Nelson Sustaining Lean in Healthcare

Developing and Engaging Physician Leadership
Erscheinungsjahr 2011
ISBN: 978-1-4398-4028-3
Verlag: Taylor & Francis
Format: PDF
Kopierschutz: 0 - No protection

E-Book, Englisch, 148 Seiten

Among the first books to focus on physician engagement during a Lean effort, Sustaining Lean in Healthcare: Developing and Engaging Physician Leadership explains how to ensure ongoing physician participation long after the consultant leaves. Dr. Michael Nelson, an early adopter of Lean in healthcare, explains how to use these synergic tools to achieve consistently high levels of quality and clinical care outcomes.

The book begins with a Lean primer that provides a firm foundation in essential Lean concepts—including value stream maps, 6S, Kanban, Heijunka, and Gemba Walks. Next, it examines how to create a physician engagement plan and covers the specific responsibilities of physician leadership through the Lean transformation. Explaining what to look for when judging success, it provides numerous examples that demonstrate how to sustain success over the long term.

Complete with tips for spotting the danger signs that might indicate your plan is off course, this book details time-tested techniques and strategies for reducing waste in healthcare. It supplies a methodology for establishing shared expectations of success with your medical team early on in the process, as well as a proven framework for simultaneous Lean deployment across multiple locations.
Praise for the book:

In this book, Dr. Nelson draws on his forty years of medical practice and his experience as an early adopter of Lean for healthcare, to identify a crucial piece to aligning healthcare organizations for success; Physician Engagement. … Healthcare executives and clinicians will appreciate and learn from Dr. Nelson’s insight.
—Robert Iversen, Director, Accenture Management Consulting

…Instead of writing another how-to book, Mike has taken the opportunity to provide insights that are sure to help any healthcare organization sustain the impact of its Lean engagement.
—Rick Malik, Worldwide Director, ValuMetrix® Services, Ortho Clinical Diagnostics

… provides realistic estimates of timelines for projects, expected satisfaction, quality, and financial paybacks, as well as the time commitments required for Lean healthcare initiatives to become durable successes.
—David Mann, PhD, Principal, David Mann Lean Consulting

… simplifies and organizes the steps needed to effectively and successfully take advantage of the significant contributions Lean management can make ….
—Edward D. Martin, MD, Co-Founder and Chairman Emeritus, Martin Blanck & Associates, Inc.

Lean has become a critical predictor of successful systems going forward. Sustaining Lean in Healthcare is the book to get this done.
—Stephen C. Beeson MD, Author of Engaging Physicians, A Manual to Physician Partnership

Zielgruppe

Physicians, Chief Medical Officer and other clinical leaders, hospital and health system executives.

Autoren/Hrsg.

Nelson, Michael

Fachgebiete

• Wirtschaftswissenschaften Wirtschaftssektoren & Branchen Dienstleistungssektor & Branchen
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Krankenhausmanagement, Praxismanagement

Inhaltsverzeichnis

The Basics of Lean
Implementation Phase
Lean Tools for Product and Process Approaches
Value Stream Maps (VSM)
6S
Kanban
Single Piece Flow
A Simple Exercise
Level Loading (Heijunka)
Product Process Flow
Lean Tools for Operator-Focused Approaches
Full Work Analysis
Standard Work
Sustainment Phase
Visual Controls
Huddles
Assessment (Audits)
Gemba Walks
Culture Change
Improvement Model
What Are We Trying to Accomplish?
How Will We Know That a Change Is an Improvement?
What Changes Can We Make That Will Result in an Improvement?
Plan
Do
Study
Act
Kaizen

Lean and Physician Culture
Clinical Decision Making and the PDSA Cycle

Creating a Physician Engagement Plan
A Bit of History
Elements of a Physician Engagement Plan
Vision and Goals
Selection and Development of Physician Champions
Reward and Recognition Plan
Approach to and Engagement with Frontline Physicians
The Physicians’ Role in Sustaining Improvements and Maintaining the Lean Culture

The Senior Leader’s Role
Success Starts at the Top
Leadership Is More Important Than Tools
The Senior Leader’s Role
Important Duties of a Leader
Create the Vision—Determine the Right Destination before You Start the Journey
Selecting the Right People
Provide Resources and Invest in Infrastructure
Executive and Champion Role Definition and Training
Frequent and Clear Communication
Strategic Alignment
Deployment Plan
Establish Measures for Success
Project Spread and Sustainability
Summary—Active Leadership Is Essential to Effective Deployment

Analysis and Preparation
Business Needs Assessment and Operational Impact
Lean Resources
Likelihood of Financial, Quality, or Satisfaction Improvements
Resources
Leadership
Desire to Improve
Architecture
Readiness
Preparation Phase
Stakeholder Analysis

Setting Expectations
Criteria for Intervention
Who
How

Physician Case Studies
Discussion
Scenario #1
Scenario #2
Scenario #3
Scenario #4
Scenario #5
Scenario #6
Scenario #7
Scenario #8

Keys to Sustaining Lean—A Physician Guide

Judging Lean Success The Process
Financial Success
A Balanced Approach
Tollgates
In-Person Monitoring
Scorecards
A Case Study

Sustaining
Lean Work
Improvement Work
Monitoring
Communications
Standardization
Summary

Pre-Implementation Tools and Approaches
Site Lean Team Selection: Roles and Responsibilities
The Site Team
Purpose of Site Team
Characteristics of Site Team Leaders and Members
Identifying Site Team Leaders
Pre-Implementation Checklist

Implementation Tools and Approaches
Typical Implementation Timeline
Gemba Walks
Cross-Training Matrix

Glossary
Index
Each chapter includes References

Über Autor(innen)

Michael Nelson, MD spent 28 years practicing pediatrics while building the practice from a solo physician office to seven pediatricians. He has served as a hospital medical staff president and in various medical director positions. For the last 13 years, he has devoted increasingly greater time to quality improvement in healthcare. For the last 5 years of employment with Presbyterian Healthcare Services, he worked full time in quality improvement and became a certified Lean Six Sigma Black Belt. He was a physician leader for Lean Systems implementation at Presbyterian.

He is credited with:

- Creating a health and chronic disease management system resulting in national benchmark performance in diabetes care

- Developing a curriculum and teaching more than 200 clinicians and senior leaders advanced tools and techniques in quality improvement

- Implementing elements of the advanced medical home

- Creating a patient-centered care environment through the creation of patient and family advisory councils in PMG clinics

- Leading and supporting successful Lean implementations resulting in dramatic improvements in ambulatory clinics and inpatient settings

He currently owns a Lean consulting business, Blue Corn Professional Services, LLC, and is a physician coach for the Studer Group.