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Health Care Improvement By Management Tools

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Health Care Improvement By Management Tools

  3. 3. Health care has significantly changed in last decade. Health care provider are facing competition,consumerism, TPA and Insurance . Healthcare is no longer the prerogative and dictate of the health care professionals. Hospitals are competeting neck to neck to attract customers. Consumers demand quality care at optimum price.
  4. 4. Corporatisation and competition in healthcare sector are forcing healthcare organisations to look for new ways and means for improving their processes. This is for improving quality of the hospital's products and services and reducing patient dissatisfaction . . Several business-management techniques like PDCA , Six Sigma, Balance score card, Lean method, Business process re engineering, Benchmarking are being used to provide quality health care at low cost.
  5. 5. <ul><li>Increased Customer/Patient Satisfaction And Care </li></ul><ul><li>Higher satisfaction. </li></ul><ul><li>Fewer complaints. </li></ul><ul><li>Improved billing. </li></ul><ul><li>Increased prescription accuracy. </li></ul><ul><li>Reduced waiting time. </li></ul><ul><li>Safer and more efficient emergency services. </li></ul><ul><li>Fewer medical errors and defects. </li></ul><ul><li>Increased service orientation. </li></ul><ul><li>Eliminate the 'I don't know' factor. </li></ul>
  6. 6. <ul><li>Increased Physician Satisfaction </li></ul><ul><li>Reduced scheduling delays. </li></ul><ul><li>Fewer physician complaints. </li></ul><ul><li>Improved working condition of clinician and staff . </li></ul>
  7. 7. <ul><li>Reduced Cost & Savings </li></ul><ul><li>Better financial and higher annual savings. </li></ul><ul><li>Optimised materials management chain. </li></ul><ul><li>Less rework and waste. </li></ul><ul><li>Better recruiting and retention power. </li></ul><ul><li>Stronger growth. </li></ul>
  8. 8. <ul><li>The PDCA Cycle </li></ul><ul><li>Six Sigma </li></ul><ul><li>Balance score card </li></ul><ul><li>Lean method </li></ul><ul><li>Business process re engineering/redesigning </li></ul><ul><li>Bench marking </li></ul>
  9. 9. The PDCA Cycle This technique provides a framework for the improvement of a process or system. It can be used to guide the entire improvement project, or to develop specific projects once target improvement areas have been identified .
  10. 10. SIX SIGMA Six Sigma is a management technique that seeks to drive defects to less than 3.4 defects per million. or 99.9997% perfect. Defects are defined as any non-conformance to customer specifications.  Once the causes of defects are identified, processes are modified to avoid the causes. Six Sigma projects normally follow a five-phase improvement
  11. 11. BALANCED SCORE CARD The balanced scorecard is a management system that enables organizations to clarify their vision and strategy and translate them into action. It provides feedback around both the internal business processes and external outcomes in order to continuously improve strategic performance and results.
  12. 13. LEAN SYSTEM The concept called “lean management” or “lean thinking” is most commonly associated with Japanese manufacturing, particularly the Toyota Production System (TPS). Lean means using less to do more. Health care organizations — are composed of a series of processes, intended to create value for those who use or depend on them (customers/patients). The core idea of lean involves determining the value of any given process by distinguishing valueadded steps from non-value-added steps, and eliminating waste (or muda in Japanese) so that ultimately every step adds value to the process..
  13. 14. BUSINESS PROCESS REENGINEERING It is the critical analysis and radical redesign of existing business processes to achieve breakthrough improvements in performance measures.
  14. 15. BENCH MARKING Benchmarking is the the process of identifying, understanding, and, wherever possible, adapting the best practices or techniques used by other organizations that may help your own organization to improve its performance .
  15. 17. Step 1: Identify The Problem Select the problem to be analyzed. Set a measurable goal for the problem solving effort. Clearly define the problem and establish a precise problem statement. Establish a process for coordinating with and gaining approval of leadership PLAN
  16. 18. Step 2: Analyze The Problem Identify the processes that impact the problem and select one List the steps in the process as it currently exists Map the Process Validate the map of the process Identify potential cause of the problem Collect and analyze data related to the problem Verify or revise the original problem statement Identify root causes of the problem Collect additional data if needed to verify root causes
  17. 19. Step 3: Develop Solutions Establish criteria for selecting a solution Generate potential solutions that will address the root causes of the problem Select a solution Gain approval and support for the chosen solution Plan the solution DO
  18. 20. Step 4: Implement a Solution Implement the chosen solution on a trial or pilot basis. If the Problem Solving Process is being used in conjunction with the Continuous Improvement Process, return to Step 6 of the Continuous Improvement Process If the Problem Solving Process is being used as a standalone, continue to Step 5
