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Walter Schroeder Library, Milwaukee School of Engineering
Item Information
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More by this author
Sindelar, Thomas B.
Subjects
Reengineering (Management)
Medical care -- United States -- Quality control.
Leadership
Medical care -- United States -- Cost control
Medical care -- United States -- Cost effectiveness.
Total quality management -- Case studies.
MSEM Thesis.
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Sindelar, Thomas B.
by title:
Process improvement ...
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Process improvement techniques in healthcare / Thomas B. Sindelar.
by
Sindelar, Thomas B.
Subjects
Reengineering (Management)
Medical care -- United States -- Quality control.
Leadership
Medical care -- United States -- Cost control
Medical care -- United States -- Cost effectiveness.
Total quality management -- Case studies.
MSEM Thesis.
Description:
85 leaves : ill. ; 29 cm.
Contents:
Thesis advisor(s): Dr. Paul Hudec.
Committee members: Curtiss Peck, Dr. John Traxler.
Introduction -- Proposition -- Healthcare in the United States -- Process improvement history -- Process improvement technique keys -- Change -- Process improvement in healthcare -- Case study -- Desired outcomes -- Root cause conclusions -- Recommendations -- Conclusions -- Appendix A- Project meeting notes and action items B- Ideal redesign worksheet.
The healthcare industry in the United States is facing a crisis. Costs continue to rise, access to care continues to get constrained, and quality of care as perceived by patients is not keeping pace with the cost. Many of the efforts utilized in healthcare today attempt to leverage new technology and cost control measures to combat these issues. Many healthcare organizations do not employ systematic process improvement to help combat these issues.
The current state of the healthcare industry is a culmination of over one-hundred years of changes. In the early 1900s, changes began in the use and influence of hospitals in patient care. An increasing number of physicians became specialists versus working in general medicine. As World War II raged on, those that joined the military received health services and treatments not widely available previously. Wages were frozen at this time and groups negotiated for improvements to insurance benefits. In the 1960s Medicare changed healthcare as coverage was now being provided based on age rather than need.
Healthcare costs continue to climb reaching nearly 16 percent of the United States' gross domestic product. The increasing cost of providing healthcare has in turn increased the expenditures of employers and employees at a rate greater than income growth. The current rapid rise in healthcare costs can be tracked in part to productivity not keeping pace with healthcare wage inflation, insurance, risk inherent in the practice of medicine, and the lack of solid information and payment responsibility in the hands of the patients.
Process improvement techniques have been used in manufacturing for years to make advancements in the areas of quality, cost, delivery, safety, and morale. Most of these efforts trace back to Toyota Motor Company in 1945 when they created their Toyota Production System as a method to make productivity and cost improvements to catch up to their American counterparts. Their steady application of such techniques over the years have allowed them to pass Ford Motor as the second largest automobile manufacturer in the world and positioned them to soon overtake General Motors as the largest.
Organizations that successfully utilize process improvement techniques have some common characteristics. These start with strong leadership at the top of an organization lending full support to the improvement efforts. Leaders create and effectively communicate a vision to the entire organization. They also lay out steps and projects for employees to execute that help achieve the vision. Resources are dedicated to the effort with a continuous improvement manager responsible for leading and training the organization in addition to insuring that the processes are correctly followed.
Process improvement tools all follow a similar six step methodololgy which includes identifying the opportunity, understanding the current state, defining the desired outcomes, determine root causes, propose and test solutions, and insure that improvements are sustained.
Managing change is an important aspect to successful process improvement efforts. Keys to managing change include the establishment of a sense of urgency, the creation of a guiding coalition, development of a vision and strategy, communication of the vision, the empowerment of action, the consolation of gain, and the use of early successes to anchor a new approach in the culture.
Healthcare organizations have slowly begun to embrace and utilize process improvement tools. When these efforts are anchored by strong leadership and are allowed to become a part of the business, successes are realized. The general culture of healthcare, given its risks, propensity for litigation, and sometimes just a belief that things are already as good as they can or need to be, tend to prevent results similar to what have been realized in manufacturing.
A case study at healthcare provider organization in a Midwestern state provided first-hand experience in quality improvement efforts in healthcare. The study showed in this healthcare organization that there was no process improvement system, adequate training, management support, clearly communicated vision, process ownership, dedication of resources, and patient input.
Process improvement tools to drive quality improvements in healthcare can be successful. Some important elements of the system are necessary for success to be achieved. This includes the correct leadership, creation and communication of a vision, having a process improvement system, a manager to control the improvement tools and processes, resources dedicated to the improvement projects, and feedback from the patients most directly affected by the process.
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Walter Schroeder Library
Master's Theses
AC805 .S5635 2006
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