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Lean health care

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https://www.readbyqxmd.com/read/28538054/achieving-high-reliability-with-people-processes-and-technology
#1
Candice L Saunders, John A Brennan
High reliability as a corporate value in healthcare can be achieved by meeting the "Quadruple Aim" of improving population health, reducing per capita costs, enhancing the patient experience, and improving provider wellness. This drive starts with the board of trustees, CEO, and other senior leaders who ingrain high reliability throughout the organization. At WellStar Health System, the board developed an ambitious goal to become a top-decile health system in safety and quality metrics. To achieve this goal, WellStar has embarked on a journey toward high reliability and has committed to Lean management practices consistent with the Institute for Healthcare Improvement's definition of a high-reliability organization (HRO): one that is committed to the prevention of failure, early identification and mitigation of failure, and redesign of processes based on identifiable failures...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28528621/using-lean-to-rapidly-and-sustainably-transform-a-behavioral-health-crisis-program-impact-on-throughput-and-safety
#2
Margaret E Balfour, Kathleen Tanner, Paul J Jurica, Dawn Llewellyn, Robert G Williamson, Chris A Carson
BACKGROUND: Lean has been increasingly applied in health care to reduce waste and improve quality, particularly in fast-paced and high-acuity clinical settings such as emergency departments. In addition, Lean's focus on engagement of frontline staff in problem solving can be a catalyst for organizational change. In this study, ConnectionsAZ demonstrates how they applied Lean principles to rapidly and sustainably transform clinical operations in a behavioral health crisis facility. METHODS: A multidisciplinary team of management and frontline staff defined values-based outcome measures, mapped the current and ideal processes, and developed new processes to achieve the ideal...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28527508/social-media-and-web-presence-for-patients-and-professionals-evolving-trends-and-implications-for-practice
#3
REVIEW
Jose E Barreto, Curtis L Whitehair
The use of social media has become very instinctive to many. It has become part of a daily routine. Enhanced communication, liberated expressions of self, becoming updated with all the trends and news, and marketing promotion are only some of the reasons why most people use social media. Health care providers including physicians should take advantage of these platforms for professional purposes. Social media extends far beyond the famous platforms such as Facebook, Twitter, Pinterest, and Instagram, used mostly for social connections...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28494624/an-overview-of-the-performance-improvement-initiatives-by-the-ministry-of-health-in-the-kingdom-of-saudi-arabia
#4
Mazen Hassanain
Saudi Arabia's Ministry of Health (MOH) use corporate performance improvement methodologies to develop and implement performance improvement initiatives designed to continue building on the Ministry's vision of transforming hospital operations and instituting a culture of quality and performance focused on the "patient first" principle. We evaluated the feasibility of setting up a performance improvement unit (PIU) within the MOH to apply the principles of Lean Six Sigma and to change management methodologies...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28439134/pharmacy-dashboard-an-innovative-process-for-pharmacy-workload-and-productivity
#5
Ashley Kinney, Quyen Bui, Jane Hodding, Jennifer Le
Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28410337/adaptation-of-lean-six-sigma-methodologies-for-the-evaluation-of-veterans-choice-program-at-3-urban-veterans-affairs-medical-centers
#6
Sherry L Ball, Lauren D Stevenson, Amy C Ladebue, Marina S McCreight, Emily C Lawrence, Taryn Oestreich, Anne C Lambert-Kerzner
OBJECTIVE: The Veterans Healthcare Administration (VHA) is adapting to meet the changing needs of our Veterans. VHA leaders are promoting quality improvement strategies including Lean Six Sigma (LSS). This study used LSS tools to evaluate the Veterans Choice Program (VCP), a program that aims to improve access to health care services for eligible Veterans by expanding health care options to non-VHA providers. RESEARCH DESIGN: LSS was utilized to assess the current process and efficiency patterns of the VCP at 3 VHA Medical Centers...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28388381/protein-requirements-of-the-critically-ill-pediatric-patient
#7
Jorge A Coss-Bu, Jill Hamilton-Reeves, Jayshil J Patel, Claudia R Morris, Ryan T Hurt
This article includes a review of protein needs in children during health and illness, as well as a detailed discussion of protein metabolism, including nitrogen balance during critical illness, and assessment and prescription/delivery of protein to critically ill children. The determination of protein requirements in children has been difficult and challenging. The protein needs in healthy children should be based on the amount needed to ensure adequate growth during infancy and childhood. Compared with adults, children require a continuous supply of nutrients to maintain growth...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28387658/do-turkish-patients-with-lumbar-disc-herniation-know-body-mechanics
#8
Sacide Yildizeli Topcu
BACKGROUND AND OBJECTIVE: Most common and important cause of the low back pain is lumbar disc herniation. Patients with lumbar disc herniation face with difficulties during daily activities due to the reduction of physical functions. In order to maintain daily activities without pain and discomfort, the patients should be informed about proper positions and body mechanics. The aim of the study was to determine the knowledge and the applications of the patients with lumbar disc herniation about body mechanics...
March 31, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28358788/an-application-of-business-process-management-to-health-care-facilities
#9
Mohsen M D Hassan
The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella...
April 2017: Health Care Manager
https://www.readbyqxmd.com/read/28350314/integrating-quality-improvement-and-continuing-professional-development-at-an-academic-medical-center-a-partnership-between-practice-plan-hospital-and-medical-school
#10
Barbara Gold, Dawn England, William Riley, Ginny Jacobs-Halsey, Corinne Webb, Bobbi Daniels
INTRODUCTION: While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts...
