Process improvement techniques are now widely deployed in many organizations to significantly improve performance; Ler 11 reviews the tools of process improvement and demonstrates their use in improving patient flow. Scheduling and capacity management continue to be major concerns for most healthcare delivery organizations, particularly with the advent of advanced. Specifically, the chapter demonstrates how simulation can be used to optimize scheduling. Chapter13 explores the optimal methods for acquiring supplies and maintaining appropriate inventory levels.
Chapter 14 outlines a systems approach to improving financial results, with a spe cial emphasis on cost reduction—one of today's most important challenges. The chapter also provides a detailed algorithm that helps practitioners select the appropriate tools, methods, and techniques to effect significant operational improvements. It demonstrates how our fictionalized case study healthcare system, Vincent Valley Hospital and Health System VVH , uses all the tools presented in the book to achieve operational excellence.
In this way, a future is envisioned in which many of the tools and methods contained in the book are widely deployed in the US healthcare system Vincent Valley Hospital and Health System Woven throughout the chapters are examples featuring VVH, a fictitious but realistic health system. The companion website contains an expansive description of WH; here we provide some essential details.
WH is located in a midwestern city with a population of 1. The health system employs 5, staff members, operates inpatient beds, and has a medical staff of physicians. It operates nine clinics staffed by physicians who are employees of the system.
VVH competes with two major hospitals and an inde. The VVH brand includes an accountable care organization to reflect the in creased emphasis it has placed on population health in its community. The organi zation also is working to create a Medicare Advantage plan. It has significantly restructured its primary care delivery segment and has contracted with a variety of retail clinics to supplement the traditional office-based primary care physicians with whom it is affiliated.
It recently added an online diagnosis and treatment service, with hour telehealth now available. Three major health plans provide most of the private payment to WH, which, along with the state Medicaid system, have recently begun a pay-for-performance reimbursement initiative.
VVH has a strong balance sheet and a profit margin of approximately 2 percent, but its senior leaders feel the organization is financially challenged. The board of VVH includes many local industry leaders, who have asked the chief executive to focus on using the operational techniques that have led them to succeed in their own businesses.
On the web at ache. The reader is expected to understand all the concepts in the book and in current use in the field and be able to apply, at the basic level, most of the tools, techniques, and programs presented. The reader is not expected to execute at the more advanced eg. Although simulation is a valuable tool in many industries, it is not used widely in healthcare, so the chapter was eliminated, with some of the principles of simulation moved to chapter We hope the industry embraces this tool in the future—and then we will bring this chapter back.
Discussion Questions 3. Workshop Summary. Accessed August 8, Joshi, M. Ransom, D. Nash, and S. Chicago: Health Administration Press. Landrigan, C. Parry, C. Bones, A. Hackbarth, D. Goldmann, and P. Home page. Ransom, S. Joshi, and D. Nash eds. Kinsman, E. James, A. Machotta, H. Gothe, J. Willis, P. Snow, andJ Kugler. Senge, P. New York: Doubleday. Futurescan: Healthcare Trends and Implications Several of the tools, techniques, and philosophies outlined in this text are based in past efforts.
Although the terminology has changed, many of the core concepts remain the same. In response to the outcry, the British government commissioned Flor nce Nightingale, now widely recognized as a pioneer in nursin practice, to oversee the introduction of nurses to military hospitals and to improve conditions in the hospitals.
When Ni ingale arrived in Scutari, Turkey, she found the military hospital there overcrowded and filthy. She instituted many changes to improve the sanitary conditions in the hospital, and many lives were saved as a result of these reforms.
Ni ghtingale was among the first healthcare professionals to collect, tabulate interpret, and graphically display data related to the impact of process chang: on care outcomes— what is known today as evidence-based medicine. To quantify the overcrowding problem, she compared the average amount of space per patient in London hospitals—1, square feet—to the space in Scutari—about square feet.
She developed a standardized document, the Model Hospital Statistical Form to enable the collection of consistent data for analysis and comparison. In February , the patient mortality rate at the military hospital in Scutari was 42 percent. As a result of Nigl ingale's chai s, by June of that year the mortality rate had decreased to 2.
To present these data in a persuasive manner, she developed a new type of graphic display, the polar area diagram. The diagram was a pie chart with a monthly slice for mortality numbers and their causes displayed in a different color. The real enemies were cholera, typhus, and dysentery. Althot the British military hierarchy was resistant to her changes, the data were convincing and resulted in reforms to military hospitals and the establishment of the Royal Commission on the Health of the Army Were she alive today, Nightingale would reco; jize many of the philosophies.
