European countries. It consists of five sub-disciplines: patient rights and information, waiting times, outcomes, generosity of public healthcare systems and pharmaceuticals. According to the ranking, Germany has a clear need for improvement in the sub-discipline of patient rights and information because out of nine indicators 4 have been evaluated poor, 4 intermediary and only 1 good. For hospitals this means a real opportunity for quality improvement by adjusting their marketing activities to customer needs. When creating the marketing plan the above-mentioned circumstances have to be taken into consideration.