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Quality
the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.
“To Err is Human”
Spotlight on how tens of thousands of Americans die yearly from medical errors.
“Crossing the Quality Chasm”
Recommends redesigning the America Health System. It gave a method on how we could improve the health systems.
What is the acronym for the 6 aims of quality?
STEEEP
What does STEEEP stand for?
Safety
Timliness
Effectiveness
Efficiency
Equity
Patient Centerdness
What does IOM stand for
Insitute of Medicine
What is the definition of Quality?
The degree to which health services forindividuals and populations increase thelikelihood of desired health outcomesand are consistent with currentprofessional knowledge.
Patients tend to emphasize
- management of interpersonal relationships
- amenities/pleasantness of care
- responsiveness to patient preferences
Third-Party payers emphasize
- cost effectiveness
- amenities of care
- responsiveness to patient preferences
How do we assess quality?
Structure, process, outcome
Criteria
specific attributes that are basis for evaluating quality.Something you have to meet or match. The criteria in order toapply for this specific job is x type of degree. What you are lookingat to "judge
Standards
express in a quantitative way, what levelthese criteria must reach to satisfy our pre-existing expectationsabout quality
What is a lean transformation?
A business management system: That focuses on continuous processimprovement, Identifies and eliminates waste or non-value-added steps, To improve the quality of patient care and outcomes, For education and team member growth
Lean Philosophy
Respect for People, Patientsand Society- Continuous Improvement
Rapid Improvement Events
- highly effective ways to implement change
- Engage the people that do the work
The True North Metrics
-Human Development
- Quality
- Timeliness
- Cost
- Growth/Capacity
Lean
-Drives out wastes (non-value added processes and procedures)
-Promotes work standardization and flow
- achieves goals by using less technical tools such as kaizen, workplace organization, and visual controls
Six Sigma
- Statistical Thinking
- Statistical data analysis, design of experiments, and hypothesis testing.
Value Stream Analysis
- High level current state map of the value stream, followed by a future-state map.
- Analyzing the value stream is the crucial first step to determine where you are going on the Lean Journey.
Value Adding
Any activity that directly contributes to satisfying the needs of a customer
Non-value added
Anything that consumes time or resources but does not add value
What are Rapid Improvement Events
Small teams devoting their time over 3-5 days to analyze and improve a defined target issue or process
Pick Charts
- Plan to do
- Implement
- Choose to do
- Kick Out
The Eight Wastes
TIMPWOOD
What does TIMPWOOD stand for
Transport
Inventory
Motion
People
Waiting
Over production
Over processing
Defects
Transportation
any unnecessary material, patient or staff movement.
Inventory
any unnecessary supplies or materials that does not support just in time delivery
Motion
any movement of people which does not add value to the product
Unused Human Potentional
Work related personnel injuries, lack of training that inhibits flow of services
Waiting
Idle time in which no value added activities take place
Over processing
Effort which adds no value to a product or service
Over production
Producing more than is needed
Defects
Repair a product or service to fufill customer requirements
Process Mapping
- Safety
- Waste Identification
- Decision Point
- Delays
- Handoffs
- Process Step
How to create a process map
- Map patient, team member, end user, and their requirements and steps as they are happening in the work environment
- Map main processes
- Detail waiting times and waste in each step
Daily Improvement Huddle
used to increase communication between leadership and frontline team members at the beginning of each workday.
Standard Work
The best known way, agreed upon, and practiced by all today.
What is A3 thinking?
A toyota invented problem-solving method. Executed on a single sheet of A3 sized paper
A3 Thinking does what?
forces consensus building, unifies culture around a simple systematic methodology.
Box 1
Reason for action, chief complaint or problem statement, identify improvement themes linked to people, quality, timleliness and financial
Box 2
The initial state, what is happening now, express the situation graphically
Box 3
The target state, agree targets to add initial state graphs, record required target, not what we think we can achieve.
Box 4
Gap analysis, identify all possible causes for the situation, cause and effect diagrams
Box 5
Box 6
Rapid Experiments, what can we do to test the hypothesis, what happened when we tried the stuff.
Box 7
Completion plan, list activities by project, events, do its, and stop its.
Box 8
Confirmed state, relates all the way back to the target condition. Does Box 8= Box 3
Box 9
Insights, lession learned, breakthroughs, and reflections.
Dashboard
drilling down to the details, for frontline, tell systems what's happening now using interactive metrics with drill down capabilities.
Scorecards
the big picture, for leaders, overlays strategies over the data, tells health systems how their doing overall
KPI's (key preformance indicators)
Mesure progress towards key goal, have high level perspective, they are relevant across different departments, used for strategic decision making.
Metrics
measures the performance of specific business activities or processes, a lower level perspective, tends to be operational or tactical.
Box 4 - Gap Analysis
Identify all possible causes for the situation, cause and effect diagrams.
Box 5 - Solution Approach
Used to present solution hypothesis. Used to move past symptoms and understand the root cause of a problem
Fishbone diagram
Cause and Effect Diagram, A visual way to identify the causes of issues or a problem
KanBan
inventory system, focuses on timely replenishment, typically visual signs or card, increases organization's efficiency, cost-effective system.
Poka-yoke
a Japanese term that means "mistake-proofing". Is any mechanism in a process that helps one avoid mistakes/defects by preventing, correcting, or drawing attention to human errors as they occur.
6s
Sort
Straighten
Scrub
Safety
Standardize
Sustain
What is the acronym for the 6 aims of quality?
