Many health-care industry bottlenecks can be eliminated, resulting in major improvements in efficiency, cost savings and patient care when hospitals borrow principles from production lines on the factory floor, according to researchers in the School of Engineering and Applied Sciences at the University at Buffalo.
At UB's Center of Excellence for Global Enterprise Management, Li Lin, Ph.D., professor of industrial engineering, and his colleagues apply industrial-engineering tools, including Six Sigma and other lean enterprise methodologies originally developed for manufacturing processes, to improve the operations and competitiveness of hospitals.
"In today's competitive environment, especially with the severe shortage of skilled nurses, the pressure on streamlining hospital operations continues to increase," said Lin. "Health-care managers are seeking new perspectives and creative ways to manage their business. We can engineer medical services with improved cost, quality and efficiency."
Lin and his colleagues use animated computer simulations that are based on statistical analyses -- routinely used to model the flow of parts through complex manufacturing processes -- to uncover the bottlenecks or potential problem areas in health-care facilities.
"What do cars on highways, manufactured parts in a factory and patients in a hospital have in common?" he asks. "They all move. We use computer simulations to analyze how patients flow through hospitals, while ensuring that th...
In this essay, the author
Explains that hospitals can eliminate health-care industry bottlenecks and improve efficiency, cost savings, and patient care by borrowing from production lines on the factory floor.
Describes how li lin, ph.d., professor of industrial engineering, and his colleagues use industrial-engineering tools, including six sigma and other lean enterprise methodologies, to improve the operations and competitiveness of hospitals.
Explains that in today's competitive environment, especially with the shortage of skilled nurses, the pressure on streamlining hospital operations continues to increase.
Describes how lin and his colleagues use animated computer simulations based on statistical analyses to uncover bottlenecks or potential problem areas in health-care facilities.
Analyzes how industrial engineers analyze how patients flow through hospitals while ensuring that the drive for efficiency doesn't dehumanize patient care.
Explains how lin's computer simulations have helped the buffalo mercy hospital envision how increased patient volume will cause congestion in its surgical unit, necessitating and justifying the construction of new operating rooms.
Describes how lin is working with mcauley-seton home care, a division of the catholic health system in buffalo, to streamline the scheduling of nurses' visits to patients' homes.
Explains how lin tracked the number of tests that each physician in a hospital ran to diagnose and treat the same disease. industrial engineers can assist hospitals in improving their efficiency with detailed statistical analysis.
Opines that while lin characterized the collection and review of such data as "very delicate," it serves as an important starting point for hospitals to find ways to cut costs and for physicians to begin sharing information on the optimal tests to run for each disease.
Describes how lin and his team develop computer animations that visually display a hospital's statistical capacity to handle patients in terms of beds, operating rooms, pre- and post-operation facilities and staff.
Explains that lin is beginning discussions on how to tackle what is likely the least efficient part of any hospital -- the emergency room.
6) mentions some critics argue that treating patients should not be considered a business. These critics argue that these initiatives have the chance of negatively affecting patient treatment and “care as the quest for achieving enhanced operational performance may dictate procedures” (Kudyba, 2010, p. 6). I do see where these critics are coming from however, look how far medicine has come and how much has improved. These new protocols and business models are extremely beneficial to not only the hospitals but to the patients, as well. Most nurses and doctors came into this business to help people. Just because they have to follow a specific business model doesn’t change their heart. These protocols have the ability to improve patient weight time, improve care protocols, which saves time and money for both parties, and save lives. There really is no other way to go about this besides treating it as a
In this essay, the author
Explains that healthcare is one of the most complex business models in the american industry because the consumer does not technically pay for the service he or she receives.
Explains patient as a profit center has to do with the ultimate objective of providing the best quality of care to patients that can override established business profit optimization goals. organizations like joint commission and department of health have established specific regulations and protocols that must be met for hospitals to receive accreditation.
Analyzes kudyba's argument that treating patients should not be considered a business, stating that new protocols and business models are beneficial to hospitals and patients.
