...Case study # 1: Hospitals are driving toward a leaner organization Case study # 1 1. The best perspective of organizational effectiveness that describes the application of lean management practices is organizational learning perspective. This perspective focuses on the most value input as known as knowledge. Organizational learning is founded on the idea that organizational effectiveness depends on the organization’s capacity to acquire, share, use, and store valuable knowledge (Mcshane & Von Glinow, 2012). Sunderland Royal hospital engages in organizational learning perspective through learning lean management from external knowledge. Sunderland’s employees took tour at Nissan Factory to acquire and share knowledge from Nissan work plant, and later they applied and stored knowledge in their work unit. Employees always play critical role in this process and they are important intellectual capital of learning organizations. They can use and share knowledge through the process by mapping out their work process and identifying ways to reduce waste process. As Sunderland’s employees discovered ways to reduce average patient’s wait time, they can improve efficiency and quality service. Also, many other health care around the world apply lean management in their organization by receiving lean training from Japan. Flinders Medical center also learned and adopted lean knowledge after seeing South Australian Medical Facility experienced problem of overload patients in its emergency...
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...Healthcare Ecosystems Barnes Jewish Hospital is the combination of The Jewish Hospital of St. Louis built in 1902 and Barnes Hospital built in 1914. The two hospitals were combined in a merger in 1996 becoming Barnes-Jewish Hospital. Barnes-Jewish Hospital is located in St. Louis, Missouri in the Central West End neighborhood. What started off as a small Jewish hospital in 1902 is now one of the best hospitals in Missouri. It is also the largest private employer of St. Louis with 9,215 employees (http://barnesjewish.org/about/fact-sheet). Barnes Jewish is a teaching hospital that has been associated with Washington University College of Medicine since before 1914. This association guaranteed that the hospital would be staffed with university professors and be a learning environment for cutting edge medicine. Impact on Growth Immigration had a large impact on the growth of The Jewish Hospital of St. Louis. The hospital was built with money from the Jewish community and the board of directors consisted of the city’s Jewish leaders but they wanted the hospital to help everyone. The board promised that the hospital would “afford medical and surgical care and nursing to sick or disabled persons of any creed or nationality” (http://barnesjewish.org/about/history). Over 3 million Jews immigrated to the United States from Europe from 1881 to 1920. The immigration was caused by economic conditions and discrimination that radiated throughout Europe (http://en.wikipedia...
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...the healthcare system and hospitals must adapt accordingly or face dire financial challenges. Some of the financial challenges will originate from the influx of Medicaid patients due to the Medicaid expansion. Based on these changes, there is an increased tendency for hospitals to engineer ways to reduce costs such as patient selection and staff reduction. However, for a hospital to participate in Medicare, which accounts for more than 50% of hospital budgets, certain laws and regulations must be followed. This paper discusses these laws and regulations and offers suggestions on how to adjust successfully to the upcoming changes. The Affordable Care Act (ACA) and Hospital Compliance In light of the current changes in the healthcare industry, it is imperative for every healthcare organization to adapt accordingly or face dire financial challenges. A major change included in the Affordable Care Act (ACA) is the expansion of Medicaid, which will provide coverage to millions of formerly uninsured US citizens and permanent residents (Rosenbaum, 2011). However, Medicaid is notorious for much lower reimbursement compared to Medicare and private/commercial insurance (M. Schmitt, personal communication, October 7, 2013). In addition, hospitals are now required to prove that the services they bill for actually improve and maintain patients’ health (Leonard, 2013). Hospitals are also required to cover the cost of medical errors and hospital-acquired infections as...
