Healthcare value proposition : creating a culture of excellence in patient experience

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Healthcare value proposition : creating a culture of excellence in patient experience

by Vincent K. Omachonu

Taylor & Francis, 2019

  • : hardback

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Includes bibliographical references and index

内容説明・目次

内容説明

Never before in the healthcare industry has there been such intense emphasis and open debate on the issue of quality. The steady rise in the cost of healthcare coupled with the need for quality have combined to put the healthcare industry at the top of the national agenda. Quality, costs, and service are not just socially provocative ideas. They are critical criteria for decision-making by patients, physicians, and many key constituents of healthcare organizations. The pursuit of improved performance has driven a host of executives and managers in search of techniques for structuring, rehabilitating, redesigning, and reengineering the organizations they serve. Unfortunately, the narrow-mindedness with which programs are implemented and the discontinuity in their application weaken the promise of success. The process of quality improvement can become an undisciplined search for illusions rather than reality. For many years, healthcare managers have embraced the narrow definition of performance solely in the context of financial success. Forward-thinking executives now realize that the road to financial success begins with success in quality and service. Quality and service are no longer separate issues - they are the same. Neither one by itself will bring about lasting success. The ultimate measure of performance is in an organization's ability to create value for its customers, and true performance must be measured in the context of the customers' total experience. This book is about how to manage performance in the context of value to the customer or patient. It brings together the many pieces of the performance improvement puzzle - quality, technology, costs, productivity, and customer service. The author also covers process improvement tools including Lean and Six Sigma, and how to create a culture of continuous improvement as well as how to improve the patient experience and productivity improvement strategies. The book is filled with examples, illustrations, and tools for improving key aspects of a healthcare organization's performance.

