This book provides a detailed description of how to apply Lean Six Sigma in the health care industry, with a special emphasis on process improvement and operations management in hospitals.The book begins with a description of the Enterprise Performance Excellence (EPE) improvement methodology developed by the author that links several methodologies including systems thinking, theory of constraints, Lean and Six Sigma to provide an enterprise-wide prioritization and value-chain view of health care. The EPE methodology helps to improve flow at the macro or value-chain level, and then identifies Lean Six Sigma detailed improvements that can further improve processes within the value-chain.

The book also provides real-world health care applications of the EPE and Lean Six Sigma methodologies that showed significant results on throughput, capacity, operational and financial performance. The Enterprise Performance Excellence methodology is described, and also the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control) problem solving approach which is used to solve problems for health care processes as they are applied to real world cases.The case studies include a wide variety of processes and problems including: emergency department throughput improvement; operating room turnaround; operating room organization; CT imaging diagnostic test reduction in an emergency department; linen process improvement; implementing sepsis protocols in an emergency department; critical success factors of an enterprise performance excellence program.

"

This book examines how healthcare organizations shape, adapt and resist developments in healthcare policy and practice. This is an international text bringing together contributions from around the globe and covers a wide range of different discussions in relation to the policy/practice gap.

This book is dedicated to population health management and how it can be used to improve the health care and outcomes for patients with poly chronic conditions. The book uses an integrated approach guided by a transdisciplinary orientation that incorporates both a macro and a micro-theoretical framework for promoting population health management. Thus, policy decision makers can prioritize how limited resources can be used to optimize health service needs of the chronically ill and disabled in the nation as well as in the globe. The book also identifies appropriate applications of health information technology that can facilitate interoperability, data sharing and effective communication to ensure that applicable knowledge is derived from the available information. Multiple implications of population health management for poly chronic conditions suggest that concerted efforts in promoting preventive strategies can yield numerous benefits. Continuous improvement efforts through impact evaluation and a commitment to the adoption of the health information technology resources needed are also critical aspects of this process. Patients with poly chronic conditions have complex needs and are often high-utilizers of health services. Great potential exists to improve the health and health care of these individuals through improved coordination integrating multiple domains of the population health management approach. Population Health Management is needed now more than ever due to the current challenges facing the health care system that were not present in previous decades. This book points out strategic directions suggested by empirical evidence and experts' opinions on innovative care management solutions observed in many advanced countries.

This book presents a collection of studies that have applied analytical methods to improve preparedness, planning, and a faster response to A&E and public health emergencies like epidemic and disease outbreak. It explores the application of quantitative Operational Research techniques such as Mathematical Modelling and Optimization, Maximum Likelihood Estimation, Multiple-Criteria Decision Analysis, Discrete-event Simulation, Data Mining, and Bayesian Decision Models. These techniques have been used for better management of emergency care, including first responders, ambulance services, A&E departments, and mass immunisation centres. This volume focuses on planning at the operational level whereas volume 2 focuses mainly on planning at the strategic level. The OR Essentials series presents a unique cross-section of high quality research work fundamental to understanding contemporary issues and research across a range of Operational Research (OR) topics. It brings together some of the best research papers from the highly respected journals of the Operational Research Society, also published by Palgrave Macmillan.

From the Preface: Collectively, the chapters in this book address application domains including inpatient and outpatient services, public health networks, supply chain management, and resource constrained settings in developing countries. Many of the chapters provide specific examples or case studies illustrating the applications of operations research methods across the globe, including Africa, Australia, Belgium, Canada, the United Kingdom, and the United States. Chapters 1-4 review operations research methods that are most commonly applied to health care operations management including: queuing, simulation, and mathematical programming. Chapters 5-7 address challenges related to inpatient services in hospitals such as surgery, intensive care units, and hospital wards. Chapters 8-10 cover outpatient services, the fastest growing part of many health systems, and describe operations research models for primary and specialty care services, and how to plan for patient no-shows. Chapters 12 - 16 cover topics related to the broader integration of health services in the context of public health, including optimizing the location of emergency vehicles, planning for mass vaccination events, and the coordination among different parts of a health system. Chapters 17-18 address supply chain management within hospitals, with a focus on pharmaceutical supply management, and the challenges of managing inventory for nursing units. Finally, Chapters 19-20 provide examples of important and emerging research in the realm of humanitarian logistics.

