Lean Healthcare Systems Engineering For Clinical Environments

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.

Apply engineering and design principles to revitalize the healthcare delivery system Healthcare Systems Engineering is the first engineering book to cover this emerging field, offering comprehensive coverage of the healthcare system, healthcare delivery, and healthcare systems modeling. Written by leading industrial engineering authorities and a medical doctor specializing in healthcare delivery systems, this book provides a well-rounded resource for readers of a variety of backgrounds. Examples, case studies, and thoughtful learning activities are used to thoroughly explain the concepts presented, including healthcare systems, delivery, quantification, and design. You'll learn how to approach the healthcare industry as a complex system, and apply relevant design and engineering principles and processes to advance improvements. Written with an eye toward practicality, this book is designed to maximize your understanding and help you quickly apply toward solutions for a variety of healthcare challenges. Healthcare systems engineering is a new and complex interdisciplinary field that has emerged to address the myriad challenges facing the healthcare industry in the wake of reform. This book functions as both an introduction and a reference, giving you the knowledge you need to move toward better healthcare delivery. Understand the healthcare delivery context Use appropriate statistical and quantitative models Improve existing systems and design new ones Apply systems engineering to a variety of healthcare contexts Healthcare systems engineering overlaps with industrial engineering, operations research, and management science, uniting the principles and practices of these fields together in pursuit of optimal healthcare operations. Although collaboration is focused on practitioners, professionals in information technology, policy and administration, public health, and law all play crucial roles in revamping health care systems. Healthcare Systems Engineering is a complete and authoritative reference for stakeholders in any field.

SYSTEMS ENGINEERING HANDBOOK A comprehensive reference on the discipline and practice of systems engineering Systems engineering practitioners provide a wide range of vital functions, conceiving, developing, and supporting complex engineered systems with many interacting elements. The International Council on Systems Engineering (INCOSE) Systems Engineering Handbook describes the state-of-the-good-practice of systems engineering. The result is a comprehensive guide to systems engineering activities across any number of possible projects. From automotive to defense to healthcare to infrastructure, systems engineering practitioners are at the heart of any project built on complex systems. INCOSE Systems Engineering Handbook readers will find: Elaboration on the key systems life cycle processes described in ISO/IEC/IEEE 15288:2023; Chapters covering key systems engineering concepts, system life cycle processes and methods, tailoring and application considerations, systems engineering in practice, and more; and Appendices, including an N2 diagram of the systems engineering processes and a detailed topical index. The INCOSE Systems Engineering Handbook is a vital reference for systems engineering practitioners and engineers in other disciplines looking to perform or understand the discipline of systems engineering.

Clinical Systems Engineering: New Challenges for Future Healthcare covers the critical issues relating to the risk management and design of new technologies in the healthcare sector. It is a comprehensive summary of the advances in clinical engineering over the past 40 years, presenting guidance on compliance and safety for hospitals and engineering teams. This contributed book contains chapters from international experts, who provide their solutions, experiences, and the successful methodologies they have applied to solve common problems in the area of healthcare technology. Topics include compliance with the European Directive on Medical Devices 93/42/EEC, European Norms EN 60601-1-6, EN 62366, and the American Standards ANSI/AAMI HE75: 2009. Content coverage includes decision support systems, clinical complex systems, and human factor engineering. Examples are fully supported with case studies, and global perspective is maintained throughout. This book is ideal for clinical engineers, biomedical engineers, hospital administrators and medical technology manufacturers. Presents clinical systems engineering in a way that will help users answer many questions relating to clinical systems engineering and its relationship to future healthcare needs Explains how to assess new healthcare technologies and what are the most critical issues in their management Provides information on how to carry out risk analysis for new technological systems or medical software Contains tactics on how to improve the quality and usability of medical devices

Quality in a lean health care setting has one ultimate goal-to improve care delivery and value for the patient. The purpose of this book is to provide a blueprint to hospitals, healthcare organizations, leaders, and patient-facing workers with tools, training, and ideas to address quality within their organization. Examples from health care an other industries are provider to illustrate lean methodology and learn their application in quality. The reader can learn how other organizations improve quality, what their roles are, and what they do daily. By the end of the book, you will have learned actionable concepts and have the tools and resources to start improving quality.

