HSMP 3600 Midterm Exam

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?