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E-grāmata: Sustaining Lean in Healthcare: Developing and Engaging Physician Leadership

  • Formāts: 148 pages
  • Izdošanas datums: 18-Sep-2018
  • Izdevniecība: CRC Press Inc
  • Valoda: eng
  • ISBN-13: 9781040083833
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  • Formāts: 148 pages
  • Izdošanas datums: 18-Sep-2018
  • Izdevniecība: CRC Press Inc
  • Valoda: eng
  • ISBN-13: 9781040083833

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Among the first books to focus on physician engagement during a Lean effort, Sustaining Lean in Healthcare: Developing and Engaging Physician Leadership explains how to ensure ongoing physician participation long after the consultant leaves. Dr. Michael Nelson, an early adopter of Lean in healthcare, explains how to use these synergic tools to achieve consistently high levels of quality and clinical care outcomes.

The book begins with a Lean primer that provides a firm foundation in essential Lean conceptsincluding value stream maps, 6S, Kanban, Heijunka, and Gemba Walks. Next, it examines how to create a physician engagement plan and covers the specific responsibilities of physician leadership through the Lean transformation. Explaining what to look for when judging success, it provides numerous examples that demonstrate how to sustain success over the long term.

Complete with tips for spotting the danger signs that might indicate your plan is off course, this book details time-tested techniques and strategies for reducing waste in healthcare. It supplies a methodology for establishing shared expectations of success with your medical team early on in the process, as well as a proven framework for simultaneous Lean deployment across multiple locations.

Praise for the book:

In this book , Dr. Nelson draws on his forty years of medical practice and his experience as an early adopter of Lean for healthcare, to identify a crucial piece to aligning healthcare organizations for success; Physician Engagement. Healthcare executives and clinicians will appreciate and learn from Dr. Nelsons insight.Robert Iversen, Director, Accenture Management Consulting

Instead of writing another how-to book, Mike has taken the opportunity to provide insights that are sure to help any healthcare organization sustain the impact of its Lean engagement.Rick Malik, Worldwide Director, ValuMetrix® Services, Ortho Clinical Diagnostics

provides realistic estimates of timelines for projects, expected satisfaction, quality, and financial paybacks, as well as the time commitments required for Lean healthcare initiatives to become durable successes.David Mann, PhD, Principal, David Mann Lean Consulting

simplifies and organizes the steps needed to effectively and successfully take advantage of the significant contributions Lean management can make .Edward D. Martin, MD, Co-Founder and Chairman Emeritus, Martin Blanck & Associates, Inc.

Lean has become a critical predictor of successful systems going forward. Sustaining Lean in Healthcare is the book to get this done.Stephen C. Beeson MD, Author of Engaging Physicians, A Manual to Physician Partnership

Recenzijas

A super overview of Lean process improvement for any healthcare leader. A focused approach to Lean that will engage the physician audience. The book will be an excellent one as preassignment reading for a Leadership Development Institute that focuses on Lean and for the organization getting ready to embark on a Lean journey, particularly if they want greater physician engagement. ... It could be particularly effective if used as a book club format for physician leaders in an organization as a way of energizing them. The book has good follow-up exercises that demonstrate key points. Dr. Nelson has researched the material thoroughly. The book has very specific medical practice and hospital examples. ... Outstanding... I highly recommend this book. Lynne Cunningham, Senior Coach, The Studer Group

Over the past two decades Lean Operations has made several significant runs in healthcare. The first attempts, with a few notable exceptions, lost momentum and were not sustainable because the incentives always seem to be misaligned. In this book, Dr. Nelson draws on his forty years of medical practice and his experience as an early adopter of Lean for healthcare, to identify a crucial piece to aligning healthcare organizations for success; Physician Engagement. Its my experience that Lean methods work on processes in all industries, but nowhere is the human element more critical to their success than healthcare, and no one role is more critical than the Physician. Healthcare executives and clinicians will appreciate and learn from Dr. Nelsons insight.Robert Iversen, Director, Accenture Management Consulting

Of the many books written about Lean journeys, Mike Nelsons book offers a unique perspective. A physician himself, Mike focuses on the role he and his colleagues can play in creating and sustaining a Lean environment. He speaks from first-hand experience, having taken his own Lean journey and playing a key role in the quality aspect of a highly successful ValuMetrix® Services Lean engagement. His book clearly illustrates a fact that is all-too-often often overlooked physicians must be included in any Lean engagement, since they are true enablers of change and are critical to sustaining the transformation. Instead of writing another how-to book, Mike has taken the opportunity to provide insights that are sure to help any healthcare organization sustain the impact of its Lean engagement.Rick Malik, Worldwide Director, ValuMetrix® Services, Ortho Clinical Diagnostics

Nelson does Lean healthcare a service as a physician and Lean practitioner focusing on engaging the physician. In this valuable resource, Nelson stresses and supplies guidance regarding the role of physician champion, and senior managements responsibilities to the Lean initiative. As importantly, he provides realistic estimates of timelines for projects, expected satisfaction, quality, and financial paybacks, as well as for the time commitments required for Lean healthcare initiatives to become durable successes.David Mann, PhD, Principal, David Mann Lean Consulting

Nelsons great service in this book is to approach Lean healthcare from the practitioners perspective and provide a very valuable and thoughtful approach which simplifies and organizes the steps needed to effectively and successfully take advantage of the significant contributions Lean management can make to their practices with the minimum expenditure of time and financial resources.Edward D. Martin, MD, Co-Founder and Chairman Emeritus, Martin Blanck & Associates, Inc.

