Innovation And Best Practices In Health Care Scheduling

Patient waits have been a long-standing concern in health care. Waits occur throughout the continuum of care and are built into and budgeted for within day-to-day operations. The status quo is changing, however, as patient experience becomes linked to provider payment, efficiency and service become differentiators between hospitals and providers, and patient expectations evolve. While excellent clinical care remains the expectation, health care consumers are now seeking health care and supporting systems that are respectful of individuals. This discussion paper, describes the important forces shaping wait times throughout health care, the evolving use of techniques and tools from other industries to improve health care access, and the move toward a person-centered model of care. Through personal experiences leading respective health care organizations, have tackled these complex issues, and presents in this paper the lessons learned along the way. Notably, acknowledging that improving access and scheduling requires systems-level transformation and that such transformation can uncover previously unrecognized resources and improve all aspects of care delivery.

According to Transforming Health Care Scheduling and Access, long waits for treatment are a function of the disjointed manner in which most health systems have evolved to accommodate the needs and the desires of doctors and administrators, rather than those of patients. The result is a health care system that deploys its most valuable resource-highly trained personnel-inefficiently, leading to an unnecessary imbalance between the demand for appointments and the supply of open appointments. This study makes the case that by using the techniques of systems engineering, new approaches to management, and increased patient and family involvement, the current health care system can move forward to one with greater focus on the preferences of patients to provide convenient, efficient, and excellent health care without the need for costly investment. Transforming Health Care Scheduling and Access identifies best practices for making significant improvements in access and system-level change. This report makes recommendations for principles and practices to improve access by promoting efficient scheduling. This study will be a valuable resource for practitioners to progress toward a more patient-focused "How can we help you today?" culture.

Patient-centered care is a way of thinking and doing things that considers patients partners in the development of a healthcare plan designed to meet their specific needs. It involves knowledge of the individual as a person and integrates that knowledge into their plan of care. Patient-centered care is central to the discussion of healthcare at the insurance and hospital-level. The quality of the service is evaluated more deeply from all the healthcare components, including insurance payments. It is the start of a new client- and patient-centered healthcare, which is based on a profound respect for patients and the obligation to care for them in partnership with them. Healthcare has been lacking a strategy to teach patients how to take care of themselves as much as they possibly can. In countries with socialized healthcare, patients don’t go to the emergency room unless it is necessary; they have a physician on call instead. This affords more personalized care and avoids patients getting lost in the hospital system. This book advocates the critical role of patients in the health system and the need to encourage healthy living. We need to educate patients on how to be more self-aware, giving them the tools to better understand what they need to do to achieve healthy lifestyles, and the protocols and policies to sustain a better life. Prevention has always been the pinnacle of medical care. It’s time to highlight and share this approach with patients and involve them as active participants in their own healthcare. This is the method on which to build the new healthcare for the next century.

The direct-to-consumer business model has transformed how people seek out goods and services from music to mortgages. So what happens now that the revolution has come for healthcare? While consumers have begun to insist on healthcare that is as convenient and personalized as nearly every other good or service they purchase, most healthcare provider organizations, physicians, and insurance companies remain woefully unprepared to meet this demand. Choice Matters is the healthcare sector's guide to understanding and delivering the brand of consumer-centered care that is an imperative for the Zocdoc age. Drawing on the authors' diverse backgrounds in medicine, business, and public policy, this practically-oriented resource offers an on-the-ground introduction for clinicians and managers to better understand: · The differences between healthcare and other consumer-driven markets · What factors are most important for consumers in seeking care providers · How consumers make decisions about healthcare · The system-wide effects of increased consumer choice in healthcare · The important distinction between patients and consumers By celebrating the possibilities inherent to consumer-centered healthcare, Choice Matters offers a refreshing, empirically informed take on how healthcare in the United States can flourish, not wither, in the new economy.