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...organizational effectiveness best describe the application of lean management practices? Describe how specific elements of that perspective relate to the interventions described in the case study. The case study in question shows many benefits of hospitals around the world adapting to lean management practices. Essentially they are looking to cut waste, and provide the most efficient care possible. The first perspective of organizational effectiveness the hospitals are utilizing is an organizational learning perspective. The hospitals have identified in their studies that several sources of capital influence their effectiveness. Specifically, human and structural capitals are being utilized to benefit the organization. “Lean works because it is based on doctors, nurses, and other staff leading the process and telling us what adds value and what doesn’t. They are the ones who know.” (McShane (2012). Organizational Behavior: Case Study 1.1. McGraw-Hill). Here, an emphasis is placed on human capital, and the knowledge, experience, and know-how hospital employees bring to the process. By bringing these individuals into the decision making process who have their hands in the work day in and day out, the outcome will be a more efficient, and smoothly running operation as evidenced by the case study. Building on the human capital used, the hospitals are also using a high performance work practice perspective. The hospital is packaging together the best use of their organizational practices...
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...QI Plan – Part I Kittitas Valley Community Hospital (KVCH) is a progressive, critical access hospital that provides exceptional health care to Kittitas County and surrounding areas. KVCH provides 24-hour emergency care and offers inpatient and outpatient hospital services. KVCH's emergency department is designated as a Level IV trauma service by the State of Washington Department of Health and is staffed 24-hours-a-day by an emergency physician (About KVCH, 2012). Over the course of this paper the types of care that KVCH focuses on, the organizations mission and their QI goals will be described as well as the role of consumers in the organizations QI process. Performance Measurement vs. Quality Improvement Processes According to the operations performance measurement program, “Performance measurement is the use of statistical evidence to determine progress toward specific defined organizational objectives. This includes both evidence of tangible fact, such as measurement of hospital acquired infections, and measurement of customer perception, such as would be accomplished through a customer satisfaction survey. In a service industry such as health care, the performance measurement process starts by defining precisely the services that the organization promises to provide, including the quality or level of service (e.g. timeliness, reliability, etc.) that is to be delivered” (Performance Measurement Fundamental, 2011). Quality improvement processes main goal is to improve...
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...Reports Lean Laboratories: Competing with Methods From Toyota Mark Graban, BSIE, MSME, MBA, CPIM, Shana Padgett, BS, MT(ASCP) (ValuMetrix Services, Ortho Clinical Diagnostics, Raritan, NJ) DOI: 10.1309/LMX0LEMR7R0USKUM Hospital laboratories throughout North America are successfully using “Lean” methods based on the Toyota Production System to win against multiple competitive threats. Some hospitals have used Lean to help eliminate point-of-care testing for the emergency department (ED). Other hospitals have used Lean to “insource” testing that had previously been done in outside reference laboratories. Lean can defend and protect employment for the laboratory, while also improving turnaround times and service for patients and reducing costs for the hospital. Hospital laboratories have also used freed up capacity to increase their reference laboratory work, bringing additional revenue to the hospital. an improvement of 37%, as shown in Figure 1. The laboratory was also better satisfying physicians who ordered tests for morning rounds, as the percent of tests on the charts by 7 am improved from 65% to more than 90%, as shown in Figure 2. After laboratory professionals demonstrated that they could dramatically reduce turnaround times, the ED discontinued the point-of-care trials. Since Lean implementation, Dr. Decker said, turnaround times “are definitely faster. All the docs agree,” adding, “the lab is no longer the rate-limiting step in the process.” Lean Instead of...
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...Analysis: 1.1 Hospitals are Driving toward a Leaner Organization Background: To obtain sustainable organizational efficiency and service quality, many hospitals have adopted an Open Systems Perspective by using “lean management” procedures borrowed from leading car manufacturers, in an effort to “reduce and remove waste from work processes”. These processes improved organizational efficiency reduced costs and provided better patient care. i What ‘seems’ to be the Problem: Secondary Symptoms Full waiting rooms, long wait times, inefficient use of supplies and budgets, needless stress and high mortality rate is feedback from the external environment that the hospitals are not meeting the needs of their stakeholders, or fitting in with their environment. Before adapting lean management processes, hospital staff and patients alike shared the burden of what appeared to be the inevitable consequences of health care delivery and a closed systems perspective.ii These problems are manifestations of organizational deficiencies which negatively affect the quality of patient care, the distribution of hospital resources and employee morale. The Real Reasons Hospitals are Facing Difficulties: Primary Problems The secondary symptoms are indicative of underlying issues, highlighting their poor organizational-environmental fitiii and the ineffectiveness of communication between Internal Subsystems.iv To a large extent hospitals have not adapted to their external environment nor have hospitals managed...
