Healthcare affordability: motivate people, improve processes, and increase performance

169 Pages·2019·7.64 MB·English

by  Odomirok

Healthcare Affordability
Continuous Improvement Series
Series Editors:
Elizabeth A. Cudney and Tina Kanti Agustiady
Design for Six Sigma: A Practical Approach through Innovation
Elizabeth A. Cudney and Tina Kanti Agustiady
Affordability: Integrating Value, Customer, and Cost for
Continuous Improvement
Paul Walter Odomirok, Sr.
Continuous Improvement, Probability, and Statistics: Using
Creative Hands-On Techniques
William Hooper
Transforming Organizations: One Process at a Time
Kathryn A. LeRoy
Statistical Process Control: A Pragmatic Approach
Stephen Mundwiller
For more information about this series, please visit: https://www.crcpress.
com/Continuous-Improvement-Series/book-series/CONIMPSER
Healthcare Affordability
Motivate People, Improve Processes,
and Increase Performance
Paul Walter Odomirok, Sr.
CRC Press
Taylor & Francis Group
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Contents
Preface .................................................................................................................ix
Chapter 1 Making the case for Healthcare Affordability ���������������������1
Affordable healthcare and Healthcare Affordability ...................................1
Some personal observations and case-study perspectives ..........................5
Some positive considerations and conditions ..............................................10
Healthcare Affordability .................................................................................12
References .........................................................................................................13
Chapter 2 Healthcare Affordability defined ������������������������������������������15
Healthcare Affordability basics .....................................................................16
Healthcare Affordability ............................................................................16
Purpose .........................................................................................................17
People ............................................................................................................18
Process ..........................................................................................................18
Performance .................................................................................................18
Profitability ...................................................................................................18
Reference ...........................................................................................................24
Chapter 3 Healthcare Affordability applied ������������������������������������������25
Creating and applying a Healthcare Affordability .....................................29
Assess → Design → Implement → Maintain ...............................................31
Assess ............................................................................................................32
Design ...........................................................................................................32
Implement ....................................................................................................33
Maintain .......................................................................................................34
The duration .................................................................................................34
Affordability planning and initial deployment ..........................................34
Summary ...........................................................................................................36
References .........................................................................................................36
v
vi Contents
Chapter 4 The strategic dimension �����������������������������������������������������������37
Leadership .........................................................................................................37
Strategy ..............................................................................................................39
Systems ..............................................................................................................41
Structure ............................................................................................................42
Strategic purpose .............................................................................................43
Strategic value delivery ...................................................................................49
Healthcare provider strategic focus and strategic plan ..............................49
Healthcare service provider affordability strategy .....................................51
Performance .................................................................................................52
References .........................................................................................................54
Chapter 5 The operational perspective ����������������������������������������������������55
Process ...............................................................................................................55
Systems and processes ....................................................................................57
People and performance .................................................................................58
Process and operational improvements........................................................59
The pursuit of process maturity ....................................................................60
Pediatric surgery .........................................................................................61
Readmissions ...............................................................................................61
Discharge ......................................................................................................62
Hospital design and construction .................................................................63
Speed of service ................................................................................................65
Lean Six Sigma deployment ...........................................................................66
Common themes of process and operational improvement......................66
Summary ...........................................................................................................69
References .........................................................................................................70
Chapter 6 The tactical reality���������������������������������������������������������������������71
The people, The work, The value ...................................................................71
Pursue Healthcare Affordability: motivate people → improve
processes → increase performance ...............................................................72
The power of problem finding .......................................................................75
The impact of problem-solving ......................................................................76
Examples ...........................................................................................................77
Healthcare: nursing supply room project ................................................77
Healthcare: catheter project .......................................................................78
Healthcare: early elective deliveries project ............................................79
Service provider: resource scheduling project ........................................82
Device provider: multiple projects ............................................................84
Reviewing performance and results .............................................................87
References .........................................................................................................89