Background The healthcare industry faces many challenges. The costs of care and level of ser vices delivered are increasing; even as the population ages, we are able to prolong lives to an ever greater extent as technology advances and expertise grows. The expectation of quality care with zero defects, or failures in care, is being pursued by government and other stakeholders, driving the need for healthcare providers to produce more of a high-quality product or service at a reduced cost.
This need can only be met through improved utilization of resources. Specifically, providers must offer their services more effectively and efficiently than at any time in the past by optimizing their use of limited financial assets, employees and staff, machines and facilities, and time.
Enter operations management. Operations management is the design, implementation, and improvement of the processes and systems that create and deliver the organization's products and services.
Operations managers plan and control delivery processes and systems within the organization. Forward-thinking healthcare leaders and professionals have realized that the theories, tools, and techniques of operations management, if properly applied, can enable their organizations to become efficient and effective care delivery environ: ments.
However, for many of the aims identified by the US healthcare system to be achieved, essentially all healthcare providers must adopt these tools and tech: niques, many of which have enabled other service industries and manufacturing sectors to improve efficiency and effectiveness. The operations management information presented in this book should similarly enable hospitals and other healthcare organizations to design systems, processes, products, and services that meet the needs of their stakeholders.
Importantly, it should also allow continuous im: provement in these systems and services to keep pace with the quickly changing healthcare landscape. To improve systems and processes, however, one must first know the system or process and its desired inputs and outputs. Knowledge-Based Management 2. This book takes a systems view of service provision and delivery, as illustrated in exhibit 2. The improvement in computer systems and new analytical approaches support the increased use of KBM, especially in terms of building a knowledge hierarchy.
As illustrated in exhibit 2. Data that are organized or processed to have meaning. Information can be useful, but it is not necessarily useful. It can answer such questions as who, what, where, and when—in other words, know what.
Information that is deliberately useful. Knowledge enables decision making—know how. A mental frame that allows use of what is known and en ables the development of new knowledge. Understanding represents the difference between learning and memorizing—know why. A high-level stage that adds moral and ethical views to under standing. Wisdom answers questions to which there is no known correct answer and, in some cases, to which there will never be a known correct answet—know right.
A simple example may help explain this hierarchy. Say your height is 67 inch es and your weight is pounds data. You have a body mass index BMI of A healthy BMI is Your BMI is high, and to be healthy you should lower it understanding.
You begin a diet and exercise program and lower your BMI wisdom Finnie , 24 summarizes the relationships in the hierarchy and notes our tendency to focus on its less important levels We talk about the accumulation of information, but we fail to distinguish be tween data, information, knowledge, understanding, and wisdom. In the past, our focus has been inversely related to importance. We have focused mainly on data and information, a little bit on knowledge, nothing on understanding, and virtually less than nothing on wisdom.
Information Dota A" rdsionsips Learning 1. Symbols or raw numbers that simply exist; they have no structure or organization.
Entities collect data with their computer systems; indi: viduals collect data through their experiences. At this stage of the hierarchy, one can presume to know nothing because raw data alone are not adequate for decision making Knowledge hierarchy The foundation of knowledge-based management, composed of five categories of learning: data, information, knowledge, understanding, and wisdom.
Knowledge Through the Ages The roots of the knowledge hierarchy can be traced to eighteenth-century philosopher Immanuel Kant, much of whose work attempted to address the questions of what and how we can know. The two major philosophical movements that significantly influenced Kant were empiricism and rationalism McCormick The empiricists, most notably John Locke, argued that human knowledge originates in one's experiences.
According to Locke, the mind is a blank slate that fills with ideas through its interaction with the world. The rationalists, including Descartes and Galileo, argued that the world is knowable through an analysis of ideas and logical reasoning. Both the empiricists and the rationalists viewed the mind as passive, either by receiving ideas onto a blank slate or because it possesses innate ideas that can be logically analyzed, Kant joined these philosophical ideologies by arguing that experience leads to knowing only if the mind provides a structure for those experiences.
Although the idea that the rational mind plays a role in defining reality is now common, in Kant's time this was a major insight into what and how we know. The intent of this text is to enable readers to gain knowledge.
