Insights Tagged as Healthcare

Improvement Insights Blog

Posts tagged "Healthcare"

Climbing Mount Quality

Some people think they have to climb Mount Everest or do a fire walk to overcome their fears. Maybe it’s just as easy to do the thing you are afraid to do in your normal life. Maybe it’s time to climb Mount Quality. Maybe it’s time to create a hassle-free experience for your company’s customers.

  “My wife’s been watching these shows about people climbing Mount Everest. You see people, they’re waiting for the final the final [ascent] and there’s a huge queue of people waiting to go up to the top of Mount Everest… (It’s like [maybe] they should put in an express lane or something!)

Posted by Jay Arthur in Healthcare, Improvement Insights, Lean, Six Sigma.

Quality Is Not a Department

A recent report from NAHQ (National Association of Healthcare Quality) found that three-quarters of hospitals had a quality department. But to achieve hassle-free healthcare and zero harm, it will take more than a department to achieve the results desired.

“The National Association for Healthcare Quality just released a report on Quality professionals in health care, and it turns out that in a lot of the situations, about three-quarters of the people responding reported that in their hospital or wherever, that Quality was a department, and in about a quarter [of the responses] Quality was individuals working on stuff.

“Let me be clear about this: Quality is not a department.

Posted by Jay Arthur in Healthcare, Improvement Insights.

Control Charts for KPIs

Several attendees told me they had ripped out their line charts and started using Control Charts for their KPIs. Here’s why:

“Hi, I’m Jay Arthur, author of “Lean Six Sigma for Hospitals” and the QI Macros [software].

“We were out at the National Association for Healthcare Quality conference; I was speaking and we were exhibiting there. After I spoke, I had a couple people come up to me who said they’d seen me at the previous year’s convention talking about how to improve things and how line [charts] and bar charts can be harming patients and they said, “You know, I went back to my hospital and we ripped out all of our line charts and we put in control charts for all of our key process indicators.

Posted by Jay Arthur in Agile Lean Six Sigma, Healthcare, Improvement Insights, QI Macros, Six Sigma.

Agile Lean Six Sigma Yellow Belt Training for Results

21st Century Quality is changing how companies implement Lean Six Sigma. Here’s how:

“Hi, I’m Jay Arthur, author of “Lean Six Sigma Demystified” and the QI Macros [software].

“Over the last couple of years I’ve been going all of the Quality conferences, and I’ve seen some presentations that I think point us in a useful direction in terms of how to go about implementing Quality and getting results more quickly, and to accelerate, to develop some exponential growth in terms of how we achieve these results.

“About a year and a half ago I was at the Lean Six Sigma conference in Phoenix , and I saw Christus Health, and they talked about how they started out trying to do the traditional “Big Sigma Black Belt / Green Belt” whole thing, but they weren’t getting any results.

Posted by Jay Arthur in Agile Lean Six Sigma, Improvement Insights, Lean, QI Macros, Six Sigma.

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.

jcaqo falls rates data

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.

Dermatology Group Boosts Coding Accuracy from 65.4% to 91.7%

In a matter of months, an NC dermatology group boosted insurance coding accuracy saving $65,000.

While most of the healthcare quality focus is on hospitals, there’s a huge opportunity to make doctor’s offices more effective and efficient. In this case, better coding results in faster payment of insurance claims. Offices can use Lean to reduce patient wait times and increase volume resulting in more revenue and better patient care.

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

Magnet Improvement Posters

Last week, we exhibited at the Magnet conference for nursing quality. Every healthcare quality conference has posters about improvement projects: Magnet, NAHQ, and IHI. What struck me about these posters was the shortage of quality tools like control charts, pareto charts and fishbone diagrams. Those posters using charts often used the incorrect type of chart for the data.

Here’s an example. This chart has so many lines on it, how can you tell what story they are trying to tell?

Injury Falls

Here’s an example using a bar chart (instead of a line graph) and the dates are in reverse order:

Bar Chart

Here’s another bar chart with the dates in the correct order, but again, time series charts like this one should be shown as a line, run or control chart.

Posted by Jay Arthur in Six Sigma.

Surgical Hospital Shut Down

The Denver Post reported that the Colorado Orthopaedic and Surgical Hospital was shut down this week after a patient’s death. What went wrong?

  • Patient was given a a pain killer in too high a dose.
  • Patient was left alone for 15 minutes after receiving the drug.
  • Staff was unfamiliar with the crash cart.
  • The rapid reponse team had trouble reaching the patient’s room.

The nurse involved resigned.
What did the hospital pledge to do? Increase training on emergency response.

All too often, managers think that better training will lead to better results. Unfortunately, employees come and go. Training degrades over time (you lose 90% of what you learn if you don’t use it in 72 hours after training.)

Posted by Jay Arthur in Service, Six Sigma.