October 2016: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#11
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28329433/understanding-maternal-postpartum-needs-a-descriptive-survey-of-current-maternal-health-services
#12
Mona Ma Almalik
OBJECTIVE: To assess mothers' learning needs and concerns after giving birth and to examine whether these needs were met at 6-8 weeks postpartum. BACKGROUND: Women experience many physiologic and psychological changes during postpartum period which is considered a vital transitional time. Exploring and meeting women's needs help woman to pass this period with little complications and enhance health care provider's ability to provide appropriate care following childbirth...
March 22, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28319589/exercise-improves-v-combining-dot-above-o-2max-and-body-composition-in-adt-treated-prostate-cancer-patients
#13
Bradley A Wall, Daniel A Galvão, Naeem Fatehee, Dennis R Taaffe, Nigel Spry, David Joseph, Jeffrey J Hebert, Robert U Newton
INTRODUCTION: Prostate cancer is the most common cancer in men and patients treated with androgen deprivation therapy (ADT) experience unfavourbale changes in body composition and associated metabolic complications, which can increase the risk of cardiovascular disease. We examined the effect of a 6-month program of aerobic and resistance exercise aimed at improving body composition and cardiorespiratory health in this population. METHODS: Ninety-seven men (43-90 years) with localized prostate cancer receiving ADT were randomized to either exercise (EX, n=50) or usual care (CON, n=47)...
March 18, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28277381/working-toward-quality-in-obstetric-anesthesia-a-business-approach
#14
Grant C Lynde
PURPOSE OF REVIEW: Physicians are increasingly required to demonstrate that they provide quality care. How does one define quality? A significant body of literature in industries outside of health care provides guidance on how to define appropriate metrics, create teams to troubleshoot problem areas, and sustain those improvements. RECENT FINDINGS: The modern quality movement in the United States began in response to revolutionary gains in both quality and productivity in Japanese manufacturing in the 1980's...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28256930/the-effects-of-a-lean-transition-on-process-times-patients-and-employees
#15
Pascale Simons, Huub Backes, Jochen Bergs, Davy Emans, Madelon Johannesma, Maria Jacobs, Wim Marneffe, Dominique Vandijck
Purpose Treatment delays must be avoided, especially in oncology, to assure sustainable high-quality health care and increase the odds of survival. The purpose of this paper is to hypothesize that waiting times would decrease and patients and employees would benefit, when specific lean interventions are incorporated in an organizational improvement approach. Design/methodology/approach In 2013, 15 lean interventions were initiated to improve flow in a single radiotherapy institute. Process/waiting times, patient satisfaction, safety, employee satisfaction, and absenteeism were evaluated using a mixed methods methodology (2010-2014)...
March 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28183346/study-protocol-improving-the-transition-of-care-from-a-non-network-hospital-back-to-the-patient-s-medical-home
#16
Roman A Ayele, Emily Lawrence, Marina McCreight, Kelty Fehling, Jamie Peterson, Russell E Glasgow, Borsika A Rabin, Robert Burke, Catherine Battaglia
BACKGROUND: The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that bridges the gap and improves the current transition of care process within the Eastern Colorado Health Care System (ECHCS)...
February 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28157487/comparison-of-body-composition-and-adipokine-levels-between-thin-and-normal-weight-prepubertal-children
#17
Jadwiga Ambroszkiewicz, Joanna Gajewska, Katarzyna Szamotulska, Grażyna Rowicka, Witold Klemarczyk, Magdalena Chełchowska
OBJECTIVE: Thinness can have substantial consequences for child development and health. Adipokines, including leptin and adiponectin, play a significant role in the regulation of important metabolic functions. The aim of this study was to investigate associations between body composition and serum leptin and adiponectin levels in thin and normal-weight children. METHODS: The authors examined 100 healthy prepubertal children, who were divided into two subgroups: thin (n=50) and normal-weight children (n=50)...
February 1, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28152815/development-of-an-integrated-practice-unit-utilizing-a-lean-approach-to-impact-value-of-care-for-brain-tumor-patients
#18
Christine Ahn, Preston White, Linda M Liau, Timothy Francis Cloughesy, Phioanh Leia Nghiemphu
99 Background: Lack of care coordination across subspecialty departments involved in the treatment of brain tumor patients at our institution has negatively impacted patient outcomes, patient experience, and costs. Meanwhile, value-based health care has become increasingly relevant as a means to respond to changing payment structures and improve quality. With the aim to increase value, we restructured medical practice across the continuum of care for brain tumor patients by developing a virtual (non co-located) Integrated Practice Unit (IPU)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152741/quality-improvement-strategies-in-medical-oncology-a-qualitative-analysis-from-a-scoping-review
#19
Laavanya Dharmakulaseelan, Simron Singh, Adam E Haynes, Brian M Wong, Matthew C Cheung
203 Background: In 2001, the Institute of Medicine (IOM) outlined imperatives to improve quality of care. Quality improvement (QI) has since become essential to cancer care but barriers still exist to the publication of and participation in QI initiatives, including limited recognition for QI and uncertainty with methodologies. We sought to identify strategies used in QI in scholarly medical oncology literature to provide practical guidance for QI. METHODS: We conducted a scoping review using Arksey and O'Malley's framework...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28138389/the-impact-of-changes-in-intensive-care-organization-on-patient-outcome-and-cost-effectiveness-a-narrative-review
#20
REVIEW
Alexander F van der Sluijs, Eline R van Slobbe-Bijlsma, Stephen E Chick, Margreeth B Vroom, Dave A Dongelmans, Alexander P J Vlaar
The mortality rate of critically ill patients is high and the cost of the intensive (ICU) department is among the highest within the health-care industry. The cost will continue to increase because of the aging population in the western world. In the present review, we will discuss the impact of changes in ICU department organization on patient outcome and cost-effectiveness. The general perception that drug and treatment discoveries are the main drivers behind improved patient outcome within the health-care industry is in general not true...
2017: Journal of Intensive Care
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