Advancing Quality Improvement Research Challenges and Opportunities: Workshop Summary (2007) / Chapter Skim
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1 Lessons in Quality Improvement
1 Lessons in Quality Improvement
Pages 11-20
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From page 11... ...
NON-HEALTH CARE SERVICE SECTOR Although improving quality requires the use of specific tools, developing these tools and putting them to use is only part of the challenge. As Scot Webster of Medtronic explained, the larger part of improvement is changing culture and driving change.
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From page 12... ...
These three issues -- lead time, external variability, and internal variability -- are important not just in manufacturing, Webster said, but in health care as well. There are a number of tools that can be used to improve quality and focus on the problems of lead time and variability, Webster said.
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From page 13... ...
The third reason Medtronic combined Lean and Six Sigma is because of their ability to form a science out of process. Analyzing processes in order to identify reasons for variability and to determine which processes statistically yield better outcomes requires that data be accumulated about those process, and through Lean Sigma, Medtronic has developed an evidence base that it uses for improvement.
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From page 14... ...
Lean Sigma should be used to support the creativity and experience of health care providers, not as a replacement. INTEGRATED HEALTH CARE DELIVERY SYSTEM As an integrated health care delivery system, Kaiser Permanente has a unique approach to quality improvement, said Scott Young of Kaiser's Care Management Institute.
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From page 15... ...
In particular, these variations can often be linked to missed opportunities to improve quality and -- at the extreme -- to safety issues, close calls, and near misses that occur every day. These safety issues and near misses can often result in poor outcomes and adverse events.
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From page 16... ...
Meeting goals in these four dimensions, Young said, is Kaiser's key to improving the quality of care for patients. The task of improving quality is made possible by support systems available throughout Kaiser, such as its electronic medical record system called KP HealthConnect, care management programs, KP Elder Care Network, and the use of evidence-based medicine.
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From page 17... ...
In 1997, Miller said, Baptist was a place that provided poor quality care and had low employee morale, below-average physician satisfaction, and poor patient satisfaction. When the hospital leadership realized that change was necessary to improve employee satisfaction and to solve financial problems, Baptist began to focus its efforts on the people associated with the system -- the patients and the employees.
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From page 18... ...
Apologizing for mistakes and then learning from them has become a large part of Baptist's culture, Miller added. 1 Baldrigecriteria are: leadership; strategic planning; focus on patients, other customers, and markets; measurement, analysis, and knowledge management; workforce focus; process management; and results (Baldrige National Quality Program, 2007)
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From page 19... ...
Issues that data are collected on include medication errors, falls, pain indicators, and the Centers for Medicare and Medicaid Services indicators, such as discharge instructions for heart failure patients. Interdisciplinary approaches are often required to make improvements, Titler said.
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From page 20... ...
Such tools include statistical process control charts, run charts, and Pareto charts. Other important strategies for improving care include listening to staff, presenting and discussing the evidence base for clinical practices such as fall prevention, and engaging unit-based change champions in process improvement and point-of-care coaching.
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