Lean Six Sigma Department of Defense Lean Six Sigma Executive level overview.
Bay Pines VA Healthcare Lean Six Sigma Training for Professional Healthcare Interns ... ·...
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Bay Pines VA Healthcare Lean Six Sigma Training for Professional Healthcare Interns and Students
Transcript of Bay Pines VA Healthcare Lean Six Sigma Training for Professional Healthcare Interns ... ·...
Bay Pines VA Healthcare Lean Six Sigma Training
for Professional Healthcare
Interns and Students
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Preventable medical errors persists as the No. 3 killer in the
U.S. (“Healthcare IT News” 2014)
One-third of hospital patients (1 out of 3) experience adverse
events and about 7% are harmed permanently or die as a
result. (The Joint Commission, April 18, 2014)
50-60% of healthcare processes are essentially waste i.e.,
patients waiting > 2 hours for treatment. (Institute of Healthcare
Improvement)
Only 21% of employees are engaged in their work. (ASQ
Survey 2010)
Health care costs, in both public and private sectors, rose by
4.1% in 2015. (Center for Health Information)
Why Lean Six Sigma in Healthcare?
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Lean Six Sigma is a systematic approach for identifying and
eliminating process variations (reducing errors), and waste
while improving flow of a process.
Recent studies conducted by the American College of
Healthcare Executives, and the American Society for Quality
found that nearly 50% of healthcare organizations were
utilizing lean six sigma methodologies to increase access to
care, improving quality of care, eliminate wasteful processes,
and reduce costs. (Becker's Hospital Review reports).
Lean Six Sigma is now touted as one of the best ways to
improve business performance across any sector. (CMS Wire).
Lean Six Sigma Is Here to Stay
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Opportunity to conduct Lean Six Sigma
Project with clinical or administrative
focus
Physician Project Champions/Mentor
Primarily self-directed with coaching
from Six Sigma Black Belts
Just in Time and Formal Training
Lean Six Sigma overview with tools
Opportunity to lead multidisciplinary
improvement team
Introductory data analysis
Introduction to Clinical and/or
Administrative Hospital Areas
Introduced to patient care and
support processes
Bay Pines Lean Six
Sigma Program Offers
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Your lean six project
will occur in one of
more of these areas
with a physician
project champion :
Medicine
Oncology
Surgery
Anesthesia
Project Work
Geriatric Medicine
Imaging
Behavioral Health
Physical Medicine
and Rehabilitation
Medicine
Primary Care
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Completion of project requirements
Passing of final exam
Multiple choice with essay and final case study with basic data analysis
Open book and notes
85% passing
Project Presentation to Healthcare Systems Senior Leadership
Prepare an VISN 8 Lean Forward Newsletter article summarizing
their project.
Upon graduation, students will have:
The ability to perform essential process analysis
Identify waste within process flow
Receive Lean Six Sigma Yellow Belt Certification
Six Sigma Certification Requirements
Recent Student Lean Six Sigma Projects
Bay Pines USF Graduates- 2014
Before
• Items stored on floor
• Excess equipment and materials taking up space
• Limited organization
After
Floor space increased
Color coded labeling system
Excess equipment/shelving removed
Stock height limit labeling line
Concise and clear directions for medication disposal cage
Cardiac Mortality Information
Management
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Lean Project Goals:
Create quality monitors to accurately capture
cardiac mortality information/outcomes for
further evaluation and improved care.
Reduce errors
Cardiac Mortality Project
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35 medical charts were reviewed by Intern, Team Lead
Results:
8 charts: Error free
27 charts were incorrect!!!
8 coded incorrectly
9 medical resident/attending error
8 ambiguous dx
From these results, it was recommended that quality
monitors be implemented to catch these errors
Baseline Process Performance
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Data Analysis
Audit of CHF deaths
ambiguous dx 10
resident/attending 9
defect free 8
coding 8
10 9
8 8
0
2
4
6
8
10
12CHF mortality chart review
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Recommendations
Hospitalist/Medical teams
Emphasis on primary admission diagnosis (dx):
What actually brought the patient in to the hospital
What is going on at the time of admission, Congestive Heart Failure (CHF) related?
Add Primary dx section to the admission/discharge summary template:
To allow coders to be able to easily determine what dx to code not search for a dx though Computerized Patient Record System (CPRS).
Medical attending to review residents notes thoroughly to ensure correct CHF dx.
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Heath Information Management System (HIMS)
Recommendations
HIMS audits all medical cases
Doesn’t look at CHF dx specifically
Should audit CHF cases to determine accuracy (quarterly?)
If an ambiguous dx is found , make an addendum in CPRS to alert the hospitalist to clarify before coding the dx.
Once principle/primary dx is easily found in medical chart, would make it less likely for error
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New CPRS Admission Template
Improving the ECHO Lab
Scheduling Process
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9% of Bay Pines inpatient echocardiogram
(Echo) orders do not contribute to improving the
patient’s clinical outcome
Eliminate unnecessary inpatient
echocardiogram would yield a cost avoidance
of $28,581 per year
The inpatient Echo process is slow to complete
leading to discharge delays
Project Problem Statement
Current State
Target StateGAPCurrent
State
Target StateGAP
Current State
Target StateGAP
Surgery Site Infections
Reason for Project
Bay Pines has historically been above the
national average for surgical site infections
(SSIs). The rate for fiscal year 2015 was
1.6%, while the National Surgery Office
(NSO) rate was 1.1% for clean type surgical
cases. This discrepancy of 0.5% amounted
to 14 patients, of which has financial
implications, regulatory and administrative
pressure and unnecessary resource
utilization.
Baseline Data
Both Op and OR time do not appear to be a significant
factor in clean SSI rates at Bay Pines
Only 14.3 of clean SSIs had significant delays in procedural time 21% of clean
SSIs had OR time delays
2016 Bay Pines Six Sigma Program Expansion
Includes Pharmacy, Social Work, Nursing, and Dietetics Students
Provides flexible hours!
Emphases utilization of lean six sigma tools and method
Emphasizes leading a healthcare project team
Benefits of Lean certification
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For more information addressing Bay
Pines Lean Six Sigma Training Program:
Joann Fenicchia, Bay Pines Systems
Redesign Coordinator at
Telephone: 727 398 6661 Ext:17627
