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Aids to deliver the RIGHT care for EVERY patient, EVERY time.
Susan BrownQuality Manager
Quality Tools at MSHA…
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Quality and Patient Safety
Patient SafetyQuality
(PI)
Corporate Director
Quality Manager
Improvement Advisors
Quality Manager
Improvement Advisors
Infection PreventionReporting
Quality & Patient Safety
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Plan
Do
Check
Act
MSHA Business Model and Improvement Methodology
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• 5 Whys• SIPOC• RCA• FMEA• Process Mapping• Cost Benefit Analysis
MSHA Framework
Facility Team
Facility Team
Facility Team
Facility Team
Facility Team
Facility Team
Facility Team
PDCA Toolkit
Lean Tools• 5S – Visual Management• VSM• Spaghetti Diagrams• Check sheets• Pareto Analysis• Brainstorming• Kanban-Trigger Systems• Mistake Proofing• Standardization
Six Sigma Methodology
Approaches
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Why Lean and 6σ?
• Quality issues in healthcare– Estimate of annual US MEDICAL errors
• 974,000 patient injured• 44-98,000 patient deaths• $17-29 billion in costs
– Estimate of preventable MEDICATION errors• 185,000 patients• 7,000 deaths• $2 billion in costs
– Estimate of Central-Line Infections• 250,000 patients• 30-62,000 deaths• $6.25 billion in costs
Spear, HBR, 2005
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Why Lean and 6σ?
• Healthcare across the US:– Increasing DEMAND
• Record # Emergency Department visits• Avg. time in ED = 4 hours• Excessive holds in ED• Diversion
– Margin EROSION• Declining reimbursements• Rising costs
– Employee TURNOVER• Almost 1 in 5• Extremely costly• Burnout factors
Spear, HBR, 2005
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Training and Development
• Recognizing need for standardization and reducing variation– UTK Center for Executive Education, Lean Healthcare program
• 1 week• Classroom and simulation education• Toyota Production System
– On-going internal training/education• Departmental – Development Ladder
– Novice– Apprentice– Practitioner– Expert
• Project
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Common Terminology
• Defining CUSTOMER• Defining VALUE• Defining Waste (non-Value)
– Overproduction– Motion– Inventory– Over-processing– Waiting – Defects/Rework– Transportation
• Understanding that everything is a process
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Examples of Tools in Action
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Before After
Visual Signals/Indicators
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What are the differences between healthcare and manufacturing?
• Tool application– No differences…
• Challenges– Healthcare cannot stop– Every patient is unique– Predictability
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• Questions/Comments