...EXECUTIVE SUMMARY Trends come and go, and this is especially true in the healthcare industry where everything is currently constantly changing. It is always important to analyze pros and cons of business trends when deciding whether to implement them in an organization. While there are countless trends to consider, six in particular will be the topic of this discussion: Mergers and acquisitions, consumerism and the role of the patient, outsourcing, Lean Six Sigma, Medicaid Expansion, and Bring Your Own Device. In the ever-changing health care world, different business and finance trends come and go. In the midst of all the uncertainty, there is only one thing for certain and that is the goal of improving the bottom line. There are countless trends on the horizon for healthcare but there are six in particular that will be discussed: Mergers and acquisitions, consumerism and the role of the patient, outsourcing, Lean Six Sigma, Medicaid Expansion, and Bring Your Own Device. Careful consideration of the pros and cons of each trend can help determine whether implementing one or more of them is right for an organization. Mergers and acquisitions are expected to grow within the healthcare industry in the coming months and even years due to the Affordable Care Act. According to KPMG, 60 percent of the healthcare executives it recently polled said they plan to make more deals in 2013 than in 2012. Many of the deals are expected to be mid-market sized or smaller...
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...With this rapid growth of patients who are seeking health care, it is inevitable that wait times to see a healthcare provider have lengthened. For this reason, an intervention for improvement of the existing flow process must be implemented to enhance the quality of care that is provided to the patients as well as improve patient satisfaction. Lean technique was implemented by eliminating any nonvalue-added activities in the current workflow, decreasing wait times, creating a quicker throughput, and improving patient satisfaction and quality patient care. Throughout this process, the information that was gathered for the lean technique solution made the trial days of implementing lean technique successful in urgent care. A second solution was developed as a backup plan, consisting of having a dedicated nurse practitioner and a...
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...Lean Thinking in Health Care Lakeshia R. Dingle Grand Canyon University: HCA-240 May 14, 2016 Lean Thinking in Health Care “Health care is big business that has a major impact on our nation’s economy” (GCU Lecture 1). It is one that is highly regulated by both federal and state level governments as well as that of accrediting agencies. Lean Thinking In the 1950s Toyota came up with the idea of lean thinking which is a set of functioning ideas and techniques that helps generate the greatest importance for individuals by decreasing waste and delays” (Feeney, 2015). The purpose of this systematic approach was to change the establishments thought process and value, which would eventually lead to the conversion of the establishment culture and behavior over a period of time. It put emphasis on the consideration of the client’s needs, staff participation and constant enhancement. It may be used as a means of “identifying and eliminating “non-value add” actions and activities to decrease “waste” and afford enhanced organization performance and volume” (Feeney, 2015). For-Profit versus Non-Profit Organizations Will there be differences between how for-profit organizations (versus nonprofit organizations) are impacted? Lean thinking is all about providing the correct items to the correct location, at the correct time, in the exact numbers, while being flexible and open to change and minimizing waste. The key principle is to generate an increment of value with less waste...
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...In the present day, there are rising concerns worldwide as regards the absence of patient-focus in numerous healthcare perspectives like outpatient and inpatient care. A way of dealing with this and concurrently ensuring a better quality of care is by embracing and integrating different lean thinking aspects. The main concept of the Lean strategy is eliminating unnecessary waste and maximising value to the customer. Thus, before any kind of Lean implementation it is essential to understand the current situation and how future improvementscan be made based on patient value. In this thesis, the voice of the patients, voice of staff and voice of the process were collected to illustrate how a patient-centric perspective can be combined with Lean...
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...Value Stream Map for MIA Mobility Current State. The value stream map (Figure 1.) for MIA Mobility, a retailer of medical supplies directed at people over 65, details the process for inventory items from purchase, through in-store storage and display, to final sale and delivery. Inventory purchase orders are placed with a lead time of three days, as MIA Mobility expects to keep only one week of inventory on shelves and in shortage stock. This time frame allows delivery of orders three days to receive items. Once the goods are received, verifying the delivery takes 2 hrs and move into the in-store stock room takes 45 minutes. Store shelves are replenished each day, with items being pulled from the stock room and placed on display shelves during times when employees are not directly providing service to customers. Estimated time for customer purchase is based on the time to enter, seek, find, select, and transact for the desired item in-store (Guidon Performance Solutions, 2009). The estimated time for customer purchase in the current state is a lead time of 15 minutes prior to the checkout process and 5 minutes to complete the checkout process. The replenishment process is also shown in Fig.1 with utilization of the inventory management system. Inventory data is entered and stored at the following points: receiving, which enters the total items received during the last shipment; storing, which tracks volumes in the stock room for in-store...
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...MSRSAS - Postgraduate Engineering and Management Programme - PEMP
Module Code Module Name Course Department
EMM515 Lean Operations and Management of Lean Organizations M.Sc. in Engineering and Manufacturing Management Mechanical and Manufacturing Engg .