We discuss tools and techniques that allow the application of logical reasoning to data toward obtaining knowledge and using it to make decisions.
This knowledge and understanding should help the reader provide healthcare in an efficient and effective manner. History of Scientific Management Frederick Taylor whose work is covered in more detail later in the chapter origi nated the term scientific management in The Principles of Scientific Management Taylor Today, the term scientific management has been replaced with operations management, but the concept is similar: Study the process or system and determine ways to optimize it to achieve improved efficiency and effectiveness Scientific management A disciplined approach to studying a system or process and then using data to optimize it to achieve improved efficiency and effectiveness.
Mass Production The Industrial Revolution and mass production set the stage for much of Taylor's, work. Prior to the Industrial Revolution, individual craftsmen performed all tasks necessary to produce a good using their own tools and procedures.
In the eighteenth century, Adam Smith advocated for the division of labor—increasing work efficiency through specialization. To support a division of labor, a large number of, workers are brought together, and each performs a specific task related to the production of a good. Thus, the factory system of mass production was born, and Henty Ford's assembly line eventually emerged, making industrial conditions ripe for Taylor to introduce scientific management.
After the intro: duction of the assembly line, this time was reduced to 93 minutes Bellis The standardization of products and work ushered in by the assembly line not only led to a reduction in the time needed to produce cars but also significantly reduced the costs of production. The Venetian Arsenal of the s employed 16, people and produced nearly one ship every day NationMaster.
Ships were mass produced using premanufactured, standardized parts on a floating assembly line Schmenner , One of the first examples of mass production in the healthcare industry is Shouldice Hospital Heskett Higher volumes of cases often result in better outcomes Halm, Lee, and Chassin Specifically, the additional practice associated with higher volume results in better outcomes.
The introduction to The Principles of Scientific Management Taylor illustrates his intent: [Our larger wastes of human effort, which go on every day through such of our acts as are blundering, ill-directed, or inefficient, and which Mr. This paper has been written First. To point out, through a series of simple illustrations, the great loss which the whole country is suffering through inefficiency in almost all of our daily acts.
To try to convince the reader that the remedy for this inefficiency lies in systematic management, rather than in searching for some unusual or extraordinary man [referring to the so-called great man theory prevalent at the time].
To prove that the best management is a true science, resting upon clearly defined laws, rules, and principles, as a foundation. And further to show that the fundamental principles of scientific management are applicable to all kinds of human activities, from our simplest individual acts to the work of our great corporations, which call for the most elaborate cooperation. And, briefly, through a series of illustrations, to convince the reader that whenever these principles are correctly applied, results must follow which are truly astounding.
Note that Taylor specifically mentions systems management as opposed to the individual; this is a common theme that we revisit throughout this book. Further, he believed that the underlying causes of soldiering were as follows Taylor : First. The fallacy, which has from time immemorial been almost universal among workmen, that a material increase in the output of each man or each machine in the trade would result in the end in throwing a large number of men out of work. The defective systems of management which are in common use, and which make it necessary for each workman to soldier, or work slowly, in order that he may protect his own best interests.
The inefficient rule-ofthumb methods, which are still almost universal in all trades, and in practicing which our workmen waste a large part of their effort. To eliminate soldiering, Taylor proposed instituting incentive schemes. While at Midvale Steel Company, he used time studies to set daily production quotas. Incentives were paid to those workers who reached their daily goals, and those who did not reach their goals were paid significantly less.
Productivity at Midvale doubled. Not surprisingly, Taylor's ideas produced considerable backlash. The resistance to increasingly popular pay-for-performance programs in healthcare today is analogous to that experienced by Taylor.
For example, while at Bethlehem Steel Corporation, he studied the shoveling of coal. Using time stud: ies and a careful analysis of how the work was performed, he determined that the optimal amount of coal per shovel load was 21 pounds.
Taylor then developed shovels that would hold exactly 21 pounds for each type of coal; workers had previously supplied their own shovels NetMBA. As a result of Taylor's improved methods, able to reduce the number of workers shoveling coal from Taylor's four principles of scientific management are to 1. He also determined could shovel all day Bethlehem Steel was to Nelson develop and standardize work methods on the basis of scientific study, and use these to replace individual rule-of-thumb methods; select, train, and develop workers rather than allowing them to choose their own tasks and train themselves; develop a spirit of cooperation between management and workers to ensure that the scientifically developed work methods are both sustainable and implemented on a continuing basis; and divide work between management and workers so that each has an equal share, where management plans the work and workers perform the work.