目次

  • Contents About the Author .......................................................................................xi Introduction.............................................................................................xiii 1 The Healthcare Industry: Challenges and Opportunities............1 Healthcare Cost and Sustainability..............................................................1 The Aging Population in the United States.................................................3 The Growing Trend of Retail Healthcare....................................................4 Telemedicine and Virtual Healthcare..........................................................6 Population Health Management..................................................................7 Price Transparency in Healthcare...............................................................8 Behavioral Healthcare................................................................................10 Data Security..............................................................................................12 Healthcare Technology and Electronic Medical Records System.............13 Data and Insights in Healthcare................................................................16 Preventive Care..........................................................................................17 Empathy and Compassion.........................................................................19 Transition from Volume-Based Healthcare to Value-Based Healthcare........22 Questions for Discussion...........................................................................23 References..................................................................................................23 2 Determinants of Value: Patients' Perspective.............................27 Privacy, Confidentiality, and Security........................................................30 Timeliness...................................................................................................31 Patient Safety..............................................................................................32 Care for the "Whole Person"......................................................................33 The Hassle Factor in Healthcare...............................................................34 Chief Complaint.........................................................................................35 Empathy, Sensitivity, and Compassion......................................................36 Post-Discharge Follow-Up..........................................................................37 Care Coordination......................................................................................37 Attention to Detail (ATD)..........................................................................39 Availability of Information.........................................................................39 True Cost and Value..................................................................................40 Clinical Outcomes as a Measure of Value.................................................41 Value Proposition: Health Outcomes Divided by Costs...........................42 The Patient Experience Value Manifesto...................................................43 Questions for Discussion...........................................................................46 References..................................................................................................47 3 The Patient Experience...............................................................51 Measuring Patient Experience: HCAHPS Surveys.....................................54 Tactics and Strategies for Improving HCAHPS Scores..............................57 HCAHPS and Health Plans........................................................................66 Questions for Discussion...........................................................................66 References..................................................................................................67 4 Value Is in the Attention to Detail..............................................71 Attentiveness-The Gold Standard............................................................76 The Power of Details.................................................................................79 Culture of Attention to Detail....................................................................80 Today's Culture of Distraction...................................................................81 Core Value Principles of ATD....................................................................83 Questions for Discussion...........................................................................85 References..................................................................................................85 Additional Reading.....................................................................................85 5 Data and Information.................................................................87 Why Collect Data?......................................................................................88 Data Collection Methods...........................................................................89 Observation................................................................................................90 Focus Groups and Interviews....................................................................91 Conducting Focus Groups: Group Composition and Size....................91 Surveys.......................................................................................................93 Documents and Records............................................................................94 Experiments...............................................................................................94 Stratifying Data..........................................................................................94 Data Variations...........................................................................................95 Types of Data.............................................................................................96 Attribute or Discrete Data......................................................................96 Variable or Continuous Data.................................................................97 Distinguishing Data Types.........................................................................97 Summary....................................................................................................98 Questions for Discussion...........................................................................98 References..................................................................................................99 6 Lean Management System.........................................................101 The Lean Process.....................................................................................104 Lean Tools and Their Applications..........................................................107 Value Stream Mapping.............................................................................107 What Is Value Stream Mapping?..............................................................108 Defining Waste......................................................................................... 110 The Process.............................................................................................. 111 Poka-Yoke................................................................................................. 113 Kaizen....................................................................................................... 115 Kaizen Events........................................................................................... 116 Day 1-Current State Documentation................................................. 117 Day 2-Current State Evaluation......................................................... 117 Day 3-Characterize the Future State
  • Plan Its Implementation........ 118 Day 4-Implement the Future State.................................................... 118 Day 5-Operationalize the Future State and Debrief........................ 119 The Five S Method................................................................................... 119 Planning for 5S.........................................................................................121 The Steps for Implementing 5S Methodology.........................................122 Benefits of 5S...........................................................................................125 SMED........................................................................................................125 Examples of SMED Healthcare Applications..........................................127 Five Whys.................................................................................................129 Kanban.....................................................................................................130 Steps for the Implementation of a Two-Bin Kanban System.................132 Benefits of Kanban in Hospitals and Clinics..........................................134 Standardized and Standard Work............................................................134 The Process..............................................................................................135 Benefits of Standardized Work................................................................136 Questions for Discussion.........................................................................137 References................................................................................................137 Additional Readings.................................................................................138 7 Six Sigma..................................................................................139 Key Concepts of Six Sigma...................................................................... 142 Examples of Defects................................................................................ 142 Control Charts.......................................................................................... 143 Control Charts for Attribute Data............................................................ 143 Attribute Data Chart Categories...............................................................146 Attribute Charts for Non-Conforming Items...........................................146 Attribute Charts for Non-Conformities....................................................146 P Chart Example...................................................................................... 147 Procedure for Constructing a P Chart..................................................... 147 Results...................................................................................................... 150 An NP Chart Example............................................................................. 150 Results...................................................................................................... 153 Variable Sample Size................................................................................ 153 Results...................................................................................................... 153 A C Chart Example.................................................................................. 154 Results...................................................................................................... 156 A U Chart Example.................................................................................. 156 Results...................................................................................................... 159 Bringing the Process Under Control....................................................... 159 Evidence of an Unstable Process............................................................. 159 The Meaning of a Stable Process............................................................160 Control Charts for Variable Data.............................................................160 Variable Data........................................................................................160 Judging Process Stability.......................................................................... 162 Example of an X - R Chart.................................................................... 162 Procedure for Constructing an R Chart................................................... 162 Results......................................................................................................166 Procedure for Constructing an X Bar Chart............................................ 167 Results...................................................................................................... 167 An X - S Chart........................................................................................ 167 Process Improvement Tools.....................................................................168 Tools for Managing Ideas........................................................................ 170 Brainstorming........................................................................................... 171 The Creativity Phase............................................................................ 173 The Clarification Phase........................................................................ 173 The Assessment Phase......................................................................... 174 Multi-Voting.............................................................................................. 174 Tools for Gathering and Analyzing Data................................................ 175 Flow Charts.............................................................................................. 175 Process for Creating Flow Charts........................................................ 175 Pareto Analysis.........................................................................................177 An Example..........................................................................................177 Cause and Effect Diagrams (Ishikawa or Fishbone Diagrams).............. 178 Process for Creating a Cause and Effect Diagram.............................. 179 Scatter Diagrams............................................................................... 179 An Example......................................................................................180 Coefficient of Correlation (R)...........................................................181 Discussion Questions and Problems.......................................................183 References................................................................................................187 Additional Readings.................................................................................187 8 Creating Value Through Digital Transformation......................189 The Meaning of Digital............................................................................190 Digital Health Applications...................................................................... 191 Impact on Employees.............................................................................. 193 Role of Leadership................................................................................... 194 Important First Steps in Implementing a Digital Strategy...................... 195 Questions for Discussion.........................................................................196 References................................................................................................196 9 Telemedicine: The Quest for Quality and Value.......................199 What Is Telemedicine?.............................................................................199 Structure-Related Measures of Quality....................................................204 Process of Care Measures........................................................................204 The Institute of Medicine (IOM) Model..............................................205 Dimensions of Quality Measurement in Telemedicine.......................206 Effectiveness and Process................................................................ 211 Patient-Centeredness and Structure.................................................212 Patient-Centeredness and Process...................................................213 Timeliness and Structure..................................................................213 Timeliness and Process.................................................................... 214 Efficiency and Structure................................................................... 214 Efficiency and Process..................................................................... 215 Equitability and Structure................................................................ 216 Equitability and Process................................................................... 216 Implications for Outcomes....................................................................... 217 Questions for Discussions....................................................................... 219 References................................................................................................ 219 Index........................................................................................................ 223

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