Name of the Student Reg. No Batch Module Leader
Liju G BUB0912004 Full-Time 2012. SANDEEP. N
M.S.Ramaiah School of Advanced Studies
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...LEAN HOSPITALS “Mark Graban’s book has documented what is now happening in hospitals all across America as we learn to apply the Toyota Production System methodology to healthcare. This book lays out the nuts and bolts of the lean methodology and also describes the more difficult challenges, which have to do with managing change. Graban’s book is full of wins—these are the same type of wins that are happening at ThedaCare every day. I wish I could have read this book six years ago, as it might have prevented some of the mistakes we made in our lean transformation journey.” — John S. Toussaint, MD, President/CEO ThedaCare Center for Healthcare Value “Coupled with a foundation of alignment and accountability, the ideas in this book provide a powerful tool to help hospitals get closer to the goal we want – perfect care.” — Quint Studer, CEO, The Studer Group, author of Results that Last “Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of healthcare. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of healthcare if standardized systems borrowed from reliable industries were implemented. Graban provides those trade secrets in an understandable and transparent fashion.” — Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman, Department of Medicine, University of Pennsylvania School of Medicine “There is an...
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...Abstract The Affordable Care Act (ACA) brings a myriad of changes to the healthcare system and hospitals must adapt accordingly or face dire financial challenges. Some of the financial challenges will originate from the influx of Medicaid patients due to the Medicaid expansion. Based on these changes, there is an increased tendency for hospitals to engineer ways to reduce costs such as patient selection and staff reduction. However, for a hospital to participate in Medicare, which accounts for more than 50% of hospital budgets, certain laws and regulations must be followed. This paper discusses these laws and regulations and offers suggestions on how to adjust successfully to the upcoming changes. The Affordable Care Act (ACA) and Hospital Compliance In light of the current changes in the healthcare industry, it is imperative for every healthcare organization to adapt accordingly or face dire financial challenges. A major change included in the Affordable Care Act (ACA) is the expansion of Medicaid, which will provide coverage to millions of formerly uninsured US citizens and permanent residents (Rosenbaum, 2011). However, Medicaid is notorious for much lower reimbursement compared to Medicare and private/commercial insurance (M. Schmitt, personal communication, October 7, 2013). In addition, hospitals are now required to prove that the services they bill for actually improve and maintain patients’ health (Leonard, 2013). Hospitals are also required...
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...Six Sigma is a quality improvement method that is being used more frequently in healthcare. This tool was developed and used in industry since around 1980 and began to be used in healthcare in the 1990's (Powell, Rushmer, & Davies, 2009). According to Lighter (2011) "This lean process management system provides quality improvement professionals with the ability to remove non-value added work and improve process efficiency" (p. 287). The healthcare industry needs to find a way to get rid of errors. Today's society demands a lot from the healthcare providers and will not tolerate unnecessary errors, no matter how small they may seem. Six Sigma works to recognize errors as soon as they occur so they will be corrected before the error is carried out. If the process is fully reliable, appropriate healthcare will be delivered in the same way to all patients every time. If the care is evidence-based, then every patient receives optimal care regardless of who actually delivers the care, when it is delivered or where it is delivered (Powell, Rushmer, & Davies, 2009). Six Sigma uses the DMAIC (Define, Measure, Analyze, Improve, Control) approach. This approach first defines the problem, measures the defects, analyzes the cause of the defects, improves the process to remove the defects, and controls the process to ensure that the defects do not recur (Powell, Rushmer, & Davies, 2009). These steps need to take place to avoid variations and maintain quality. If the steps...
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...An NHS Confederation leading edge report Lean thinking for the NHS Daniel Jones and Alan Mitchell, Lean Enterprise Academy UK A report commissioned by the NHS Confederation The voice of NHS leadership The NHS Confederation brings together the organisations that make up the modern NHS across the UK. We help our members deliver better health and healthcare by: • influencing policy and the wider public debate on the full range of health and health service issues • supporting health leaders through information sharing and networking • working for employers to improve the working lives of staff and, through them, to provide better care for patients. For more information on our work, please contact: NHS Confederation 29 Bressenden Place London SW1E 5DD Tel 020 7074 3200 Fax 020 7074 3201 Email enquiries@nhsconfed.org www.nhsconfed.org Disclaimer All views and opinions in this publication are those of the author and are not the authorised views or opinions of the NHS Confederation. The NHS Confederation shall not be liable for any indirect, special, consequential, or incidental damages or defamation arising from any views, opinions or information contained within this publication. Registered Charity no. 1090329 Published by the NHS Confederation © NHS Confederation 2006 ISBN 1 85947 127 7 Ref: BOK 56701 Acknowledgements This report was written by: Daniel Jones and Alan Mitchell, Lean Enterprise Academy UK with David Ben-Tovim, Flinders Medical Centre, Australia David...