Contents vii
Chapter 7 First and foremost, assess the situation ��������������������������������91
Customer, value, and value stream ...............................................................92
Strategy ..............................................................................................................94
Systems ..............................................................................................................96
Structure ............................................................................................................96
Strategic level ...............................................................................................97
Operational level .........................................................................................98
Tactical level .................................................................................................98
Assess step by step ...........................................................................................98
Chapter 8 Design the solution and plan for success ���������������������������101
Process improvement tooling .......................................................................105
System tooling—The 7 Flows...................................................................105
Process problem-solving tools .................................................................106
PDCA ......................................................................................................106
DMAIIC .................................................................................................107
A3 framework .......................................................................................109
Team tooling ....................................................................................................111
Forming .......................................................................................................111
Storming .....................................................................................................112
Norming .....................................................................................................112
Performing ..................................................................................................113
Team structural tooling ..................................................................................114
Prioritization tools ..........................................................................................114
Ease of implementation matrix ................................................................115
Payoff matrix ...............................................................................................117
The efficiency matrix .................................................................................117
An implementation team standard for kaizens and projects ...................118
Step by step .................................................................................................118
References ........................................................................................................119
Chapter 9 Implement improvements �����������������������������������������������������121
Pre-planning, setup, and preparation for the implementation ...............122
Initial designing and planning phase .........................................................122
Implementation deployment phase 1 .....................................................123
Implementation deployment phase 2 .....................................................124
Implementation deployment phase 3 .....................................................125
Implementation deployment phase 4 .....................................................125
Chapter 10 Maintain and sustain the results … continuously
improve �������������������������������������������������������������������������������������127
Maintain: the step by step .............................................................................131
Reference .........................................................................................................131
viii Contents
Chapter 11 Enterprise wide responsibilities ������������������������������������������133
The enterprise flow view ..............................................................................136
Healthcare affordability success ..................................................................136
References .......................................................................................................137
Chapter 12 The end … start now ���������������������������������������������������������������139
The “Where” ...................................................................................................139
The “What” .....................................................................................................142
The “How” ......................................................................................................143
The when, the who, and the why .................................................................143
Appendix A .....................................................................................................145
Appendix B .....................................................................................................147
Appendix C .....................................................................................................149
Appendix D .....................................................................................................151
Index ................................................................................................................153
Preface
Shortly after the Theory of Affordability materialized in 2007 and the
foundational text, Affordability: Integrating Value, Customer and Cost for
Continuous Improvement was released in December 2016, it became a pparent
to me that although affordability could be achieved for any specific prod-
uct or service, its scope can range across entire enterprises and markets.
Affordability provides a new and unique, triple-lens view through which
to see, observe, and examine an enterprise, and create a focus to aim and
balance value, customer, and cost. Inherent is the capability to optimize
(1) customer requirements and the delivery of value, (2) expenses and
resources for value delivery, and (3) create competitive pricing that gener-
ates substantial revenue for maintaining the organization’s sustainability
that increases demand and stimulates growth.
Affordability for the greater good of society can be targeted at enter-
prises such as healthcare, education, government, banking, retail, man-
ufacturing, as well as others. This book is focused specifically on the
healthcare enterprise and the achievement of healthcare affordability for
all its primary facets: healthcare providers, medicine and pharmaceutical
providers, healthcare machine and device providers, healthcare service
and supply providers, and healthcare insurance and payment providers.
The overarching goal is to accomplish a patient-centered environment for
attaining healthcare affordability. The approach is achieved through moti-
vation of people, improvement of processes, and increase of performance.
The four cornerstones for the foundation of healthcare affordability
have been defined as a result of the work I’ve done with a multitude of
the clients and industries I’ve served over the past 25 years. The first two
of the cornerstones are leadership and strategy that resides at the strate-
gic executive level of every organization. The third and fourth corner-
stones for performance are lean and six sigma at the operational and
tactical levels, using and utilizing their primary philosophies, methods
and techniques for improvement, and most of all, they are the tools in
two comprehensive tool boxes supplemented with the basic and advanced
quality tools. Leadership and strategy sets direction, aligns the resources,
ix