Aids to deliver the RIGHT care for EVERY patient, EVERY time.
Susan BrownQuality Manager
Quality Tools at MSHA…
Quality and Patient Safety
Patient SafetyQuality
(PI)
Corporate Director
Quality Manager
Improvement Advisors
Quality Manager
Improvement Advisors
Infection PreventionReporting
Quality & Patient Safety
Plan
Do
Check
Act
MSHA Business Model and Improvement Methodology
• 5 Whys• SIPOC• RCA• FMEA• Process Mapping• Cost Benefit Analysis
MSHA Framework
Facility Team
Facility Team
Facility Team
Facility Team
Facility Team
Facility Team
Facility Team
PDCA Toolkit
Lean Tools• 5S – Visual Management• VSM• Spaghetti Diagrams• Check sheets• Pareto Analysis• Brainstorming• Kanban-Trigger Systems• Mistake Proofing• Standardization
Six Sigma Methodology
Approaches
Why Lean and 6σ?
• Quality issues in healthcare– Estimate of annual US MEDICAL errors
• 974,000 patient injured• 44-98,000 patient deaths• $17-29 billion in costs
– Estimate of preventable MEDICATION errors• 185,000 patients• 7,000 deaths• $2 billion in costs
– Estimate of Central-Line Infections• 250,000 patients• 30-62,000 deaths• $6.25 billion in costs
Spear, HBR, 2005
Why Lean and 6σ?
• Healthcare across the US:– Increasing DEMAND
• Record # Emergency Department visits• Avg. time in ED = 4 hours• Excessive holds in ED• Diversion
– Margin EROSION• Declining reimbursements• Rising costs
– Employee TURNOVER• Almost 1 in 5• Extremely costly• Burnout factors
Spear, HBR, 2005
Training and Development
• Recognizing need for standardization and reducing variation– UTK Center for Executive Education, Lean Healthcare program
• 1 week• Classroom and simulation education• Toyota Production System
– On-going internal training/education• Departmental – Development Ladder
– Novice– Apprentice– Practitioner– Expert
• Project
Common Terminology
• Defining CUSTOMER• Defining VALUE• Defining Waste (non-Value)
– Overproduction– Motion– Inventory– Over-processing– Waiting – Defects/Rework– Transportation
• Understanding that everything is a process
Examples of Tools in Action
Before After
Visual Signals/Indicators
What are the differences between healthcare and manufacturing?
• Tool application– No differences…
• Challenges– Healthcare cannot stop– Every patient is unique– Predictability
• Questions/Comments