Explains kudyba's meaningful use priorities for improving quality, safety, efficiency, and reduce health disparities by providing patient care team with access to comprehensive patient health data, using evidence-based order sets and computerized provider order entry.
States kudyba's timeline for meaningful use, which includes data capture and sharing, advance clinical processes, and improved outcomes. patients should be able to access self-management tools online.
States that electronic health records are computerized versions of the old paper charts but in real-time, patient centered records.
Explains how healthcare informatics can use information derived from electronic health records to improve the effectiveness of care.
The use of technology to improve processes and eliminate waste is embraced by the Toyota Production System and should be incorporated by hospitals and health care offices as well. Technology can reduce the manual labor involved in many processes that take place within a hospital and improve overall efficiency. As mentioned earlier, due to limited staff in our sports medicine department, athletes would come in for rehabilitation whenever they wanted to come in; however, this caused for multiple people coming in at the same time and me not being able to fully treat everyone to the fullest; this caused for non-value-added-activity. My solution to this problem was to implement appointment times by using an online scheduling app that I have access
In this essay, the author
Explains the use of technology to improve processes and eliminate waste is embraced by the toyota production system and should be incorporated by hospitals and health care offices.
In Elizabeth case, she and her team can take measures through a system redesign to improve the quality and efficiency of the hospital systems. The US health system as a whole need improvement on quality of care,
In this essay, the author
Explains that a new redesign system can make important changes and improve performance of their current systems of care.
Explains that elizabeth and her team can take measures through a system redesign to improve the quality and efficiency of the hospital systems.
There are many positives to my organization's nursing model. Berger (2017), is always working to improve health care solutions and advance services in our county for many on-coming years ("The Berger way"). I see this as a positive and negative. This is a pro because we are always looking for opportunities for advancement, however, it also means that there are many areas that need advancement. Being a small rural hospital, often I find that we do not always have everything that a patient may need. There are times when we have to send patients to larger organizations simply because we do not have the proper resources or consulting doctors available. This will be a time consuming process trying to advance
In this essay, the author
Opines that berger's nursing model is a positive and negative one. they believe that looking forward and innovating for the future is great, but organizations need to work on smaller goals to complete larger solutions.
Opines that berger's focus on the community is their biggest positive aspect of their organizational model.
Explains that each organization has its own idea's and values on how their organization should be run.
Opines that nurses can be involved in the way mission and visions are carried out by following policy and being involved. shared governance is framework for empowering accountability and decisions to make an organization effective.
Next a question of how realistic an emergency room simulation should be if the simulation would be evoking gender
In this essay, the author
Describes ethical systems that might help inform professionals in the field of medical hci.
Contrasts consequential systems of ethics where the emphasis is on the outcome or consequence of a course of action.
Explains how three different ethical frameworks could apply to medical human computer interactions (hci) as a subset of hci.
Explains consequentialism, non-consequentialism, and virtual ethics are described as systems and then applied to a medical hci context.
Explains that the modern period of philosophical history can be traced back to the greek philosopher epicurus. utilitarian philosophers argue along similar lines when they talk about happiness being the ultimate good.
Explains that medical hci would be interested in using utilitarianism to determine a range of ethical decisions.
Opines that utilitarianism as an ethical system would guide the researcher by getting her to ask whether or not keeping the subjects' identities confidential will lead to the greatest happiness.
Opines that medical hci is merely providing a context in which utilitarianism is being employed.
Explains that a medical hci researcher would have to determine what course of action to take. rule utilitarianism would start by having the researcher apply the rule to the situation and work out if the application of that rule would lead to greater total sum of happiness.
Explains kant's categorical imperative as testing mechanism to discover a duty for non-consequentialist theories of ethics.
Explains that ls was in the wrong when she made her propaganda films, not because her films promoted evil, but because it is wrong in its own right to make propaganda movies that promote evil.