Over the years, I have read a number of books on Lean implementation. Dr Nelson's approach is clear, practical, easy to read and prescriptive. Efficient use of resources and time are some of the most important directives for leaders to survive in these reforming times. Lean has become a critical predictor of successful systems going forward. Sustaining Lean in Healthcare is the book to get this done. Well done, Dr. Nelson. I learned a ton.Stephen C. Beeson MD, Author of Practicing Excellence, A Physician's Manual to Exceptional Health Care & Engaging Physicians, A Manual to Physician Partnership

Acknowledgments xi
Introduction xiii
Foreword xvii
1 The Basics of Lean
1(24)
Implementation Phase
3(3)
Lean Tools for Product and Process Approaches
3(1)
Value Stream Maps (VSM)
3(3)
6S
6(2)
Kanban
8(1)
Single Piece Flow
8(1)
A Simple Exercise
9(1)
Level Loading (Heijunka)
10(1)
Product Process Flow
11(1)
Lean Tools for Operator-Focused Approaches
11(1)
Full Work Analysis
11(1)
Standard Work
12(1)
Sustainment Phase
12(3)
Visual Controls
12(3)
Huddles
15(1)
Assessment (Audits)
15(1)
Gemba Walks
16(2)
Culture Change
18(2)
Improvement Model
20(2)
What Are We Trying to Accomplish?
21(1)
How Will We Know That a Change Is an Improvement?
21(1)
What Changes Can We Make That Will Result in an Improvement?
21(1)
Plan
22(1)
Do
22(1)
Study
22(1)
Act
23(1)
Kaizen
23(1)
References
24(1)
2 Lean and Physician Culture
25(6)
Clinical Decision Making and the PDSA Cycle
28(2)
Reference
30(1)
3 Creating a Physician Engagement Plan
31(8)
A Bit of History
31(1)
Elements of a Physician Engagement Plan
32(6)
Vision and Goals
33(1)
Selection and Development of Physician Champions
34(2)
Reward and Recognition Plan
36(1)
Approach to and Engagement with Frontline Physicians (Chapter 4)
36(1)
The Physicians' Role in Sustaining Improvements and Maintaining the Lean Culture
37(1)
References
38(1)
4 The Senior Leader's Role
39(6)
Success Starts at the Top
39(1)
Leadership Is More Important Than Tools
40(1)
The Senior Leader's Role
40(4)
Important Duties of a Leader
40(1)
Create the Vision---Determine the Right Destination before You Start the Journey
40(1)
Selecting the Right People
41(1)
Provide Resources and Invest in Infrastructure
41(1)
Executive and Champion Role Definition and Training
41(1)
Frequent and Clear Communication
42(1)
Strategic Alignment
42(1)
Deployment Plan
42(1)
Establish Measures for Success
43(1)
Project Spread and Sustainability
43(1)
Summary---Active Leadership Is Essential to Effective Deployment
44(1)
Reference
44(1)
5 Analysis and Preparation
45(12)
Business Needs Assessment and Operational Impact
45(8)
Lean Resources
46(1)
Likelihood of Financial, Quality, or Satisfaction Improvements
46(1)
Resources
47(1)
Leadership
47(1)
Desire to Improve
48(1)
Architecture
48(1)
Readiness
48(5)
Preparation Phase
53(1)
Stakeholder Analysis
54(2)
References
56(1)
6 Setting Expectations
57(6)
Criteria for Intervention
61(1)
Who
61(1)
How
61(1)
Reference
62(1)
7 Physician Case Studies
63(6)
Discussion
66(3)
Scenario #1
66(1)
Scenario #2
67(1)
Scenario #3
67(1)
Scenario #4
67(1)
Scenario #5
67(1)
Scenario #6
68(1)
Scenario #7
68(1)
Scenario #8
68(1)
8 Keys to Sustaining Lean---A Physician Guide
69(8)
References
76(1)
9 Judging Lean Success The Process
77(8)
Financial Success
78(2)
A Balanced Approach
80(1)
Tollgates
80(1)
In-Person Monitoring
80(1)
Scorecards
81(2)
References
83(2)
10 A Case Study
85(12)
11 Sustaining
97(10)
Lean Work
98(1)
Improvement Work
99(2)
Monitoring
101(1)
Communications
102(1)
Standardization
103(3)
Summary
106(1)
References
106(1)
12 PreImplementation Tools and Approaches
107(4)
Site Lean Team Selection: Roles and Responsibilities
107(2)
The Site Team
107(1)
Purpose of Site Team
107(1)
Characteristics of Site Team Leaders and Members
108(1)
Identifying Site Team Leaders
108(1)
PreImplementation Checklist
109(2)
13 Implementation Tools and Approaches
111(8)
Typical Implementation Timeline
111(1)
Gemba Walks
111(1)
Cross-Training Matrix
111(8)
Glossary 119(4)
Index 123(6)
About the Author 129
Michael Nelson, MD spent 28 years practicing pediatrics while building the practice from a solo physician office to seven pediatricians. He has served as a hospital medical staff president and in various medical director positions. For the last 13 years, he has devoted increasingly greater time to quality improvement in healthcare. For the last 5 years of employment with Presbyterian Healthcare Services, he worked full time in quality improvement and became a certified Lean Six Sigma Black Belt. He was a physician leader for Lean Systems implementation at Presbyterian.





He is credited with:















Creating a health and chronic disease management system resulting in national benchmark performance in diabetes care





Developing a curriculum and teaching more than 200 clinicians and senior leaders advanced tools and techniques in quality improvement





Implementing elements of the advanced medical home





Creating a patient-centered care environment through the creation of patient and family advisory councils in PMG clinics





Leading and supporting successful Lean implementations resulting in dramatic improvements in ambulatory clinics and inpatient settings







He currently owns a Lean consulting business, Blue Corn Professional Services, LLC, and is a physician coach for the Studer Group.