Download presentation
Presentation is loading. Please wait.
Published byCaitlin Shepherd Modified over 9 years ago
1
Implementing Process Improvement In Healthcare By Gagan Rajpal With Craig A. Stevens PMI Nashville Symposium 2013 1 gaganrajpal1@gmail.com craigastevens@westbrookstevens.com
2
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 2 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach This is an example text. Go ahead and replace it 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com
3
Process Improvement is all about implementing changes; many times these are small, requiring no project management. However, other improvements require major changes that become projects. The biggest problem with many of the process improvement programs is that you have to have a degree in statistics or engineering to understand them. However, it does not have to be that way. During this presentation, we will apply a simple three- phase Process Improvement process using PM, LEAN, Six Sigma, and TQM approaches to real Healthcare examples as applied by University of Tennessee’s Industrial and Systems Engineering Department. Implementing Process Improvement In Healthcare 1/7/20133 craigastevens@westbrookstevens.com
4
Reinforce the Simple Three Phases To Show Some Examples of Process Improvement using Healthcare Goals and Objectives This Presentation Improvement Focused Teams 4 craigastevens@westbrookstevens.com
5
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 5 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach This is an example text. Go ahead and replace it 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com ✓
6
Three Easy to Understand and Use Improvement Phases 6 A = Assessments P = Problem Solving I = Implementation Using Project Management Tools/Support
7
Westbrook Stevens, Seven Attributes of Excellent Management Model, 1990 © People and Team Building 7 From Book Geronimo Stone http://www.llumina.com/store/geronimostone2.htm http://www.llumina.com/store/geronimostone2.htm
8
Step 1 –Build the Assessment Candidate Portfolio Example craigastevens@westbrookstevens.com
9
Hospital Service Doctor’s Office/ Department Patient Admissions Life cycle of a patient needing services at East Tennessee Children Hospital Incoming Patients A f t e r A d m i s s i o n s Resource Allocation gaganrajpal1@gmail.com
10
Step 2 –Assessment Phase 10 A = Assessments P = Problem Solving I = Implementation Using Project Management Tools/Support craigastevens@westbrookstevens.com
11
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 11 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach This is an example text. Go ahead and replace it 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com ✓ ✓
12
Hospital Service Doctor’s Office/ Department PatientAdmissions Incoming Patients PART I : Incoming Patients Applicable Lean Principle : Consistent incoming patient flow Incoming patient flow and trend
13
Hospital Service Doctor’s Office/ Department PatientAdmissions Incoming Patients PART I : Incoming Patients Applicable Lean Principle : Consistent incoming patient flow Incoming patient flow and trend gaganrajpal1@gmail.com
14
Number of patients in year 2007 & 2010 are extrapolated Is there any “trend” in number incoming patients over the years? gaganrajpal1@gmail.com
15
Is there any “trend” in number incoming patients over the years? gaganrajpal1@gmail.com
16
Is there any “trend” in “number” of incoming patients within an year? gaganrajpal1@gmail.com
17
Is there any “trend” in “type” of incoming patients within an year? gaganrajpal1@gmail.com
18
Is there any “trend” in “number” incoming patients within a week? gaganrajpal1@gmail.com
19
Is there any “trend” in “type” of incoming patients within a week?
20
Is there any “trend” in “number & type” of incoming patients within a day?
21
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 21 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com ✓ ✓ ✓
22
Hospital Service Doctor’s Office/ Department Patient Admissions Incoming Patients Is staffing logistics appropriate? Is patient registration a smooth process? Current layout PART II : Patient Admission Applicable Lean Principle : Efficient, effective and reliable admissions process
23
Hospital Service Doctor’s Office/ Department PatientAdmissions Incoming Patients Is staffing logistics appropriate? Is patient registration a smooth process? Current layout PART II : Patient Admission Applicable Lean Principle : Efficient, effective and reliable admissions process
24
Step 2 –Assessment Phase 24 A = Assessments P = Problem Solving I = Implementation Using Project Management Tools/Support craigastevens@westbrookstevens.com
25
Is staffing logistics appropriate? gaganrajpal1@gmail.com
26
3-4 registrations/ hr Is staffing logistics appropriate? Temporary solution will be to move one of the evening personnel to the peak hours gaganrajpal1@gmail.com
27
Doctor’sOffice PatientRegistration Pre-Cert # Order Patients Name Date of birth Diagnosis Tests to be done Doctor’s Sign Legal guardianship House Address Is patient registration a smooth process? Rarely on Order Bad Faxes No signature Legal guardianship paper No diagnosis on order Not having insurance card No Order Grand parents or Neighbors Step parents Interpreter gaganrajpal1@gmail.com
28
Admissions Doctor’s Office/ Department Insurance Company Parents Operator Is patient registration a smooth process? (Continued) gaganrajpal1@gmail.com
29
Step 3 – Build the Problem Solving Portfolio 29 A = Assessments P = Problem Solving I = Implementation Using Project Management Tools/Support craigastevens@westbrookstevens.com
30
Recommendations Pre-screening orders and have more proactive approach Creating a Kanban system for orders that need attention Having Pre-cert # already on the order Having a “complete” & “readable” order Better fax machines “Standard format” for orders (Website access to input patient data) No need for faxes Direct upload onto the database Can be easily read Time & Money saved Pre-registration on phone In case of surgery, doctor could send order directly to surgery In case of standing order, direct admit gaganrajpal1@gmail.com