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...will identify the resolution or attempted resolution and provide comments about the role of the managers. American Healthcare is in a crisis. Healthcare cost is rising too quickly and too many preventable errors occur in most hospitals around the world. The industry is struggling with cost; poor quality, nursing shortages and employee dissatisfaction are symptoms of deeper problems inherent in the systems itself. Today, a number of leading organizations are demonstrating they can provide better value through proven and tested process improvement methods. Lean is a set of methods, principles, and philosophies that form a complete management system. Health care organizations are crashing equivalently, due to an outdated management system, which is based on a command and control paradigm and this has caused many healthcare patients to die unnecessarily from this medical error. Managers are to ensure that standard work is being applied and is improving through a scientific method. Managers need verification that the standard work is followed occurs through a series of audits. If a defect is identified there is a standard process in place for staff to use to address the problem. Daily problems solving using the plan/do/study act process is core to that manager work. Healthcare management needs to examine the issue thoroughly. In traditional healthcare management, managers are rewarded for telling their superiors that dysfunctional...
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... Lean management is a concept that is tightly linked to the story Of The Toyota Motor Company that has roots since the 1918. Lean is a multilevel concept is a systematic method for elevating waste within a manufacturing process. This concept was introduced into several different healthcare facilities. It was Joseph Juran who merged the lean concept for the manufacturing concept to the health care industry. He wrote:”as the health industry try to undertake change; it is well advised to take into account the experiences of the other industry in order to understand what work and what has not.” In order to implemented lean in the healthcare industry it was suggested the patient be the primary focus since they paid for services. The patient determine what is constitutes waste. It was noticed that the lean principle is popular in the U.S.A. “For example, at Virginia Mason Medical Center, where “patient is God,” the hospital reported increased profit margin, decreased in death , and decreased in the number of medication errors (Teich &Falloul 2013).” The health care system in the U.S.A has shown that it lacks efficiency, and it is not patient center. By having a system geared to the idea of the patient being the “primary customer,” emphasizing clinical services outcome, and adopting rigorous quality improvement this concept can be a chagellence at a macro level. It should begin at micro level and finish at a macro level. Overall the concept of lean is to eliminate...
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...Healthcare Ecosystems Barnes Jewish Hospital is the combination of The Jewish Hospital of St. Louis built in 1902 and Barnes Hospital built in 1914. The two hospitals were combined in a merger in 1996 becoming Barnes-Jewish Hospital. Barnes-Jewish Hospital is located in St. Louis, Missouri in the Central West End neighborhood. What started off as a small Jewish hospital in 1902 is now one of the best hospitals in Missouri. It is also the largest private employer of St. Louis with 9,215 employees (http://barnesjewish.org/about/fact-sheet). Barnes Jewish is a teaching hospital that has been associated with Washington University College of Medicine since before 1914. This association guaranteed that the hospital would be staffed with university professors and be a learning environment for cutting edge medicine. Impact on Growth Immigration had a large impact on the growth of The Jewish Hospital of St. Louis. The hospital was built with money from the Jewish community and the board of directors consisted of the city’s Jewish leaders but they wanted the hospital to help everyone. The board promised that the hospital would “afford medical and surgical care and nursing to sick or disabled persons of any creed or nationality” (http://barnesjewish.org/about/history). Over 3 million Jews immigrated to the United States from Europe from 1881 to 1920. The immigration was caused by economic conditions and discrimination that radiated throughout Europe (http://en.wikipedia...
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...Veteran hospitals and clinics The "U.S. Department Of Veterans Affairs " (2016). Today veteran hospitals use VistA, which is VA's award winning Health Information Technology (IT) system. It provides an integrated inpatient and outpatient electronic health record for VA patients, and administrative tools to help VA deliver the best quality medical care to Veterans. VistA is also used to manage multimedia for cardiology, radiology and pathology. It is able to provide video clips of each scan as well as images. Veteran hospitals today also use BCMA barcode medication administration system. The BCMA is used when a patient needs medication; each nurse scans the patient bracelet as well as the medication that will be given to the patient to verify this is the correct medication for that patient. Vistas became the instrument of change at the VA in the mid 1900’s and since this change Veteran hospitals and care facilities have noticed a drastic change in patient care in health care records. Veteran healthcare facilities started up doing the Civil War in 1865. Veteran hospital and healthcare facilities started off just like any other hospital or healthcare facility by using paper and writing down patient information and later filing that patient information. Twenty years ago veteran hospitals used the...
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... 5-6 2- Patients flow model at hdf 6-8 V- patient Flow and Capacity Theories 9-12 3- Process mapping 10 4- theory of constraints 10-11 5- lean tools 11-12 VI- HDF processes evaluation from the capacity theories perspective 12-16 VII- Proposed changes and their effects on customer service 16-18 VIII- Final Recommendations and conclusion 19-21 IX- REFERENCE I- Executive Summary: Reducing operational inefficiencies is paramount to healthcare providers across the globes, who are exasperated with their self-defeating efforts to offer the best customer service to patients that balance between quality, cost efficiency, dependability and flexibility. However, they find themselves forced to compromise between these dimensions and focus on one...
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