Frank, who worked in the construction industry, noticed that no two bricklayers performed their tasks the same way. He believed that bricklaying could be standardized and the one best way determined. He eliminated these motions by developing an adjustable scaffold designed to hold both bricks and mortar Taylor As a result of this and other improvements, Frank Gilbreth reduced the number of motions in bricklaying from 18 to 5 International Work Simplification Institute and raised output from 1, to 2, bricks a day Perkins He applied what he had learned from his bricklaying experiments to other industries and types of work.
In his study of surgical operations, Frank Gilbreth found that doctors spent more time searching for instruments than performing the surgery. He developed a technique still seen in operating rooms today: When the doctor needs an instrument, he extends his hand, palm up, and asks for the instrument, which is then placed in his hand. This technique eliminates searching for the instrument and al: lows the doctor to stay focused on the surgical area, thus reducing surgical time Perkins Frank and Lillian Gilbreth may be more familiarly known as the parents in the book Cheaper by the Dozen Gilbreth and Carey which was made into a movie by the same title in and remade in The Gilbreths incorporated many of their time-saving ideas in their family as well.
For example, they bought just one type of sock for all 12 of their children, thus eliminating time-consuming sorting Scientific Management Today Scientific management fell out of favor during the Depression, partly because of the sense that it dehumanized employees, but mainly because of a general belief in society that productivity improvements resulted in downsizing and increased unemployment.
Not until World War I did scientific management, renamed opera: tions research, see a resurgence of interest. In healthcare today, standardized methods and procedures are used to reduce costs and increase the quality of outcomes.
Specialized equipment has been developed to speed procedures and reduce labor costs. In a sense, we are still searching for the one best way. However, we must heed the lessons of the past. Ifthe tools of operations management are perceived to be dehumanizing or to result in down: sizing by healthcare organizations, their implementation will meet significant resis tance. Project Management The discipline of project management began with the development of the Gantt chart in the early twentieth century.
From this, work, he developed bar graphs to illustrate the duration of project tasks and dis. These Gantt charts were used to help manage large projects, including construction of the Hoover Dam, and proved to be such a powerful tool that they are commonly used today. Although Gantt charts were originally adopted to track large projects, they are not ideal for very large, complicated projects because they do not explicitly show precedence relationships, that is, what tasks need to be completed before other tasks can start.
In the s, two mathematic project scheduling techniques were developed: the program evaluation and review technique PERT and the critical path method CPM.
Both techniques begin by developing a project network show. PERT uses a probability distribution the beta distribution , rather than a point estimate, for the duration of each project, task. The probability of completing the entire project in a given amount of time can then be determined. This technique is most useful for estimating project completion time when task times are uncertain and for evaluating risks to project completion prior to the start of a project.
CPM uses the project network and point estimates of task duration times to determine the critical path through the network, or the sequence of activities that will take the longest to complete.
If any one of the acti ies on the critical path is delayed, the entire project is delayed. This technique is most useful when task times can be esti mated with certainty and is typically used in project management and control.
Although both of these techniques are powerful analytical tools for planning, implementing, controlling, and evaluating a project plan, performing the required calculations by hand is tedious, and use of the techniques was not initially wide.
With the advent of commercially available project management software for personal computers in the late s, use of PERT and CPM increased consid erably. Today, numerous project management software packages are commercially available.
Projects are an integral part of many of the process improvement initiatives found in the healthcare industry. Project management and its tools are needed to ensure that projects related to quality, Lean, and supply chain management are completed in the most effective and timely manner possible.
Program evaluation and review technique PERT A graphic technique to link and analyze all tasks within a project; the resulting graph helps optimize the project's schedule. Critical path method CPM The critical path is the longest course through a graph of linked tasks in a project. The critical path method is used to reduce the total time of a project by decreasing the duration of tasks on the critical path.
Introduction to Quality Any discussion of quality in industry—including healthcare—should begin with those recognized as originators in quality improvement methodology. Here we introduce the individuals credited with developing various quality approaches, and later in the section we discuss some prevailing quality improvement processes. This introductory discussion establishes the background for the in-depth treatment of the concepts throughout the book.
Walter Shewhart IFW. Edwards Deming and Joseph Juran profiled in later subsections are considered the fathers of the quality movement, Walter Shewhart may be seen as its grandfather.
