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The Industry Must Identify and Avoid These Traps
By Mark Matthews MD
Operative Definitions:
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Waste in healthcare processes can be classified into 8 different subtypes:
- Overproduction: This term refers to the performance of redundant work. Examples include duplicate charting, multiple forms with the same information, copies of reports being sent automatically, and multiple caregivers asking the patient for the same information.
- Motion: This term refers to the extra steps taken by employees in order to complete a task (part or all of a process). People working in healthcare facilities or offices often spend a large part of their day moving around the environment searching for people or information, gathering supplies, moving items, dropping off records, etc.
- Waiting: This is epidemic in most healthcare settings and is often referred to as “queuing.” Waiting for items like medical records or radiographs, or a patient waiting for providers is simply inactive time with no value content at all.
- Transport: The unnecessary movement of patients, supplies or materials that are necessary for, involved in or produced by a process. Examples include delivery of medication from a distant central pharmacy, procurement of an unexpected surgical pack to the operating room, staff needing to travel a great distance to retrieve supplies, or transporting patients large distances from the emergency room to obtain diagnostic tests. This movement adds time to a process and contains no value.
- Over-processing: Excess processes that do not add value from the patient’s perspective. The most prevalent example of this in healthcare is the processing of regulatory paperwork or the inclusion of extra steps merely to satisfy a regulatory condition. Also included are activities like order clarification due to poor handwriting or erroneous abbreviations, missing medications from a pharmacy area leading to a delay in treatment, and redundant charting or paperwork.
- Inventory waste: Seen when too much product is acquired ahead of actual demand. This leads to a risk that items may become outdated or expired, leading to waste and excess cost. This is most often seen in healthcare in association with poor inventory management. Inspection of the average hospital storeroom will yield many items that will not be needed for months to years ahead. In addition, catering to the individual needs of all surgeons in the operating room leads to the accumulation of multiple trays and costly instruments that are used infrequently.
- Rework: This term refers to work that contains errors or defects that require correction. In healthcare, this is seen in coding and billing errors requiring reprocessing, medication errors requiring additional reconciliation, patient mishaps requiring reporting and perhaps additional treatment, and surgical errors requiring re-operation.
- Not using people to their full potential capabilities: This is often referred to as the “8th form of waste” because it was described after the original 7 forms of waste related to manufacturing were defined. It refers to a mismatch of a particular task to the skill set of the person assigned to perform that task. It is common to see significant variation in the ways different people will perform the same task. This often arises when there is an unclear expectation set forth by management or a lack of standard processes. Matching tasks to skill sets can lead to improved quality of work, employee satisfaction, and employee loyalty.
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About the Author
Dr. Mark Mathews has 20 years of active clinical practice in the field of Anesthesiology. Located in Scottsdale, Arizona, he has served on the management board of his large multi-specialty anesthesiology group in the Phoenix area as well as various committees within the Scottsdale Healthcare System. Currently, he is developing simulation models mimicking various medical inpatient and outpatient processes with an emphasis on improving Patient Safety through the application of Lean and Six Sigma analysis. After receiving his Bachelor of Science and Medical Degrees from the University of Arizona, Dr. Mathews completed his residency training in Anesthesiology at the University of Minnesota. Subsequently, he received specialized fellowship training in Neuroanesthesiology from the Barrow Neurological Institute in Phoenix, Arizona. Currently, he is a Diplomat of the American Board of Anesthesiology and maintains numerous memberships in professional medical societies.
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Filed under: Health Economics, Quality Initiatives | Tagged: lean six sigma healthcare, mark matthews MD, six sigma healthcare |
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4 tips to boost hospital efficiency
Excellent insight, Dr. Matthews. This looks like a six-sigma manufacturing POV.
On the other hand, implementing new health information technology and processes can be tedious, and the work doesn’t stop once go-live occurs. Constant changes are needed to keep HIT systems up to speed and better improve their performance.
But luckily, not every update requires hours to complete. So, here are four quick and simple HIT tweaks to improve hospital efficiency.
http://www.govhealthit.com/news/4-tips-boost-hospital-efficiency
Chase
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More on Healthcare Waste
The American healthcare system is experiencing rapid change, largely driven by the recognition by both public and private payers that the trajectory of healthcare spending growth must be slowed. Despite the recent slowdown in healthcare spending growth, which many attribute to the recession, efforts to transform benefit design and payment systems are proceeding rapidly.
For example, public payers are both cutting payment rates and experimenting with bundled and global payment models. Private payers are adopting similar payment models and developing more sophisticated benefit designs that encourage patients to seek care from low cost and maybe high value providers, and to avoid expensive and maybe low value services.
See more at: http://www.healthcaretownhall.com/?p=7551#sthash.49nq66vi.dpuf
Ann Miller RN MHA
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