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...the task assigned to in my project for my Lean Principles class. As a resu t of the throI process, I am aware now more than before that we are using a lot of the Lean Tools already in our day- to -day processes. However we are using them without the knowledge of what it is we are doing or why we are even doing it. After taking this ean Principes course at MATC, I am really more conscious about where we actuay have Lean Principes in place and how it serves as an essential mechanism in keeping our processes at the utmost efficiency. The company sends us emails all the time about “Simplification” all the time and little did any of us know it was all Lean Processes they were imposing on us. All of this being said it was kind of difficult for me to choose a process to apply Lean To because in most ways, our company is aready being as efficient as can be in amost every aspect. However, after consuting with a variety of individuas, I have encovered a business practice with one specific cient, Hospita A (privacy) that is not as productive as coud be and , as a resut, not as profitable. Therefore, I have chosen to work on changing the way we are servicing Hospital A (privacy) on weekends. THE PROBLEM As I mentioned I would like to try to change the way we are handling service to Hospital A on the weekend. I spoke to some of the couriers and they too can see the need to change the process. In the data I have collected in the last 7 weeks Hospital A has had at least 1 call out each weekend...
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...With this rapid growth of patients who are seeking health care, it is inevitable that wait times to see a healthcare provider have lengthened. For this reason, an intervention for improvement of the existing flow process must be implemented to enhance the quality of care that is provided to the patients as well as improve patient satisfaction. Lean technique was implemented by eliminating any nonvalue-added activities in the current workflow, decreasing wait times, creating a quicker throughput, and improving patient satisfaction and quality patient care. Throughout this process, the information that was gathered for the lean technique solution made the trial days of implementing lean technique successful in urgent care. A second solution was developed as a backup plan, consisting of having a dedicated nurse practitioner and a...
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...A Lean Start James Swisher, PE Vice President, Project Management & Continuous Improvement Mary Washington Healthcare, Fredericksburg, VA Agenda • • • • • • Background Roadmaps Planning for Lean Self Training Lean Leaders Monthly Meeting Agenda • • • • • • • Yellow Belt Program Results What’s Worked Well Challenges Lessons Learned In Progress / Future Management Buy-in Background – Health System • Mary Washington Healthcare (MWHC) – Since 1899 • Over 40 facilities and services – Mary Washington Hospital – 437 beds – Stafford Hospital – 100 beds – Emergency and Outpatient Center – Snowden at Fredericksburg – Women’s Health Institute • Approximately 5,000 employees Background – Project Management • Consultant engagement – Lean projects identified • Project Management & Continuous Improvement (PMCI) – September 2010 – Project Management Office – Industrial Engineer/Lean Expert • Corporate Efficiency & Operations Committee • Leadership Commitment to Lean – Executive Leadership Training, July 2011 – Executive Office Training, 2011 Envisioned Roadmap for Lean Consultants identify projects PMCI created with initial staff Associates trained as Lean Leaders & Lean Master Leaders Lean Leaders paired with projects Ongoing Lean communication and education to the Organization Planning for Lean • Lean Training Research – Multiple national providers – Institute of Industrial Engineers (IIE) • Trainee Selection • Lean Green Belt Certification...
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... 3-4 II- Introduction 4 III- Company Profile 4-5 IV- Problem and Processes Description 5-8 1- Problem definition 5-6 2- Patients flow model at hdf 6-8 V- patient Flow and Capacity Theories 9-12 3- Process mapping 10 4- theory of constraints 10-11 5- lean tools 11-12 VI- HDF processes evaluation from the capacity theories perspective 12-16 VII- Proposed changes and their effects on customer service 16-18 VIII- Final Recommendations and conclusion 19-21 IX- REFERENCE I- Executive Summary: Reducing operational inefficiencies is paramount to healthcare providers across the globes, who are exasperated with their self-defeating efforts to offer the best customer service to patients that balance between quality, cost efficiency, dependability and...