Both Deming and Juran studied under Shewhart, and much of their work was influenced by his ideas. Shewhart believed that managers need certain information to enable them to make scientific, efficient, and economical decisions. He developed statistical process control SPC charts to supply that information Shewhart He also believed that management and production practices need to be continuously eval: uated, and then adopted or rejected on the basis of this evaluation, if an organization hopes to evolve and survive.
Plan-do-check-act PDCA A core process improvement tool with four elements: Plan a change to a proces: enact the change, check to make sure it is working as expected, and act to make sure the change is sustainable. Edwards Deming Deming was an employee of the US government in the s and s, working with statistical sampling techniques.
He became a supporter and student of Shewhart, believing Shewhart's techniques could be useful in nonmanufacturing environments, Deming applied SPC methods to his work at the National Bureau of the Census to improve clerical operations in preparation for the population census. While he was there, the Union of Japanese Scientists and Engineers invited him to lecture on quality control techniques, and Deming brought his message to Japanese executives: Improving quality reduces expenses while increasing productivity and market share.
During the s and s, Deming's ideas were widely known and implemented in Japan, but not in the United States The energy crisis of the s was the turning point. The television documentary If Japan Can Why Can't We?
Much like the Institute of Medicine report To Err Is Human increased awareness of the need for quality in healthcare, this documentary drove US industry's attention to the need for quality in manufacturing. Deming's quality ideas reflected his statistical background, but his experience in their implementation prompted him to expand his approach.
He instructed managers in the two types of variation—special cause, resulting from a change in the system that can be identified or assigned and the problem fixed, and common cause, deriving from the natural differences in the system that cannot be eliminated without changing the system.
Although identifying the common causes of variation is possible, these causes cannot be fixed without the authority and ability to improve the system, for which management is typically responsible.
In the preface to Out of the Crisis, Deming writes: Drastic changes are required. The first step in the transformation is to learn how to change Long term commitment to new learning and new philosophy is required of any management that seeks transformation. The timid and the faint: hearted, and people that expect quick results are doomed to disappointment.
Whilst the introduction of statistical problem solving and quality techniques and computerization and robotization have a part to play, this is not the solution Solving problems, big problems and little problems, will not halt the decline of American industry, nor will expansion in use of computers, gadgets, and robotic machinery, Benefits from massive expansion of new machinery also constitute a vain hope.
Massive immediate expansion in the teaching of statistical methods to production workers is not the answer either, nor wholesale flashes of quality control circles. All these activities make their contribution, but they only prolong the life of the patient, they cannot halt the decline.
Only transformation of management and of Government's relations with industry can halt the decline. Out of the Crisis contains Deming's famous 14 points for management. Although not as well known, he also included an adaptation of the 14 points for med: ical services exhibit 2.
Paul B. Establish constancy of purpose toward service. Specify standards of service for a year hence and forfive years hence. Define the patients whom you are seeking to serve. Constancy of purpose brings innovation. Innovatefor better service. Put resources into maintenance and new aids to production. Decide whom the administrators are responsible to and the means by which they will be held responsible. Translate this constancy of purpose to service to patients and the community.
The board of directors must hold onto the purpose Adopt the new philosophy. We are in a new economic age. We can no lon: ger live with commonly accepted levels of mistakes, materials not suited to the job, people on the job who do not know what the job is and are afraid to ask, failure of management to understand their job, antiquated methods of training on the job, and inadequate and ineffective supervision.
The board must put resources into this new philosophy, with commitment to in-service training. Require statistical evidence of quality of incoming materials, such as pharmaceuticals. Inspection is not the answer. Inspection is too late and is unreliable. Inspection does not produce quality. The quality is already built in and paid for.
Require corrective action, where needed, for all tasks that are performed in the hospital. Institute a rigid program of feedback from patients in regardto their satisfaction with services. Look for evidence of rework or defects and the cost that may accrue.
Deal with vendors that can furnish statistical evidence of control. We must take a clear stand that price of services has no meaning without adequate measure of quality. Without such a stand for rigorous mea: Sures of quality, business drifts to the lowest bidder, low quality and high cost being the inevitable result. Requirement of suitable measures of quality will, in all likelihood, require us to reduce the number of vendors.
We must work with vendors so that we understand the procedures that they use to achieve reduced numbers of defects.