31
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 31 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com ✓ ✓ ✓ ✓
32
The current layout 1.4 Miles/ shift gaganrajpal1@gmail.com
33
Recommendations Change the current layout Apply principles 5 S in patient admissions office Sort (Seiri), Straighten (Seiton), Shine (Seiso), Standardize (Seiketsu) and Sustain (Shitsuke) gaganrajpal1@gmail.com
34
Step 6 – Select the Solutions and Build a Project Portfolio 34 A = Assessments P = Problem Solving I = Implementation Using Project Management Tools/Support craigastevens@westbrookstevens.com GFR
35
The “current” layout Front Desk Call Center Fax Room Marty’s Office 1 2 3 4 The “new” layout gaganrajpal1@gmail.com
36
The Achievable Target 5-6 registrations/ hr
37
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 37 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com ✓ ✓ ✓ ✓ ✓
38
Hospital Service Doctor’s Office/ Department PatientAdmissions Incoming Patients A f t e r A d m i s s i o n s Resource Allocation PART III : After Admission Patient flow Alignment between admissions & services provided Lean Principle Applicable : Customer satisfaction due to the reduction in wait time via Just In Time system/ pull system
39
Hospital Service Doctor’s Office/ Department PatientAdmissions Incoming Patients After Admissions Resource Allocation PART III : After Admission Patient flow Alignment between admissions & services provided Lean Principle Applicable : Customer satisfaction due to the reduction in wait time via Just In Time system/ pull system
40
Step 2 –Assessment Phase 40 A = Assessments P = Problem Solving I = Implementation Using Project Management Tools/Support craigastevens@westbrookstevens.com
41
Focus Areas gaganrajpal1@gmail.com
42
Focus Areas gaganrajpal1@gmail.com
43
Value added Vs Non-value added time Patient registration Explaining the procedure Taking history Actual procedure Redundancy Waiting Walking/ transportation Excessive processing Errors gaganrajpal1@gmail.com
44
Current state 38.7 % Non-value added time gaganrajpal1@gmail.com
45
Current state 70 % Non-value added time gaganrajpal1@gmail.com
46
Current state – OPS Ear Tube Lead time: 233 min VA/ T: 85.3 min WIP: 168 min 63.4 % Non-value added time gaganrajpal1@gmail.com
47
Current state 55.6 % Non-value added time gaganrajpal1@gmail.com
48
Current state 46.6 % Non-value added time gaganrajpal1@gmail.com
49
Redundancy in paper work Waiting for technician Waiting for room Same questions asked by several personnel Orders lost Delay in bringing patients from the floor lack of transporter technician being busy with other patients sometimes lack of technicians Types of waste gaganrajpal1@gmail.com
50
Current state – OPS Ear Tube 4 th Floor 6 th Floor gaganrajpal1@gmail.com
51
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 51 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com ✓ ✓ ✓ ✓ ✓ ✓
52
Hospital Service Doctor’s Office/ Department PatientAdmissions Incoming Patients After Admissions Resource Allocation PART IV : Resource allocation model gaganrajpal1@gmail.com
53
Hospital Service Doctor’s Office/ Department PatientAdmissions Incoming Patients After Admissions Resource Allocation PART IV : Resource allocation model gaganrajpal1@gmail.com
54
Step 3 – Build the Problem Solving Portfolio 54 A = Assessments P = Problem Solving I = Implementation Using Project Management Tools/Support craigastevens@westbrookstevens.com
55
1.To increase service/ patient satisfaction 2.To minimize cost Depends on- - Number of people - Time/ Schedule of different departments Allocation of resources to patient admissions gaganrajpal1@gmail.com
56
SIPOC - Department - Doctor Patient -Time - Schedule Admissions to the entrance of the service Service -Time - Quality Patient Supplier InputProcess Output Customer Logic : Ability to provide resources to serve the customer Resources are provided in the process, therefore, they should dictate the schedule Our approach gaganrajpal1@gmail.com
57
InsuranceInsurance OrderOrder Relation to PatientRelation to Patient Social Security #Social Security # AddressAddress Doctor’s nameDoctor’s name Service RequiredService Required Availability of serviceAvailability of service # of patients in queue for service# of patients in queue for service Avg. time required for serviceAvg. time required for service Input
58
Admissions X-ray Pulmonary Lab Neurology Surgery Type - 1 Type - 2 Type - 3 Type - 4 Type - n Patient QAQAQAQA Q S1 Q S2 Q S3 Q S4 Q S5 Q S11 Q S12 Q S13 Q S14 Q S1n Output = Min: ∑ Q A + Q S1 + Q S11 -------------- Output
59
1.To increase service/ patient satisfaction 2.To minimize cost Depends on- - Number of people - Time/ Schedule of different departments Allocation of resources to patient admissions gaganrajpal1@gmail.com
60
SIPOC - Department - Doctor Patient -Time - Schedule Admissions to the entrance of the service Service -Time - Quality Patient Supplier InputProcess Output Customer Logic : Ability to provide resources to serve the customer Resources are provided in the process, therefore, they should dictate the schedule Our approach gaganrajpal1@gmail.com
61
Insurance Order Relation to Patient Social Security # Address Doctor’s name Service Required Availability of service # of patients in queue for service Avg. time required for service Input gaganrajpal1@gmail.com
62
Admissions X-ray Pulmonary Lab Neurology Surgery Type - 1 Type - 2 Type - 3 Type - 4 Type - n Patient QAQAQAQA Q S1 Q S2 Q S3 Q S4 Q S5 Q S11 Q S12 Q S13 Q S14 Q S1n Output = Min: ∑ Q A + Q S1 + Q S11 -------------- Output gaganrajpal1@gmail.com
63
Creating a Team Focused Improvement Program Agenda Goals/Objectives General PI Processes ✓ 2 2 1 1 63 77 66 55 4 4 Process Analysis Value Chain Analysis Layout Analysis and Spaghetti Diagrams SPIOC 88 Summary of PI Program Approach 3 3 PI Assessment and Performance Measures craigastevens@westbrookstevens.com ✓ ✓ ✓ ✓ ✓ ✓ ✓
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.