Explains that kant's categorical imperative can help identify if there is a duty to prefer one course of action over another.
Argues that keeping subjects' identities private should be turned into a universal law based on kant's categorical imperative.
Analyzes the problem of determining whether or not a simulation that evokes racial or gender stereotypes is acceptable.
Opines that the non-consequentialist systems place too much of a burden on any suggested course of action.
Analyzes aristotle's nicomachean ethics, wherein the emphasis is placed on the reasoning process which is seen as itself a virtual activity, but also directs on toward what virtuous action may be in given context.
Explains that virtue ethics is focused on the character or type of person one would become by choosing one course of action over another.
Opines that the challenge with employing virtue ethics is to find appropriate vices for the scenarios.
Explains that three ethical systems are applied to two scenarios in medical hci. consequentialist, nonconceptualist and virtue ethics apply to a scenario where the researcher has to determine whether to keep confidential subjects' dna.
In recent years developed countries are facing rising costs in health care. Health policy makers implement health reform policies to control costs and to develop health outcomes (Hadad et al. 2013). Despite cost containment is a major objective of health reforms, encouragement of innovation and ensuring supportive environment for technological improvement are behind factors of future strategies of health reform policies. Because innovation and technology are drivers of rising health expenditures (Sorenson et al.
In this essay, the author
Explains that health policy makers implement health reform policies to control costs and develop health outcomes. innovation and technology are drivers of rising health expenditures.
Lean Six Sigma can be termed as a program of process improvement that incorporates two ideas which are lean, and six sigma. Lean comprises of techniques for minimizing the time required to deliver services or products. Six Sigma comprises of techniques for refining the quality of services and products, significantly contributing to amplified satisfaction of the client. By incorporating them, Lean Six Sigma can be seen to be a proven strategy of business management that assists organizations in operating more efficiently. Many quality improvement experts and business analysts believe that this program is the most prevalent business performance methodology in corporate developments history (Taghizadegan, 2006).
In this essay, the author
Explains that lean six sigma is a program of process improvement that incorporates lean, and six sigma.
Explains that approving six sigma in organizations of healthcare is commonly used for managing the power and politics of quality development than applying innovative statistical tools of problem solving.
Explains that the six sigma program, with its persistence on top executive obligation and devoted infrastructure of black belt, can penetrate through the fog of politics and power in healthcare administrations and used to improve the organizations daily processes.
Explains that six sigma can be used to improve healthcare processes because it offers an influential tool for making a culture of joint accountability for development.
Describes dmaic as a process that can be used to identify and measure the overall performance of lean six sigma.
Opines that a control strategy in place is key to ensure that the process is consistently carried out.
Explains how each methodology of improvement adds valuable techniques, ideas, and concepts to the organization. the challenge is usage of the particular powers that each method possesses to help it develop.
This is a research analysis of an article titled “STEP-UP: Study of the Effectiveness of a Patient Ambulation Protocol” by authors C. R. Teodoro, K. Breault, C. Garvey, C. Klick, J. Obrien, T. Purdue, A. Stolaronek, H. W. Wilbur and L. Matney. This article is a study of the effects of implementing a patient ambulation protocol on a medical-surgical floor in a community hospital.
In this essay, the author
Explains the research analysis of an article titled "step-up: study of the effectiveness of a patient ambulation protocol".
Explains that the lack of an effective ambulation protocol in hospitals leads to a plethora of secondary issues such as deep vein thrombose, pressure ulcers, and loss of mobility.
Explains that the study was conducted on a 30-bed medical-surgical unit in northeastern u.s.
Explains that the sample was selected from patients on an inpatient medical-surgical unit with the following criteria: an estimated length of stay of greater than or equal to three days, an age of eighteen years or older, medical order for ambulation, no restrictions, ability to
Explains that the amount of ambulation was determined by recording distance traveled in steps captured with a pedometer (shrinq, model 304, sportline, hazleton, pa).