  19. 21. Step 5: Evaluate The Results Gather data on the solution Analyze the data on the solution Achieved the Desired Goal? What went wrong? What we learned? If YES, go to Step 6. If NO, go back to Step 1. CHECK
  20. 22. Step 6: Standardize The Solution. Identify systemic changes and training needs for full implementation Adopt the solution Plan ongoing monitoring of the solution Continue to look for incremental improvements to refine the solution Look for another improvement opportunity This can be the beginning of the ramp of improvement. ACT
  21. 23. <ul><li>Case studies </li></ul><ul><li>1.PROLONGED POST OPERATIVE STAY </li></ul><ul><li>PLAN: </li></ul><ul><li>IDENTIFY THE PROBLEM </li></ul><ul><li>Comparison of the hospital's length-of-stay data to &quot;best practice&quot; hospitals revealed that 53 percent of the hospital's patients were discharged on or after the seventh post-op day compared to 18 percent for benchmark hospitals </li></ul><ul><li>ANALSE THE PROBLEM </li></ul><ul><li>ANALYSIS revealed that patients with atrial fibrillation stayed more than two days longer than those without . 6.9 days with atrial fibrillation, 4.6 days without. </li></ul><ul><li>That those who did not ambulate also had a two-day difference in length of stay – 6.8 days with no consistent ambulation, 4.8 days with consistent ambulation . </li></ul>
  22. 24. <ul><li>DO: </li></ul><ul><li>DEVELOP THE SOLUTION </li></ul><ul><li>A standard operating procedure related to ambulation of patients was developed and accountability clearly identified. </li></ul><ul><li>A protocol for treating atrial fibrillation was developed . </li></ul><ul><li>IMPLEMENT THE SOLUTION </li></ul><ul><li>Protocols were implemented on pilot basis. </li></ul>
  23. 25. <ul><li>Evaluate The Results </li></ul><ul><li>Gather data on the solution </li></ul><ul><li>Analyze the data on the solution </li></ul><ul><li>Achieved the Desired Goal. The protocol was very effective at reducing post operative stay from 53 to 22 percent at more than 6 days. </li></ul><ul><li>WENT to Step 6. </li></ul>
  24. 26. <ul><li>ACT : </li></ul><ul><li>Standardize The Solution </li></ul><ul><li>The team will continue to monitor performance indicators on post-op length of stay, adherence to the atrial fibrillation protocol and ambulation to make sure that procedures are followed and improvements are sustained. </li></ul>
  25. 27. <ul><li>Case studies-2 </li></ul><ul><li>DELAY IN REPORTING OF LAB REPORT </li></ul><ul><li>PLAN: </li></ul><ul><li>Identify The Problem </li></ul><ul><li>In 200 hundred beded hospital, providing both acute care and emergency services,Physician were complaining that reports from lab are not available in morning round </li></ul><ul><li>Analyze The Problem </li></ul><ul><li>The two biggest drags on the process were the actual delivery of the test ubes to the lab and their analysis. </li></ul><ul><li>The phlebotomist would collect10 to 15 patient samples and return to the lab with a basketof tubes all at once. </li></ul>
  26. 28. <ul><li>DO: </li></ul><ul><li>Develop Solutions </li></ul><ul><li>simple solution: Designate a “runner” to </li></ul><ul><li>bring test tubes from the floor to the lab every 15 minutes . </li></ul><ul><li>Implement a Solution </li></ul><ul><li>Implement the chosen solution on a trial or pilot basis. </li></ul>
  27. 29. <ul><li>CHECK </li></ul><ul><li>Evaluate The Results </li></ul><ul><li>Sampleof 920 blood results delivered before the redesign, 68% reached theappropriate doctors by required time. </li></ul><ul><li>Sample of 1,020 results using thenew process, the percentage delivered by the required time increased to 98%. </li></ul><ul><li>ACT </li></ul><ul><li>Standardize The Solution. </li></ul><ul><li>Plan ongoing monitoring of the solution. </li></ul><ul><li>Continue to look for incremental improvements to refine the solution </li></ul><ul><li>. </li></ul>
  28. 30. <ul><li>CASE STUDIES:3 </li></ul><ul><li>PLAN </li></ul><ul><li>IDENTIFY PROBLEM : </li></ul><ul><li>Delay in reporting of USG Report. </li></ul><ul><li>ANALYSE THE PROBLEM : </li></ul><ul><li>Bladder not full. </li></ul><ul><li>Patient not informed of the prior preparation. </li></ul><ul><li>Number of people waiting are more. </li></ul><ul><li>Doctors not available </li></ul><ul><li>No proper scheduling of In Patient and Out Patient </li></ul><ul><li>No allocation of work load </li></ul>
  29. 31. <ul><li>DO: </li></ul><ul><li>DEVELOP SOLUTION: </li></ul><ul><li>Developing a leaflet which would explain the prerequisite of the procedure. </li></ul><ul><li>Scheduling all the In Patient cases requiring fasting in the morning before 9.30 am and the other In Patient cases along with Out Patient cases in the afternoon to avoid waiting time. </li></ul><ul><li>Scheduling the doctors to ensure at least two doctors are made available at any point of time. </li></ul><ul><li>Reorganizing of the reporting procedure to make available the reports within 45 minutes of completion of the procedure. </li></ul><ul><li>IMPLEMENT THE SOLUTION </li></ul>
  30. 32. CHECK Evaluate The Results Result depicts the reduction of the waiting time and reporting time and with increase in the efficiency levels to 98% 35.6 12.9 34.2 After NA 14.8 49.7 Before Reporting  Time(minutes Procedure Time(minutes) Waiting Time(minutes) IMPLEMENTATION OF PDCA
  31. 33. Problem: Post-operative surgical infection is a major cause of patient injury, mortality and healthcare cost. USE OF PDCA Case studies-4 93% 50% Redose After 240 Minutes 94% 32% Right Antibiotic Administered 88% 14% Antibiotic Given Within 60 Minutes After Before Procedure
  32. 34. THANK YOU