Healthcare is changing. It is moving to a paperless environment and becoming a team-based, interdisciplinary and patient-centred profession. Modern healthcare models reflect our data-driven economy, and adopt value-driven strategies, evidence-based medicine, new technology, decision support and automated decision-making. Amidst these changes are the patients, and their right to data protection, privacy and autonomy. The question arises of how to match phenomena that characterise the predominant ethos in modern healthcare systems, such as e-health and personalised medicine, to patient autonomy and data protection laws. That matching exercise is essential. The successful adoption of ICT in healthcare depends, at least partly, on how the public's concerns about data protection and confidentiality are addressed. Three backbone principles of European data protection law are considered to be bottlenecks for the implementation of modern healthcare systems: informed consent, anonymisation and purpose limitation. This book assesses the adequacy of these principles and considers them in the context of technological and societal evolutions. A must-read for every professional active in the field of data protection law, health law, policy development or IT-driven innovation.

Information technology is changing healthcare in numerous wide-ranging aspects, including significantly improving the overall quality of patient care and therefore helping to reduce limitations in people's daily lives. The Digital Pill reflects on how digital technologies can combat chronic diseases including diabetes, cancer, cardiovascular, respiratory and neurodegenerative diseases as well as mental disorders. Chronic diseases touch every family, generate infinite suffering and cause the lion's share of every countries' healthcare spending across the world. The authors carefully study a broad selection of contemporary companies and healthcare organizations that are shaping digital healthcare. They report pioneering cases from large and small technology, insurance, and pharmaceutical companies as well as healthcare providers of all sorts across the globe and bring forward patterns and corner stones of an affordable and patient centric digital healthcare. The Digital Pill is essential reading for anyone working in, engaged with or interested in understanding the future of healthcare.

This book presents a novel view of healthcare system transition in post-communist countries. It is the first region-wide comparative study of hospital governance in Eastern Europe. Comprehensive new material shows the evolution and significance of governance, complementing recent publications on the topic from industrialised countries. Throughout the book, governance is described and substantiated as a major component that, together with provider payment mechanisms, defines the hospital sector's operations. This view subscribes to the economists' growing appreciation of extra-financial aspects in the discussion of incentives and regulation of healthcare markets. In particular, the book explains how governance arrangements may affect the outcomes of healthcare financing reforms, and should thus be seen as a critical determinant of their success or failure. This new model of thinking about healthcare system transition emerges from an analysis of 22 countries over the course of two decades. While the primary focus of the study is on developing the hospital sector, an extensive background chapter provides a standalone introduction to the dynamically changing landscape of healthcare in Eastern Europe and an overview of the various problems and challenges the region is facing. Practitioners, policy-makers, academics and students interested in Eastern European healthcare systems, their origins, current status and ways forward, will appreciate the book's reflections on the problem complexity, the clarity of its concepts, and its accessible style of presentation.

Recent global and national debates have shown that demographic change, the rising incidence of chronic disease, and the unmet need for more personalized care are trends demanding a new, integrated approach to health and social care. The advancement and adoption of technology in both health and social care settings is a valuable tool for encouraging change and improving the quality and efficiency of care provided to patients and care clients. Achieving Effective Integrated E-Care Beyond the Silos presents a collection of real-life examples, frameworks, business models, financial implications, and methods of evaluating the technological tools that are enabling a more human-centered approach to health and social care. Based on relevant research in the field of integrated e-care, this publication is ideally designed for use by practitioners, researchers, and decision-makers in the care field.

This issue of Nursing Clinics of North America will focus on Magnet Hospitals. Article topics will include nursing workforce data on magnet versus non-magnet hospitals, magnet culture and satisfaction, best practices in ensuring engagement among nurses, nursing retention, partnerships between academics and practice, and nursing retention strategies.

This book examines the extent to which social position impacts exposure to intimate partner violence (IPV) and whether women with IPV exposure are more vulnerable to social inequities in health. At the intersection of sociological theories on health, gender, and policy, this book explores these issues against the social policy contexts of the United States, Germany, and Norway. It applies a conceptual framework which argues that differential exposure to IPV and differential vulnerability to poor health are two primary mechanisms driving health inequities for IPV survivors. Empirical analysis reveals context-specific nuances in the interactions of social position and IPV exposure in their impact on health, and suggests that encouraging women's economic independence and ensuring access to health care are vital policy intervention points for reducing the health inequities of IPV survivors. This book offers a cross-national comparative look at the role of social policy in the lives of IPV survivors, highlighting the effects of various policy approaches in three modern welfare states and suggesting policy implications.

