Latest "healthcare" Posts

Celebrate Nurses Week 2018

To commemorate Nurses Week 2018, Jay speaks with LeAnn Thieman, author of “Chicken Soup for the Nurses Soul” and the founder of SelfCare for HealthCare.



Posted by Jay Arthur in healthcare, Improvement Insights, Jay Arthur Blog.

Reducing Patient Falls – A Case Study

The Joint Commission Journal on Quality and Patient Safety (Feb 2018) has an article entitled “Temporal Trends in Fall Rates with the Implementation of a Multifaceted Fall Prevention Program.” Ouch!

I believe the story could have been told easily with quality improvement tools, so here’s how I’d go about it. First, there are a number of tables (i.e., spreadsheets of performance data) like the one below.

The first year, 2003, had only 200 falls because they started measuring in July. The first full year of measurement was 2004.

It would be easy to turn these into control charts, but the authors chose a boxplot with a trend line of predicted falls.

Posted by Jay Arthur in healthcare, Jay Arthur Blog, QI Macros, Six Sigma.

Hospital Costs a “Hungry Tapeworm on U.S. Economy” says Warren Buffett

I have been thinking for some time that someone would come along, start buying up hospitals and forcing them to adopt the Lean principles of Amazon and Six Sigma to achieve the “science and evidence” that Don Berwick has been challenging the IHI to adopt.

Warren Buffet has the money, but usually invests in “well-run” companies, not ones in trouble. An estimated half of all hospitals are in financial trouble (often because of the lack of Lean Six Sigma).

Bezos and Amazon have the operational efficiency needed in virtually all healthcare environments.

Dimon has a big bank.

They are all worried about the quality of healthcare and the rising costs.

Posted by Jay Arthur in healthcare, Lean, QI Macros, Six Sigma.

Leveraging Healthcare IT Systems Data for Improvement

The November-December 2017 Harvard Business Review has an article about leveraging healthcare data. Authors describe healthcare productivity growth as anemic. While most healthcare organizations are using the data to monitor performance, few are using it to analyze how processes and protocols can be improved.

Solution: Use IT to transform the way you deliver medical care, “prioritizing quality improvement over cost cutting. Improving clinical work processes can achieve both lower costs and higher quality.

Virtually all IT systems from electronic healthcare records to billing systems allow exporting data to Excel. From there, QI Macros Data Mining Wizard will find every viable improvement project in the data.

Posted by Jay Arthur in healthcare, QI Macros, Six Sigma.

Mistakes Companies Make In Voice Mail Messages

What does your voicemail message say about your company?

Here’s a look at what can go wrong.

Posted by Jay Arthur in healthcare, Improvement Insights, Six Sigma.

Why We Wait in Emergency Rooms (ER)

A study of 90,000 patients reported in the November-December 2017 HBR found that as patient volume increases, some ER doctors favored easier cases to feel more productive. This is known as task completion bias: “we gravitate toward easy-to-finish tasks to create a sense of accomplishment – even if those tasks aren’t very important.”

The study found that ER doctors favoring easier cases were significantly less productive than their peers.

Posted by Jay Arthur in healthcare, Lean, QI Macros.

Are We Teaching Students the Unnecessary Things?

I’m here at the IISE (Institute of Industrial and Systems Engineers) conference in Pittsburgh.

One professor had been teaching students how to use Excel to create control charts, but he was beginning to feel like that was a waste of classroom time (duh!).

I beat him up a little for teaching DIY Excel stuff to students. If the professor does it, they think that’s how it’s done. With QI Macros he can get them right into analysis.

I feel the same way at ASA (American Statistical Association) when they use “R” to do statistics. Sure it’s free, but should statisticians be programming in “R” or just using software to achieve the same result.

Posted by Jay Arthur in healthcare, Lean, Manufacturing, Service, Six Sigma, Statistics.

Top Leaders Deliver Reliably

May-June 2017 HBR discusses the results of a 10-year study of what makes CEOs great.

Of the four traits, number 4, Delivering Reliably, was found to be the most powerful of the four essential behaviors. Reliable CEOs were 15 times more likely to succeed.

I have found that one of the most effective ways to deliver reliably is to use Lean Six Sigma to simplify, streamline and optimize performance.

Posted by Jay Arthur in healthcare, Lean, Manufacturing, Service, Six Sigma.

Lean Insights from “The Founder” Movie

Early in the movie, the McDonald’s brothers describe how they came up with the concept for speedy service. It’s Lean.

They had too many menu items, so they decide to simplify down to burgers, fries and soft drinks. (Think Lean inventory.)

They go to a tennis court and use chalk to lay out a possible floor plan to deliver service fast. One brother stands on a ladder watching while the employees pantomime cooking burgers, fries and soft drinks.

They go through several iterations to converge on their final design. (Think value stream mapping and spaghetti diagramming.)
I think they might have done it faster with cardboard boxes, but I wasn’t there.

Posted by Jay Arthur in healthcare, Lean, Manufacturing, Service.

Quality Tool Usage at IHI 2016 Poster Presentations

I’ve been monitoring the use of quality tools at the Institute for Healthcare Improvement conference for over a decade. This year there was a slight uptick in the use of control charts, but still far below my expectations.


How can healthcare hope to achieve and sustain improvements without control charts?

There were over 500 posters, but too many had no charts at all.

I was there in 2006 when Don Berwick asked every attendee to commit to using science and evidence. I was there in 2015 when he repeated the request, asking for control charts, Pareto charts and histograms of performance improvement.

Posted by Jay Arthur in healthcare, QI Macros, Six Sigma.