Healthcare Value Proposition
-10%
portes grátis
Healthcare Value Proposition
Creating a Culture of Excellence in Patient Experience
Omachonu, Vincent K.
Taylor & Francis Ltd
11/2018
230
Dura
Inglês
9781138499690
15 a 20 dias
620
Descrição não disponível.
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
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
Este título pertence ao(s) assunto(s) indicados(s). Para ver outros títulos clique no assunto desejado.
Healthcare Providers;Healthcare Organizations;Healthcare Industry;Chronic;Face To Face;Personal Health Records;HCAHPS Survey;Urgent Care Centers;HCAHPS Score;American Nursing Association;Patient Encounter;Vaccine Preventable Diseases;Digital Transformation;Patient Satisfaction;X-bar Chart;Retail Clinics;Kaizen Event;Non-conforming Items;Control Chart;MIT Sloan Management Review;ICU Los;IHS Markit;Physician Patient Communication;Bar Codes;Digital Transformation Journey
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
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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Healthcare Providers;Healthcare Organizations;Healthcare Industry;Chronic;Face To Face;Personal Health Records;HCAHPS Survey;Urgent Care Centers;HCAHPS Score;American Nursing Association;Patient Encounter;Vaccine Preventable Diseases;Digital Transformation;Patient Satisfaction;X-bar Chart;Retail Clinics;Kaizen Event;Non-conforming Items;Control Chart;MIT Sloan Management Review;ICU Los;IHS Markit;Physician Patient Communication;Bar Codes;Digital Transformation Journey