Explains that investigators were trained in proper use of pedometers, including clearing memory and recording. the ambulation group was asked to set goals for the next two days by asking the patient to estimate how far they would walk.
Explains that the ambulatory group increased and the usual care group decreased, whereas before the program no significant difference was found. the decrease in the non-ambulation group was unexpected.
Opines that the statistics were provided upfront with data and graphs, but some equations weren't provided, such as their equation for choosing a sample size which was able to show an increase of 133%.
Analyzes how s' lack of discussion about their unexpected drop in the usual care group could show bias. they state that the study could easily be implemented despite the drop-in care for patients.
Explains that an uneven split of patients could change the statistics for both groups to look different than what they originally were providing. a smaller ambulation sample size allows you to see the increase more clearly than if an additional two patients had been added.
Explains that s stated they had two limitations, the first being that education materials were limited and that different results might have occurred with longer education programs.
Analyzes the limitations of the article, such as the sample size and the higher percentage of post-surgery patients. the research only occurred on one floor of a community hospital in the us.
Opines that the multiple areas of bias may have influenced the results of the study. the pedometer could be inaccurate due to the quality and style of its data collection.
Explains that the results of the study are clinically significant while requiring little effort implementing their ambulation program is of negligible risk to the patient and in fact is an incredible benefit.
Explains that the study produced evidence that ambulation protocols are effective in improving patients' mobility, which is highly applicable to all hospitals.
Opines that pedometers can improve goal setting based on steps rather than distance and monitoring of patient ambulation improving charting and record keeping of steps traveled.
Concludes that the study suggests that more staff may be needed for an effective ambulation protocol, as seen with the drop in the number of usual care patients; further study is needed to see if this drop is due to other factors.
Despite the fact that lean manufacturing suggests the ability for large amounts of improvements and the theories are generally straightforward, most organizations applying lean manufacturing are not benefiting from its advantages. An Industry Week (2008) study in 2007 uncovered that about 70% of manufacturers in the United States had employed a lean manufacturing program; yet, just 2% of organizations completely accomplished their expected results and 74% of organizations conceded that they were not making anticipated growth. The extensive implementation of lean manufacturing and the resulting poor results has provoked much research into comprehension of the source for the lean manufacturing implementation
In this essay, the author
Explains that organizations employ lean principles drawn by the potential benefits of expanded operational efficiencies, increased quality, and increased value for their clients and ultimately increased profits resulting from the decrease of expenses.
Opines that corporate change necessitates disappointment with the current condition of the company and a well-managed transformation process.
Explains how external factors can affect the current solutions that are set in place. companies can establish a well-defined market niche that can benefit their business in several areas such as new customer base, reliable market share, and potential for new uses of current products and services.
Explains how fred winslow taylor, a foundry manager from philadelphia, established the framework for mass production.
Defines lean manufacturing as removing waste in a manufacturing process, and states that it requires time and discipline to achieve the transition.
Explains that lean manufacturing is a system for operational enhancement obtained from the toyota production system, but most organizations are not benefiting from its advantages.
With improvements in home health care and other services available to provide subacute continuity of care outside of the hospital setting, early discharge became one of the means by which hospitals have been able to reduce the overall length-of-stay to remain profitable (Shi & Singh, 2015).
In this essay, the author
Explains that hospital downsizing is the result of the successful implementation of cost-saving programs that have shifted the primary areas for patient care from inpatient to various outpatient care facilities and disciplines.
Explains that the modernization of hospitals and hospital services can be traced back to 1840 when facilities began to change their focus from caring for the impoverished and mentally ill, to providing complete health care to the population.
Explains how the tax equity and fiscal responsibility act of 1982 changed reimbursement from a system based on the individual cost of each item and service provided to the patient.
Explains that managed care affects how hospitals and physicians practice medicine by focusing on cost-saving measures such as active patient management and patient participation.
Explains that hospital closures and mergers have contributed to the declining number of available beds and facilities, reflecting a marked decrease in new facilities.