Patient Safety and Quality Improvement PART 2 Diamse Campecino
Patient Safety and Quality Improvement PART 2 Diamse Campecino
Patient Safety and Quality Improvement PART 2 Diamse Campecino
Act Plan
testing ideas
before
Study Do implementing
changes
“Six Sigma”
•In statistics, a ‘sigma’ refers to the standard deviation from the
mean of a population
•Std Dev describes the likelihood of your next data point deviating
form the mean of the whole data set
•Six Sigma is all about variance reduction
•Variance is a symptom of waste
•High variance means lots of waste (low sigma)
*Leveraging Lean in Healthcare: Transforming Your Enterprise into a High Quality Patient Care Delivery System: Charles Protzman, George Mayzell, Joyce KerpcharAuerbach Publication: 2011
Continuous
Gemba Improvement
The starting place
for finding value Eliminating
waste
What is
LEAN
The thinking? The
5 S’s 7 W’s
Process / Developing
Flow an Eye
Mapping For Waste
5 S:
Sort, Set in Order, Shine, Standardize, Systematize
• 5 S: an organized, never ending, effort to
•Remove all physical waste out of the workplace that is not required
for doing work in that area
•Setting things in order
•Identify, label, allocate a place to store it so that it can be easily
found, retrieved and put away
Process Mapping: Current State to Future State
Not enough
Patient Patient Escorts Patient
Clerk requests Patient escorted to Arrives at
Arrives at Yes
ID + medical Pre- Outpatient Outpatient
Registration registered?
card Radiology Radiology
Desk
Not enough No
Registrars
Clerk
Registrar enters
assigns patient
patient to information into
Registrar system
Patient
Patient Clerk/Registrar Patient information Arrives at
Arrives at requests ID + scanned into Outpatient
Registration medical card System and Verified Radiology
Desk
Potential Solutions:
Cross train clerks/registrars
Card Reader + IT Integration into registration system
Move Radiology Clerk Station Closer to Radiology
Better Signs and Directions from registration to Radiology
The Cause-And-Effect Diagram
Used to systematically analyze the special causes of a problem. It begins with
major causes and works backwards to the root causes. It organizes the results
of the brainstorm. Also known as the fish-bone diagram and the Ishikawa
diagram (named after its inventor, Dr. Kaoru Ishikawa of Japan)
MAJOR CAUSE 1 MAJOR CAUSE 2 MAJOR CAUSE 3
Common Categories of Major Causes
(5Ms + E):
• Man (People)
THE EFFECT • Methods (Policies and Procedures)
(The Problem) • Materials (Supplies)
• Machine (Equipment)
• Money
• Environment
MAJOR CAUSE 4 MAJOR CAUSE 5
Evaluation of Board’s
Quality/Pt. Safety Role/Responsibility
1.Do high-quality hospital have better management
practices than low-quality hospitals?
•How:
•Attention to Quality by Board Time spent (~25%) monitoring Quality: tracking effective use
of Board approved Metrics
•Result: Effective Board governance improves a hospital’s overall
performance – not just on Quality!
◦
Tsai, Jha, Gawande, Huckman, Bloom and Sadun. “Hospital Board and Management Practices Are Strongly Related to Hospital Performance on Clinical
Quality Metrics.” Health Affairs, 34 (8) (2015): 1304-1311.
“Board” Role in PS/QI