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...report Lean thinking for the NHS Daniel Jones and Alan Mitchell, Lean Enterprise Academy UK A report commissioned by the NHS Confederation The voice of NHS leadership The NHS Confederation brings together the organisations that make up the modern NHS across the UK. We help our members deliver better health and healthcare by: • influencing policy and the wider public debate on the full range of health and health service issues • supporting health leaders through information sharing and networking • working for employers to improve the working lives of staff and, through them, to provide better care for patients. For more information on our work, please contact: NHS Confederation 29 Bressenden Place London SW1E 5DD Tel 020 7074 3200 Fax 020 7074 3201 Email enquiries@nhsconfed.org www.nhsconfed.org Disclaimer All views and opinions in this publication are those of the author and are not the authorised views or opinions of the NHS Confederation. The NHS Confederation shall not be liable for any indirect, special, consequential, or incidental damages or defamation arising from any views, opinions or information contained within this publication. Registered Charity no. 1090329 Published by the NHS Confederation © NHS Confederation 2006 ISBN 1 85947 127 7 Ref: BOK 56701 Acknowledgements This report was written by: Daniel Jones and Alan Mitchell, Lean Enterprise Academy UK with David Ben-Tovim, Flinders Medical Centre, Australia David Fillingham, Bolton Hospitals NHS Trust...
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...(2008) provided a comprehensive case study that involves a children’s hospital called Akron Children’s Hospital, which is one of the largest pediatric care provider with 253 beds. This hospital was founded in 1890 and offers close to This hospital was founded in 1890 and offers several areas of practice all geared towards children. Akron Children’s Hospital operates in the shadows several other competitors that are also recognized nearby: Rainbow Babies and Children’s Hospital as well as the Cleveland Clinic. Cooper & Schindler (2008) stated that even though Akron Children’s Hospital is large and well regarded, it is overshadowed by its competitors. The hospital needs a communication strategy in order to distinguish itself and to strengthen its commitment to the children as well as the high-quality advanced care that it provides. The hospital also must find out the criteria that parents use in order to decide which hospital to use for their children if acute care services are needed. Expanding its market beyond Cleveland should also be something that the hospital should explore. The issue that Akron Children’s Hospital is experiencing is the fact that it does not know which strategies to use in order to expand and overshadow its competitors. While Akron Children’s Hospital is one of the largest pediatric care providers with 253beds, it lacks the strategies in which to compete in its market. The hospital is over shadowed by two other competitors and cannot successfully work...
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...Doctors should receive a higher pay than they are usually paid because they work a lot harder than most people do. Doctors are often underappreciated of their jobs and do not get the recognition they deserve. Doctors deserve a higher pay due to working harder than most people with any paying job does. Most people don’t really think highly of doctors. They often tend to think they only want their patient’s money. People don’t know that doctors spend most of their time in hospitals or clinics. They usually don’t get breaks because they’re busy trying to help all these patients get the right treatment they need. With a higher pay, doctors will get the salary they deserve and be able to afford to take care of their own families. Doctors having...
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...The two management models that will be critically evaluated on their usefulness to managers in the service sector are the Just In Time (JIT) and the Lean manufacturing models. Both of these manufacturing models have been used for decades in the manufacturing sector since they have been invented in the 1960s. Currently in the global economy most manufacturing is happening in both South and East Asia, while most of the services for the global economy are happening in the Western Europe and North America (Wild, 2002). There are several factors why it is like this in the world company. For manufacturing industry there are manufacturing models that are being used and for the services there are services models that are being used. The basic concept in manufacturing sector to improve the efficiency of the production is by increasing the production output or decreasing the workforce required (Drury, 2008). Whereas the basic concept in the service sector to improve the efficiency of the services is by adding a new worker that improves the value of the service of the company. That is why when new workers want the join any company they may have to do an interview for that company and explain why the company should chose that worker than any of the others and prove he can improve the company’s service. The JIT manufacturing model has been used a lot in manufacturing and has given Japan manufacturing massive success over the last few decades especially for Toyota (Drury, 2008). The JIT...
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