Healthcare leaders around the world are facing tough challenges, including the need to deliver better value for patients and payers, which means improving quality while reducing cost. It might seem impossible to do both, but organizations around the world are proving it's possible, through Lean. Health systems are able to enhance all dimensions of patient care, including both safety and service, while creating more engaging and less frustrating workplaces for healthcare professionals and staff... all leading to improved long-term financial performance. Building on the success of the first two editions of this Shingo Prize-Winning book, Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Third Edition explains how to use the Lean philosophy and management system to improve safety, quality, access, and morale while reducing costs. Lean healthcare expert Mark Graban examines the challenges facing today’s health systems, including rising costs, falling reimbursement rates or budget constraints, employee retention, and harm to patients. The new edition of this international bestseller (translated into eight languages) begins with an overview of Lean methods and mindsets. It explains how engaging staff and leaders in Lean practices such as value stream mapping and process observation can help reduce wasted motion for caregivers, prevent delays for patients, and improve the long-term health of your organization. In addition to a new introduction from John Toussaint, this updated edition includes: New and updated material on identifying waste, A3 problem solving, employee idea management, kanban for materials management, and strategy deployment New case studies and examples—including a new 5S case study (Franciscan St. Francis Health) and other case examples highlighting the challenges and successes of an academic medical center and a small urgent access hospital, featuring quotes and stories from executives New examples and updated data throughout, including revised chapters on patient safety and patient flow challenges and the improvements driven by Lean Detailing the mindsets and methods needed for a successful transition to a Lean culture, the book provides the understanding of Lean practices—including value stream mapping, standardized work, error proofing, root cause problem solving, and daily improvement processes—needed to reduce common hospital errors and improve performance in other dimensions. The balanced approach outlined in this book will guide you through the process of improving the quality of care and service while reducing costs in your hospital. *The Lean Certification and Oversight Appeals committee has approved Lean Hospitals as recommended reading for those in pursuit of Lean Bronze Certification from SME, AME, Shingo Prize, and ASQ

Foreword by Michael F. Gutzeit, M.D., Chief Medical Officer and Vice President of Quality, Children's Hospital of Wisconsin This practical, how-to book clearly and succinctly takes the reader through six proven “success steps” for implementing lean in any healthcare environment: 1. Create physician flowbr 2. Support physician value-added timebr 3. Visually communicate patient statusbr 4. Standardize everyone’s workbr 5. Lay out the clinic for minimal motionbr 6. Change the care delivery model Why go through such a transformation? Because it works. Tell a doctor that he can see the same number of patients, offering the same high quality and personal care, and have an extra 90 minutes at the end of his clinic day – and that means something. Tell the staff that they can look forward to actually ending on time, with satisfied patients, no backlog, and having focused their attention completely on quality patient care – and they will listen. These Lean principles and success steps work in clinics ranging from orthopedics to neurology to cardiac care—the specialty doesn’t matter. They work in small practices and large hospital settings. Lean methodology provides the tools to address the frustrations patients and doctors alike experience in the clinic process. Included throughout the book is a case study showing the lean transformation undertaken at the Orthopedic Center at Children’s Hospital of Wisconsin, with numerous quotes and insights from those actually involved. This transformation resulted in patient wait times being reduced by more than 70 percent, the clinic being able to see 25 percent more patients in less space, patient satisfaction scores sometimes reaching 100 percent, and staff satisfaction scores improving by more than 25 percent.

This edited volume focuses on research conducted in the area of healthcare systems management. Chapters are extensions of works presented at the International Conference on Management of Ergonomic Design, Industrial Safety and Healthcare Systems. The book addresses the need to have the knowledge of technological and resource management, clinical performances and quality of healthcare delivery systems in order to make hospital systems well and adequately designed and operationally effective ensuring the quality of healthcare to patients. It is a useful resource for students, researchers, industrial professionals and design engineers.