Healthcare Quality Management: A Case Study Approach is the first comprehensive case-based text combining essential quality management knowledge with real-world scenarios. With in-depth healthcare quality management case studies, tools, activities, and discussion questions, the text helps build the competencies needed to succeed in quality management. Written in an easy-to-read style, Part One of the textbook introduces students to the fundamentals of quality management, including history, culture, and different quality management philosophies, such as Lean and Six Sigma. Part One additionally explains the A3 problem-solving template used to follow the Plan-Do-Study-Act (PDSA) or Define, Measure, Analyze, Improve, and Control (DMAIC) cycles, that guides your completion of the problem-solving exercises found in Part Two. The bulk of the textbook includes realistic and engaging case studies featuring common quality management problems encountered in a variety of healthcare settings. The case studies feature engaging scenarios, descriptions, opinions, charts, and data, covering such contemporary topics as provider burnout, artificial intelligence, the opioid overdose epidemic, among many more. Serving as a powerful replacement to more theory-based quality management textbooks, Healthcare Quality Management provides context to challenging situations encountered by any healthcare manager, including the health administrator, nurse, physician, social worker, or allied health professional. KEY FEATURES: 25 Realistic Case Studies–Explore challenging Process Improvement, Patient Experience, Patient Safety, and Performance Improvement quality management scenarios set in various healthcare settings Diverse Author Team–Combines the expertise and knowledge of a health management educator, a Chief Nursing Officer at a large regional hospital, and a health system-based Certified Lean Expert Podcasts–Listen to quality management experts share stories and secrets on how to succeed, work in teams, and apply tools to solve problems Quality Management Tools–Grow your quality management skill set with 25 separate quality management tools and approaches tied to the real-world case studies Competency-Based Education Support–Match case studies to professional competencies, such as analytical skills, community collaboration, and interpersonal relations, using case-to-competency crosswalks for health administration, nursing, medicine, and the interprofessional team Comprehensive Instructor’s Packet–Includes PPTs, extensive Excel data files, an Instructor’s Manual with completed A3 problem-solving solutions for each Case Application Exercise, and more! Student ancillaries–Includes data files and A3 template

It has been almost 20 years since the Institute of Medicine released the seminal report titled, Crossing the Quality Chasm. In it, the IoM identified six domains of care quality (safe, timely, effective, efficient, equitable, and patient-centric) and noted a huge gap between the current state and the desired state. Although this report received a great deal of attention, sadly there has been little progress in these areas. In the U.S., healthcare still has huge disparities, is inefficient, and is fragmented with delays in care that are often unsafe. Most U.S. citizens are expected to suffer from a diagnostic error sometime during their lifetime, not receive a large fraction of recommended care, and pay for one of the most expensive systems in the world. Much has been written about quality improvement over the years but many prominent quality and safety experts. Yet progress has been slow. Some have called on the healthcare professions to look outside of healthcare to other industries using examples in nuclear power and airlines for safety, the hotel and entertainment industry for a ‘customer’ focus, and the automotive industry, particularly Toyota for efficiency (Lean). This book by Dr. Oppenheim on lean healthcare systems engineering (LHSE) is a fresh approach that brings forth concepts that systems engineers have used in huge national defense projects. What’s unique in this book is that these powerful system engineering tools are modified to be able to address smaller sized healthcare problems that still involve similar problems in fragmentation and poor communication and coordination. This book is an invaluable reference for a new powerful process named Lean Healthcare Systems Engineering (LHSE) for managing workflow and care improvement projects in all clinical environments. The book applies to ambulatory clinics and hospitals of all types including operating rooms, emergency departments, and ancillary departments, clinical and imaging laboratories, pharmacies, and population health. The book presents a generic rigorous but not mathematical step-by-step process of integrated healthcare, systems engineering and Lean. The book also contains the first major product created with the LHSE process, namely tabularized summaries of representative projects in healthcare delivery applications, called Lean Enablers for Healthcare Projects. Each full-page enabler table lists the challenges and wastes, powerful improvement goals, risks, and expected benefits, and some useful descriptions of the healthcare system of interest. The book provides user-friendly solutions to major problems in healthcare delivery operations in all clinical environments, addressing fragmentation, wastes, wrong incentives, ad-hoc and stove-piped management, lack of optimized processes, hierarchy gradient, lack of systems thinking, “blaming and shaming culture”, burnout of providers and many others.