This book collects several contributions, written both by statisticians and medical doctors, which focus on the identification of new diagnostic, therapeutic and organizational strategies in order to improve the occurrence of clinical outcomes for Acute Coronary Syndromes (ACS) patients. The work is structured in two different parts: the first one is focused on cooperative project mainly on statistical analysis of large clinical and administrative databases; the second one faces the development of innovative diagnostic techniques, with specific reference to genetic and proteomic, and the evolution of new imaging techniques for the early identification of patients at major risk of thrombotic, arrhythmic complications and at risk of poor revascularization.

Healthcare Informatics: Improving Efficiency and Productivity examines the complexities involved in managing resources in our healthcare system and explains how management theory and informatics applications can increase efficiencies in various functional areas of healthcare services. Delving into data and project management and advanced analytics, this book details and provides supporting evidence for the strategic concepts that are critical to achieving successful healthcare information technology (HIT), information management, and electronic health record (EHR) applications. This includes the vital importance of involving nursing staff in rollouts, engaging physicians early in any process, and developing a more receptive organizational culture to digital information and systems adoption. We owe it to ourselves and future generations to do all we can to make our healthcare systems work smarter, be more effective, and reach more people. The power to know is at our fingertips; we need only embrace it. -From the foreword by James H. Goodnight, PhD, CEO, SAS Bridging the gap from theory to practice, it discusses actual informatics applications that have been incorporated by various healthcare organizations and the corresponding management strategies that led to their successful employment. Offering a wealth of detail, it details several working projects, including: A computer physician order entry (CPOE) system project at a North Carolina hospital E-commerce self-service patient check-in at a New Jersey hospital The informatics project that turned a healthcare system's paper-based resources into digital assets Projects at one hospital that helped reduce excesses in length of stay, improved patient safety; and improved efficiency with an ADE alert system A healthcare system's use of algorithms to identify patients at risk for hepatitis Offering the guidance that healthcare specialists need to make use of various informatics platforms, this book provides the motivation and the proven methods that can be adapted and applied to any number of staff, patient, or regulatory concerns.

In the fast-paced world of health care clinical effectiveness relies not only upon medical, but also administrative competence. This issue of Neurologic Clinics features 14 articles from experts in their respective areas of office management. Articles include practice and compensation models; negotiating with payers; using benchmarks; web based neurology resources (clinical); web based neurology resources (practice management); use of electronic health records in neurology practice; hot topics in risk management; HIPPA and other regulatory issues; ethical issues; new concepts in residency and fellowship training; using evidence based medicine; P4P and PQRI; patient education; and the future of neurology.

IT in Pharmacy: An Integrated Approach aims to describe and discuss the major areas of pharmacy IT innovation (e-prescribing, drug databases, electronic patient records, clinical decision support, pharmacy management systems, robots and automation etc) from a systems and a professional perspective. It will also consider how the areas of pharmacy IT link together and can be used to enable and develop pharmacy professional practice. The book will examine pharmacy IT from an international perspective, taking into account all parts of the world where IT systems are used in pharmacy practice - namely - North America, the UK, Western Europe and Australia - and will compare pharmacy IT in the different regions. This book is from the author of Principles of Electronic Prescribing (Springer, 2008)

Decentralizing Health Services

A Global Perspective

Krishna Regmi, editor

Current economic, demographic, and environmental shifts are presenting major challenges to health care systems around the world. In response, decentralization--the transfer of control from central to local authorities--is emerging as a successful means of meeting these challenges and reducing inequities of care. But as with health care itself, one size does not fit all, and care systems must be responsive to global reality as well as local demand.

"Decentralizing Health Services" explores a variety of applications of decentralization to health care delivery in both the developing and developed worlds. Outfitted with principles, blueprints, and examples, this ambitious text clearly sets out the potential role of decentralized care as a major player in public health. Its models of service delivery illustrate care that is effective, inclusive, flexible, and in tune with the current era of preventive and evidence-based healthcare . Contributors point out opportunities, caveats, and controversies as they:

Clarify the relationships among decentralization, politics, and policyDifferentiate between political, fiscal, and administrative decentralization in health care systemsConsider public/private partnerships in health systemsExplain how the effects of decentralization can be evaluated.Present the newest data on the health outcomes of decentralizationExplore some challenges and global issues of health systems in the 21st centuryAnd each chapter features learning goals, discussion questions, activities, and recommendations for further reading