Improve constantly and forever the system of production and service. Restructure training, 2. Develop the concept of tutors. Develop increased in-service education. Teach employees methods of statistical control on the job. Provide operational definitions of al jobs. Provide training until the learner's work reaches the state of statisti eal control, Improve supervision. Supervision is the responsibility of the management.
Supervisors need time to help people on the job. Supervisors need to find ways to translate the constancy of purpose to the individual employee. Supervisors must be trained in simple statistical methods with the aim to detect and eliminate special causes of mistakes and rework 4.
Focus supervisory time on people who are out of statistical controt and not those who are low performers. Ifthe members of a group are in fact in statistical control, there will be some low performers and some high performers.
Teach supervisors how to use the results of surveys of patients. Drive out fear. We must break down the class distinctions between types of workers within the organization — physicians, nonphysicians, clinical providers versus nonclinical providers, physician to physician. Discontinue gossip. Cease to blame employees for problems of the system. Management should be held responsible for faults of the system. People need to feel secure to make suggestions.
Management must follow through on suggestions. People on the job cannot work effectively ifthey dare not offer suggestions for simplification and improvement of the system. One way would be to encour9. Break down barriers between departments. Eliminate numerical goals, slogans, and posters imploring people to do better. Instead, display accomplishments of the management in respect to helping employees improve their performance. Work standards must produce quality, not mere quantity.
It is better to take aim at rework, error, and defects. Bring statisticaltechniques down to the level of the individual employee's job, and help him to gather information about the nature of his job in a systematic way. Institute a vigorous program for retraining people in new skills. Pmbok 11th Edition Free Download Pdf If what you're looking for is where you can download pmbok 11th edition free download pdf book of The pmbok The Lazy Project Manager pdf The lazy project manager pdf is a very intriguing book that anyone will find very interesting.
A good number Pmp Project Management Professional Exam Study Guide pdf Do you happen to have been searching for a place where you can download pmp project management professional exam study Standard For Program Management 4th Edition pdf If you are not sure which site let you download standard for program management 4th edition pdf books for free, Have you seriously been searching online for where you can download technical Stocks For The Long Run 5th Edition If all you mostly do is constantly search online for a site where you can download stocks for the long Stock Trading EBook The free PDF version of stock trading book can be gotten seamlessly, thanks to this online library that has consistently The Psychology Of Investing Pdf Well if you need where you can download this the psychology of investing PDF free, alongside several finance investment books Packed with The Encyclopedia Of Operations Management Pdf Want to learn the art and science of operation management, then look no further than the encyclopedia of operations management book, this The Linda Raschke The ability to use analytics effectively is a critical skill for anyone involved in the study or practice of health services administration.
This book provides a comprehensive set of methods spanning tactical, operational, and strategic decision making and analysis for both current and future health care administrators.
Learn critical analytics and decision support techniques specific to health care administration Increase efficiency and effectiveness in problem-solving and decision support Locate appropriate data in different commonly-used hospital information systems Conduct analyses, simulations, productivity measurements, scheduling, and more From statistical techniques like multiple regression, decision-tree analysis, queuing and simulation, to field-specific applications including surgical suite scheduling, roster management, quality monitoring, and more, analytics play a central role in health care administration.
Analytics and Decision Support in Health Care Operations provides essential guidance on these critical skills that every professional needs. By one estimate, the U. Replete with examples, this bookshows how to diagram hospital flows, trace interconnections, and optimize flows for better performance. Readers will find specific guidance on improving emergency departments, operating rooms, hospital floors, and diagnostic units; and successfully applying metrics.
Coverage includes: reducing ER overcrowding and enhancing patient safety…improving OR scheduling, enhancing organizational learning, and responding to surgeons and other stakeholders… improving bed availability, optimizing nurse schedules, and creating more seamless patient handoffs… reducing lab turnaround time, improving imaging responsiveness, and decreasing lab errors…successfully applying the right metrics for every facet of hospital performance. The authors conclude by previewing the "Hospital of the Future," addressing issues ranging from prevention and self-care to the evolution of technology and evidence-based medicine.
The SAGE Course Companion on Operations Management is an accessible introduction to the subject that will help readers to extend their understanding of key concepts and enhance their thinking skills in line with course requirements. It provides support on how to revise for exams and prepare for and write assessed pieces. Readers are encouraged not only to think like an operations manager but also to think about the subject critically.