This book demonstrates how to successfully manage and lead healthcare institutions by employing the logic of business model innovation to gain competitive advantages. Since clerk-like routines in professional organizations tend to overlook patient and service-centered healthcare solutions, it challenges the view that competition and collaboration in the healthcare sector should not only incorporate single-end services, therapies or diagnosis related groups. Moreover, the authors focus on holistic business models, which place greater emphasis on customer needs and put customers and patients first. The holistic business models approach addresses topics such as business operations, competitiveness, strategic business objectives, opportunities and threats, critical success factors and key performance indicators.The contributions cover various aspects of service business innovation such as reconfiguring the hospital business model in healthcare delivery, essential characteristics of service business model innovation in healthcare, guided business modeling and analysis for business professionals, patient-driven service delivery models in healthcare, and continuous and co-creative business model creation. All of the contributions introduce business models and strategies, process innovations, and toolkits that can be applied at the managerial level, ensuring the book will be of interest to healthcare professionals, hospital managers and consultants, as well as scholars, whose focus is on improving value-generating and competitive business architectures in the healthcare sector.

In this book, Dr. Gabow, former CEO of Denver Health of 20 years, teams up with Philip Goodman, a 34-year veteran of Denver Health who directed the Lean System group, to share their Lean journey. The Lean Prescription: Powerful Medicine for Our Ailing Healthcare System tells the story of how Dr. Gabow led Denver Health to become the first healthcare organization to be awarded the Shingo Bronze Medallion Prize for Operational Excellence. Detailing the foundational Lean principles, the book provides readers with the benefit of the experience of an integrated healthcare system's successful seven-year Lean journey. This book grew out Gabow’s 40 years' experience as a practicing physician, teacher, researcher, and leader of a large, urban public healthcare system. About 10 years into her 20 years as CEO of the healthcare system, she began to look at how one could actually make healthcare work right. After a year of study, she and her team concluded that Lean was exactly what healthcare needed. During the seven-year Lean journey that followed, Denver Health dramatically improved quality of care. Denver Health achieved a reduction of the expected mortality rate to the lowest among the academic health center members of the University Health System Consortium in 2011.The financial results were equally impressive. Denver Health realized almost $200 million of well-documented, hard financial benefit over seven years. This book provides authoritative guidance on how to effectively implement a Lean transformation in a healthcare system that includes hospitals, HMOs, community health centers, call centers, and paramedics. Providing an accessible explanation of the Lean philosophy and tools, the book includes helpful exercises and examples of Lean applications. The book goes beyond the hospital environment to the broader healthcare sector.

The report recommends that China maintain the goal and direction of its healthcare reform, and continue the shift from its current hospital-centric model that rewards volume and sales, to one that is centered on primary care, focused on improving the quality of basic health services, and delivers high-quality, cost-effective health services. With 20 commissioned background studies, more than 30 case studies, visits to 21 provinces in China, the report proposes practical, concrete steps toward a value-based integrated service model of healthcare financing and delivery, including: 1) Creating a new model of people-centered quality integrated health care that strengthens primary care as the core of the health system. This new care model is organized around the health needs of individuals and families and is integrated with higher level care and social services. 2) Continuously improve health care quality, establish an effective coordination mechanism, and actively engage all stakeholders and professional bodies to oversee improvements in quality and performance. 3) Empowering patients with knowledge and understanding of health services, so that there is more trust in the system and patients are actively engaged in their healthcare decisions. 4) Reforming public hospitals, so that they focus on complicated cases and delegate routine care to primary-care providers. 5) Changing incentives for providers, so they are rewarded for good patient health outcomes instead of the number of medical procedures used or drugs sold. 6) Boosting the status of the health workforce, especially primary-care providers, so they are better paid and supported to ensure a competent health workforce aligned with the new delivery system. 7) Allowing qualified private health providers to deliver cost-effective services and compete on a level playing field with the public sector, with the right regulatory oversight, and 8) Prioritizing public investments according to the burden of disease, where people live, and the kind of care people need on a daily basis.