Heralding changes poised to revolutionize care, " Decentralizing Health Services" will broaden the horizons of researchers and administrators in health services, health economics, and health policy"

In an effort to combat human error in the medical field, medical professionals continue to seek the best practices and technology applications for the diagnosis, treatment, and overall care of their patients. Improving Health Management through Clinical Decision Support Systems brings together a series of chapters focused on the technology, funding, and future plans for improved organization and decision-making through medical informatics. Featuring timely, research-based chapters on topics including, but not limited to, data management, information security, and the benefits of technology-based medicine, this publication is an essential reference source for clinicians, scientists, health economists, policymakers, academicians, researchers, advanced level students, and government officials interested in health information technology.

The development of better processes to relay medical information has enhanced the healthcare field. By implementing effective collaborative strategies, this ensures proper quality and instruction for both the patient and medical practitioners. Health Literacy: Breakthroughs in Research and Practice examines the latest advances in providing and helping patients and medical professionals to understand basic health information and the services that are most appropriate. Including innovative studies on interactive health information, health communication, and health education, this multi-volume book is an ideal source for professionals, researchers, academics, practitioners, and students interested in the improvement of health literacy.

"This book will be a terrific introduction to the field of clinical IT and clinical informatics" -- Kevin Johnson "Dr. Braunstein has done a wonderful job of exploring a number of key trends in technology in the context of the transformations that are occurring in our health care system" -- Bob Greenes "This insightful book is a perfect primer for technologists entering the health tech field." -- Deb Estrin "This book should be read by everyone. " -- David Kibbe This book provides care providers and other non-technical readers with a broad, practical overview of the changing US healthcare system and the contemporary health informatics systems and tools that are increasingly critical to its new financial and clinical care paradigms. US healthcare delivery is dramatically transforming and informatics is at the center of the changes. Increasingly care providers must be skilled users of informatics tools to meet federal mandates and succeed under value-based contracts that demand higher quality and increased patient satisfaction but at lower cost. Yet, most have little formal training in these systems and technologies. Providers face system selection issues with little unbiased and insightful information to guide them. Patient engagement to promote wellness, prevention and improved outcomes is a requirement of Meaningful Use Stage 2 and is increasingly supported by mobile devices, apps, sensors and other technologies. Care providers need to provide guidance and advice to their patients and know how to incorporated as they generate into their care. The one-patient-at-a-time care model is being rapidly supplemented by new team-, population- and public health-based models of care. As digital data becomes ubiquitous, medicine is changing as research based on that data reveals new methods for earlier diagnosis, improved treatment and disease management and prevention. This book is clearly written, up-to-date and uses real world examples extensively to explain the tools and technologies and illustrate their practical role and potential impact on providers, patients, researchers, and society as a whole.

This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore's hospitals from the patient's perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hospitals. Although the book was written from the perspective of FM service quality for hospitals, the findings and recommendations are also relevant for other non-healthcare sectors where appropriate lessons may also be drawn for FM and service quality in general. It will particularly benefit Quality Managers, Facilities Managers and Hospital Administrators.

"This book is essential reading for researchers of tobacco policy change. Too many studies simply complain that change is too slow because tobacco companies are too powerful and politicians lack the will to challenge them. This book goes much further, to help us understand not just industry strategy but the policy processes in which policy advocates engage, learn from each other, and help create essential global tobacco policy change." Paul Cairney, University of Stirling, UK "This book is rare in making genuinely significant contributions across both public health and policy studies. By focusing on the battle for standardised packs, it engagingly addresses one of the most prominent recent innovations in health policy that has relevance both beyond Europe and across multiple spheres of health policy. In doing so, it also offers an innovative analysis of the role of transnational corporations in policy transfer."Jeff Collin, University of Edinburgh, UK This book analyses the battle for standardised cigarette packaging ('plain packaging') in Europe, drawing on the concepts of multi-level governance and policy transfer. It analyses the strategies of policy makers, non-governmental organisations and transnational tobacco companies in attempting either to advance or to block the introduction of standardised packaging. Taking a global and multi-level approach, it analyses these struggles within European Union institutions, EU member states, and across jurisdictions, as NGOs and tobacco companies worked transnationally to counter each other. As well as presenting original empirical research detailing these policy battles, the book provides new theoretical insights into policy transfer processes, particularly within multi-level polities, showing how transnational corporations can have dramatic effects on these processes. The book will appeal equally to public health researchers, policy analysts and political scientists.