Lee Revere

Integrating Six Sigma with Total Quality Management: A Case Example for Measuring Medication Errors

EXECUTIVE SUMMARY Six Sigma is a new management philosophy that seeks a nonexistent error rate. It is ripe for healthcare because many healthcare processes require a near‐zero tolerance for mistakes. For most organizations, establishing a Six Sigma program requires significant resources and produces considerable stress. However, in healthcare, management can piggyback Six Sigma onto current total quality management (TQM) efforts so that minimal disruption occurs in the organization. Six Sigma is an extension of the Failure Mode and Effects Analysis that is required by JCAHO; it can easily be integrated into existing quality management efforts. Integrating Six Sigma into the existing TQM program facilitates process improvement through detailed data analysis. A drilled‐down approach to root‐cause analysis greatly enhances the existing TQM approach. Using the Six Sigma metrics, internal project comparisons facilitate resource allocation while external project comparisons allow for benchmarking. Thus, the application of Six Sigma makes TQM efforts more successful. This article presents a framework for including Six Sigma in an organizations TQM plan while providing a concrete example using medication errors. Using the process defined in this article, healthcare executives can integrate Six Sigma into all of their TQM projects.

Integrating Six Sigma and CQI for improving patient care

Examines Six Sigma as a strategy for improving service which tries to reduce defects and therefore improve a firm’s marketing position. Looks at how this as been applied in business and then examines its place in healthcare. Concludes that the few healthcare institutions that have implemented Six Sigma have done so in the interest of business and not so much in the area of patient care, where it is proposed that it will improve things dramatically.

RFIDs can improve the patient care supply chain.

Abstract Technologies that increase efficiency, enhance quality, and improve patient safety are essential for all healthcare organizations. Radio frequency identification devices (RFIDs) seem to be right for this challenge. RFIDs can be integrated into all areas of the internal patient supply chain, serving as clearinghouses of information. By providing timely information on patients, processes, and equipment, RFIDs can save time and reduce costs while simultaneously improving quality and patient safety. Healthcare leaders owe it to all constituencies to take a serious look at what RFIDs can offer.

An empirical investigation into Six Sigma critical success factors

This pilot research explores the critical success factors of Six Sigma to gain insight into the gaps between Six Sigma theory and execution, and to understand the primary drivers of financial improvements. The findings demonstrate the key aspects that seem to be consistent among Six Sigma organisations. Results show organisations cite Six Sigma for cost reduction, notoriety of its success and increased revenues. Chi-square analyses indicate gaps exist between theory and actual practice across the three critical success factors of team selection, project selection and project implementation. A larger percent of respondents agree on the criticality of key tasks/issues, yet fewer companies execute them in practice. Regression results demonstrate the factors of team selection and project selection significantly impact the financial improvement performance of the responding organisations. These results are beneficial for researchers investigating Six Sigma, business leaders considering its implementation and for existing companies seeking to achieve even greater improvement gains.

Re‐engineering proves effective for reducing courier costs

The success of business process re‐engineering (BPR) is dependent on the use of data‐driven methods that provide cost‐effective and optimal solutions. Todays business managers are inundated with methodologies and tools that claim to provide sustaining process improvement results. Determining the appropriate BPR method(s) to employ is a daunting task for many businesses. Understanding the technical complexities of these methods is even more overwhelming. However, with the increased availability of management science software, business managers can easily identify and employ proven management science techniques. Readily available software that provides timely results, is easily adaptable to resource changes, and does not require extensive technical competencies. This paper demonstrates how scientific management techniques, coupled with management science software (Management Scientist, Project Management and Excel), provided a feasible and achievable solution to a laboratory courier service BPR project. The solution yields a 19.5 percent reduction in annual laboratory courier specimen costs while improving service levels.

How healthcare organizations use the Internet to market quality achievements.

EXECUTIVE SUMMARY The increasingly competitive environment is having a strong bearing on the strategic marketing practices of hospitals. The Internet is a fairly new marketing tool, and it has the potential to dramatically influence healthcare consumers. This exploratory study investigates how hospitals use the Internet as a tool to market the quality of their services. Significant evidence exists that customers use the Internet to find information about potential healthcare providers, including information concerning quality. Data were collected from a random sample of 45 U.S. hospitals from the American Hospital Association database. The data included hospital affiliation, number of staffed beds, accreditation status, Joint Commission quality awards, and number of competing hospitals. The studys findings show that system‐affiliated hospitals do not provide more, or less, quality information on their websites than do non‐systemaffiliated hospitals. The findings suggest that the amount of quality information provided on a hospital website is not dependent on hospital size. Research provides evidence that hospitals with more Joint Commission awards promote their quality accomplishments more so than their counterparts that earned fewer Joint Commission awards. The findings also suggest that the more competitors in a marketplace the more likely a hospital is to promote its quality as a potential differential advantage. The studys findings indicate that a necessary element of any hospitals competitive strategy should be to include the marketing of its quality on the organizations website.

Learning retention in online versus F2F instruction

This research explores the long-term effect of online learning by evaluating learning achievement in a subsequent, related course. A prior study indicated online learning was inferior to face-to-face learning. This study expands that research by following the same students, both online and face-to-face, from the prerequisite class through a subsequent course. The results indicate that if online instruction is inferior to face-to-face in learning complex content, reduced learning achievement does not have an adverse effect on learning achievement in a related, subsequent course. The results of this research are an important step towards understanding the long-term impact of online learning.

Improving resource efficiency through management science

EXECUTIVE SUMMARY Optimal management of resources is a very complex and difficult task for healthcare systems. Nevertheless, healthcare providers can employ data‐driven methodologies and management science tools, coupled with managerial insights, to significantly improve both their resource effectiveness and efficiency. Understanding the full technical complexities of management science models is a daunting task for healthcare managers, but they can be aided by the increased availability of management science software. Readily available software does not require extensive technical competencies and is easily adaptable to resource changes. This article reports how a large healthcare system improved the cost effectiveness and service efficiency of its laboratory courier service through the use of management science techniques and readily available software. The laboratory courier system existed to serve a large multihospital healthcare system located in a major Texas metropolis. The routing and scheduling solution reported in this article yielded a very substantial 16.4 percent reduction in annual laboratory courier costs and a significant improvement in service levels. This study indicates that management science techniques and software are readily adaptable to the healthcare environment and are amenable to use by healthcare administrators.

Design and Implementation of the Texas Medicaid DSRIP Program

Texas is one of 8 states that have received a Medicaid 1115 Transformation Waiver in which federal supplemental payments are being used to incentivize delivery system reform. Under the Texas Transformation Waivers 5-year Delivery System Reform Incentive Payment (DSRIP) program, hospitals and other providers have established regional health care partnerships, conducted regional needs assessments, and developed and implemented projects addressing local gaps in service. The projects were selected from menus, supplied by the Texas Health and Human Services Commission and the Centers for Medicare & Medicaid Services, which defined acceptable infrastructure development and/or program innovation and redesign initiatives. Providers receive payment for planning the projects and achieving metrics and milestones related to project implementation and performance. This article describes the major features of the Texas DSRIP model and the resulting implementation and performance to date in the most populous region of the state.

A comparison of inpatient severity, average length of stay, and cost for traditional fee-for-service medicare and medicare HMOs in Florida.

Abstract: This research compares the mean severity level, length of stay, and cost of Medicare health maintenance organization (HMO) and Medicare fee-for-service (FFS) inpatients. The results suggest Medicare HMOs have healthier inpatients and shorter lengths of stay, but more costly per-day utilization. These findings are contrary to the assumption that HMOs reduce daily utilization.