Improving Healthcare Operations: The Application of Lean, Agile and Leagility in Care Pathway Design

142 Pages·2017·9.24 MB·English

by  Sharon J Williams (auth.)

Improving Healthcare Operations
SharonJWilliams
Improving
Healthcare
Operations
The Application of Lean, Agile and Leagility
in Care Pathway Design
SharonJWilliams
CollegeofHuman&HealthSciences
SwanseaUniversity
Swansea,UnitedKingdom
ISBN978-3-319-46912-6 ISBN978-3-319-46913-3(eBook)
DOI10.1007/978-3-319-46913-3
LibraryofCongressControlNumber:2016953103
©TheEditor(s)(ifapplicable)andtheAuthor(s)2017
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Dedicatedto Patricia
A
CKNOWLEDGEMENTS
The author would like to thank all the patients, relatives, healthcare
professionals and managers that took part in this study. This study was
funded by the Health Foundation as part of the author’s improvement
sciencefellowship.Withouteitherofthesethisstudywouldnothavebeen
possible. This research was inspired by the late Professor Denis Towill,
Cardiff Business School, Cardiff University, to whom the author is most
grateful and saddened he did not see the final manuscript. The author
would also like to thank Dr Lynne Caley, Professor Pauline Found and
PhillipWilliamsforreadingtheearlydraftchaptersandMadeleineHolder
andLizBarlowwho commissionedthisworkandprovidedguidance and
support when bringing togetherthe finalmanuscript.
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C
ONTENTS
1 Healthcare Systems in the Twenty-first Century 1
2 Improving HealthcareSystems 15
3 Lean in Healthcare 29
4 Delivering Agile andPerson-centred Care 45
5 Leanness Plus Agility= Leagility 57
6 Methodology 69
7 Analysis ofthe COPDPathway: Lean,AgileandLeagility 79
8 Analysis ofthe Huntington’s DiseasePathway:Lean,
Agility andLeagility 95
ix
x CONTENTS
9 Discussion andTheoreticalReflections 107
10 Conclusion andFutureResearch Agenda 121
Index 133
L A
IST OF BBREVIATIONS
A&E Accident&EmergencyDept.(alsoknownasED)
BLF BritishLungFoundation
CCG ClinicalCommissioningGroup
COPD ChronicObstructivePulmonaryDisease
DP DecouplingPoint
HD Huntington’sDisease
HDA Huntington’sDiseaseAssociation
ICP Integratedcarepathway
IDP InformationDecouplingPoint
MDP MaterialDecouplingPoint
MDT Multidisciplinaryteam
PCC Person-centredcare
PDP PatientDecouplingPoint
QI Qualityimprovement
R&D ResearchandDevelopment
RRS Runners,repeatersandstrangers
SCM Supplychainmanagement
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L F
IST OF IGURES
Fig.1.1 Conceptofa“joined-up”,patient-centredhealthcaresystem 5
Fig.1.2 Theoreticalframework 6
Fig.2.1 Seamlesshealthcaresupplysystem 20
Fig.2.2 Actioningthesystemsapproachinseamlesshealthcare
deliverysystem 21
Fig.4.1 Distinguishingattributesofleanandagilesupply 49
Fig.4.2 Distinguishingattributesofleanhealthcareandagile
healthcaresupply 50
Fig.4.3 Modelforimprovement 53
Fig.5.1 Lean,agileorleagile?Matchingyoursupplychain
tothemarketplace 59
Fig.5.2 Supplychainstrategiesandpositioningofdecouplingpoints 61
Fig.5.3 Conceptualmodel:Leagilityinthedesignandintegration
ofhealthcaresystems 65
Fig.7.1 HighlevelofprocessmapofCOPDpatientpathway 82
Fig.7.2 ProposeduseoftheDPinasub-COPD
process—respiratoryclinic 84
Fig.7.3 Exampleofanemotionmapforpatients 91
Fig.7.4 Exampleofanemotionmapforstaff 92
Fig.8.1 HighlevelofmapofHDpatientpathway 98
Fig.8.2 Back-officeandfront-officedecouplingpointforHDpathway 100
Fig.9.1 Distinguishinglean,agileandleagilityattributes
oftheCOPDpathway 111
Fig.9.2 Distinguishinglean,agileandleagilityattributes
oftheHDpathway 112
Fig.9.3 Patientpathwaysandpositioningofdecouplingpoints 113
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