1Instructions
OBJECTIVES
- Evaluate the awareness of organizational power structures and decision-making processes of quality improvement managers.
- Apply change leadership strategies to a healthcare quality management scenario.
- Describe how financial analysis can justify quality improvement efforts.
- Analyze an organizational process using a Value Stream Map.
SUMMARY
The Rio Grande Eye Clinic regularly performs complex surgeries, but 50% are simple cataract surgeries. According to financial analysis, the clinic is losing approximately $1,000 per cataract case due to the costs of the procedure being higher than the Medicare payment. Rio Grande is losing approximately $650,000 annually.
These results trouble the VP of Operations, Jane Lucas. Unfortunately, Dr. Elena DeSilva, the Clinic Chair, cannot see where their processes could be improved, so there has been little to no change. The VP of Operations must apply change leadership strategies to convince Dr. DeSilva, including communicate the needed change with urgency, define and describe the better future, and empower an interprofessional team to plan, test, implement, disseminate, and maintain the change.
To accomplish this, the VP of Operations called in the Clinic Administrator, a certified Lean Expert, for assistance. The Clinic Administrator pulled a representative from each of the departments representing high-level steps of the process to create a Value Stream Map (VSM). This session helped pinpoint each source of waste within the process to ultimately reduce the high costs of the cataract surgeries. Some of these sources of waste include lack of standardization with room turnover, surgery scheduling and communication, use of anesthesiology rather than conscious sedation, and use of ophthalmologists for follow-up appointments instead of the optometrists. By eliminating these wasteful processes, Rio Grande can reduce the costs of the cataract surgeries and improve financial performance.
2Discussion Questions Ch 2
- Why do you think Ignaz Semmelweis failed where Florence Nightingale
succeeded in healthcare quality management? - Describe the management innovations employed by quality pioneers, such as Deming and Shewhart, to create reliable processes for delivering quality.
- What innovation did Avedis Donabedian contribute to the field of healthcare quality? How does this innovation impact the practice of healthcare quality management?
- What does the term “Lean” mean in the context of Womack and Jones’s original research on the Japanese automobile industry? How can Lean be applied to healthcare?
- Describe the resources available to healthcare quality management
practitioners, and how these resources could be utilized to improve your
healthcare organization.