Describes how to build a competitive edge by developing superior operations This comprehensive, practice-oriented text illustrates how healthcare organizations can gain a competitive edge through superior operations — and demonstrates how to achieve them. Underscoring the importance of a strategic perspective, the book describes how to attain excellence in the four competitive priorities: quality, cost, delivery, and flexibility.
The competitive priorities are interrelated, with excellent quality laying the foundation for performance in the other competitive priorities, and with targeted improvement initiatives having synergistic effects. The text stresses the benefits of aligning the entire operations system within the parameters of a business strategy. It equips students with a conceptual mental model of healthcare operations in which all concepts and tools fit together logically. It describes how to negotiate the different perspectives of clinicians and administrators by offering a common platform for building competitive advantage.
To bring the cultural context of a healthcare organization to life, the book engages students with a series of short vignettes of a fictitious healthcare organization as it strives to achieve the status of a highly reliable organization. Integrated throughout are a variety of tools and quantitative techniques with step-by-step instructions to assist in problem solving and process improvements. Also included are mind maps linking competitive priorities and concepts, quick-reference icons, dashboards displaying measurement and process tracking, and boxed features.
Several project ideas, team assignments, and creative thinking exercises are proposed. Key Features: Includes mind maps to connect competitive priorities, concepts, and tools Provides an extensive tool kit for problem solving and process improvements Presents icons throughout the text to emphasize competitive priorities and tool coverage Emphasizes measurement with dashboards and includes data files for statistical process control, queuing, and simulation Demonstrates human dynamics and organizational challenges through realistic vignettes Presents boxed features of frequently asked questions an real-world implementations of concepts Provides comprehensive Instructor Packet and online tutorials.
As the U. In this new system of care, physicians work alongside health care teams, where nurses, pharmacists, and other professionals must collaborate to provide better, more affordable care to many more patients than ever before. This volume provides an important guide to understanding how health professionals fit within the emerging model of healthcare, and serves as a vital resource for readers in health policy management, medicine, public health, and organizational studies.
Physical Assessment for Nurses and Healthcare Professionals offers a practical and comprehensive guide to best clinical practice when taking patient history and physical examination. This accessible text is structured in accordance with the competencies for advanced practice in assessment, diagnosis and treatment as published by the RCN. Following a systematic, systems-based approach to patient assessment, it includes a summary of the key clinical skills needed to develop and improve clinical examination in order to confidently assess, diagnose, plan and provide outstanding care.
In this revised edition, colour photographs and case studies have been included to assist health care practitioners in their assessment of the patient. This important guide: Includes a highly visual colour presentation with photographs and illustrations Features a wide range of key learning points to help guide practice Offers illustrative examples, applications to practice and case studies Written for health care students, newly qualified and advanced nurse practitioners, and those in the allied health professions, Physical Assessment for Nurses and Healthcare Professionals is the essential guide for developing the skills needed to accurately access patient history and physical examination.
In this era of global competition, the demands of customers are growing, and the quest for quality has never been more urgent. Quality has evolved from a concept into a strategy for long-term viability. The third edition of Principles of Total Quality explains this strategy for both the service and manufacturing sectors. This edition addresses the theme of reliability against the backdrop of increasing litigation in the area of product performance.
New chapters also introduce and provide a historical perspective for Six Sigma, and discuss practical applications of the concepts of service excellence within healthcare organizations.
The book also expands its analysis of management of process quality, customer focus and satisfaction, organizing for TQM, control charts for variables, and quality function deployment. How do policy makers and managers square the circle of increasing demand and expectations for the delivery and quality of services against a backdrop of reduced public funding from government and philanthropists?
Leaders, executives and managers are increasingly focusing on service operations improvement. In terms of research, public services are immature within the discipline of operations management, and existing knowledge is limited to government departments and large bureaucratic institutions. Drawing on a range of theory and frameworks, this book develops the research agenda, and knowledge and understanding in public service operations management, addressing the most pressing dilemmas faced by leaders, executives and operations managers in the public services environment.
This will be of interest to researchers, educators and advanced students in public management, service operations management, health service management and public policy studies. This book examines the design of two care pathways to establish how key principles associated with systems thinking, quality improvement, and supply chain management can improve the design of these services.
Including empirical qualitative data collected from two care pathways, it intends to provide organizations with an alternative in order to produce the level and quality of care that is expected by patients.
0コメント