Lean Doctors


Book Description

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 flow 2. Support physician value-added time 3. Visually communicate patient status 4. Standardize everyone's work 5. Lay out the clinic for minimal motion 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.




The Lean Doctors Workbook


Book Description

The content of this workbook is based on the book Lean Doctors: A Bold and Practical Guide to Transforming Healthcare Systems, One Doctor at a Time, and on the authors’ years of transforming care delivery systems with lean. The Six Success Steps discussed in the book are presented here with a focus on implementing them to achieve dramatic and sustainable change. The Success Steps are building blocks; the order in which you apply them matters. They are presented here in an order that has worked in the real world; working through them logically will help you on the path to successful implementation. Each Success Step includes a practical explanation of the theory and maps that illustrate how that particular step impacts the care process in the context of a detailed case study. The authors use several Lean mapping tools, including lean process maps, spaghetti diagrams, and swim lane diagrams. In addition to illustrating lean concepts and their application in the context of a case study discussed throughout the book, these maps provide instructive examples that can help you create similar maps for the processes you operate. With its interactive format and step-by-step design, this workbook is ideal for use in the classroom to teach Lean principles, or with a lean project team to guide a clinical implementation. Together with Lean Doctors, this workbook will help the student of lean or the lean project team learn and apply a complete lean system in a healthcare setting.




How Doctors Think


Book Description

On average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong—with catastrophic consequences. In this myth-shattering book, Jerome Groopman pinpoints the forces and thought processes behind the decisions doctors make. Groopman explores why doctors err and shows when and how they can—with our help—avoid snap judgments, embrace uncertainty, communicate effectively, and deploy other skills that can profoundly impact our health. This book is the first to describe in detail the warning signs of erroneous medical thinking and reveal how new technologies may actually hinder accurate diagnoses. How Doctors Think offers direct, intelligent questions patients can ask their doctors to help them get back on track. Groopman draws on a wealth of research, extensive interviews with some of the country’s best doctors, and his own experiences as a doctor and as a patient. He has learned many of the lessons in this book the hard way, from his own mistakes and from errors his doctors made in treating his own debilitating medical problems. How Doctors Think reveals a profound new view of twenty-first-century medical practice, giving doctors and patients the vital information they need to make better judgments together.




Elements of Programming


Book Description

Dr. Joseph Scherger's career in family medicine has spanned 40 years. His training also included a Masters in Public Health where he studied nutrition at the University of Washington. He has always included preventive medicine and wellness in his medical practice. He is physically active with running, one of many choices for being in good shape. Until 2013 he followed the nutrition guidelines promoted by leading organizations such as the American Heart Association. In 2013 he expanded his knowledge in nutrition by reading the books of physician leaders such as William Davis and David Perlmutter. One of his partners in practice (and now his personal physician) Hessam Mahdavi introduced him to Functional Medicine, a focus on treating the causes of disease rather than just treating disease with drugs and procedures. Following this new knowledge and approach, Dr. Scherger greatly improved his own health and the health of many of his patients. This book is that story, loaded with information and scientific references that validate this exciting new approach to nutrition and good health. We live in a toxic food environment yet healthy foods are readily available. Dr. Scherger will help you make the choices that will result in your becoming lean and fit.




Accelerating Health Care Transformation with Lean and Innovation


Book Description

Accelerating Health Care Transformation with Lean and Innovation: The Virginia Mason Experience describes how Virginia Mason Medical Center (VMMC) has systematically integrated innovative structures, methods, and cultural practices into its implementation of Lean. Describing how an organization can create a strategy and build a culture of innovation and learning, it supplies concrete examples that show how Lean and innovation can work hand-in-hand to improve and transform value streams. It also explains how to use the voices of patients and their families to drive improvement and innovation.




Lean Six Sigma for the Medical Practice


Book Description

To help medical practices increase profitability without cutting costs or boosting revenues, Greenbranch Publishing announces a new book by Lean Six Sigma Master Black Belt Frank Cohen and Practice Management Expert Owen Dahl: Mastering Lean Six Sigma for the Medical Practice - Improving Profitability by Improving Processes. For the first time, this new book translates Lean Six Sigma principles and tools specifically for the real-world medical practice environment. Drawing on his involvement with over 2,000 medical practices, author and Lean Six Sigma Master Black Belt Frank Cohen empowers practices - and their advisors - to use 24 process improvement tools to boost efficiency so more of the revenues that come in go directly to the bottom line. What types of improvements can practices make? Learn how to use analytics to identify inconsistent behavior by payers - so practices can hold payers' feet to the fire. See how process improvement can help practices reduce denials by upwards of 50%. Use these techniques to improve both patient satisfaction and staff morale. Learn how to eliminate bottlenecks in your practice and use metrics to make smart practice improvement decisions. Over the past 20 years, Lean and Six Sigma approaches have created profit breakthroughs for other types of businesses. Cohen and Dahl bring this methodology to health care providers, whittling down the myriad of traditional Lean Six Sigma tools to only those that matter most to their practices. Add Lean Six Sigma for the Medical Practice to your "must-read-now" bookshelf and take the first steps toward improving everything from patient visit cycle time to, A/R to staff and patient satisfaction and morale to compliance.




Beyond Heroes


Book Description

Hospitals have long relied on the heroics of one brilliant nurse or doctor to save the day. Such heroics often result in temporary workarounds and quick fixes that leave not only patients and quality care at risk, but also increase costs. This is the story of an organization breaking that habit. Like a growing number of healthcare organizations around the world, ThedaCare, Inc. has been using lean thinking and the principles of the Toyota Production System to improve quality of care, reduce waste, and become more reliable. But lean thinking was incompatible with ThedaCare’s old top-down, hero-based system of management. Kim Barnas, former SVP of ThedaCare, shows us how she and her team created a management system that is stable and lean, to spur continuous improvement. Beyond Heroes shows the reader, step by step, how ThedaCare teams developed the system, using the stories of its doctors, nurses and administrators to illustrate. The book explores each of the eight essential components of the lean system, from front-line problem solving with the scientific method to daily team huddles and creating standard work for leaders all the way to the top of an organization. Finally, the author introduces four executives from healthcare systems across North America who have implemented ThedaCare’s system and share the lessons they learned along the way. Beyond Heroes is not just a call to action or an argument for a better healthcare system. It is a necessary roadmap through the rocky terrain ahead, one that healthcare leaders can customize to their special needs.




Lean Healthcare Systems Engineering for Clinical Environments


Book Description

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.




Transforming Health Care


Book Description

For decades, the manufacturing industry has employed the Toyota Production System the most powerful production method in the world to reduce waste, improve quality, reduce defects and increase worker productivity. In 2001, Virginia Mason Medical Center, an integrated healthcare delivery system in Seattle, Washington set out to achieve its compe




Clean & Lean


Book Description

The Instant New York Times Bestseller Eat clean, get lean! Losing weight can be simple—get back to basics on your plate, harness the power of intermittent fasting for quick results, save time and money, and train your body to move, and the excess pounds will slip away. The bestselling author of SHRED and The Clean 20 cracks the code for all of us who live in the modern world where we’ve lost touch with what real food is—and how good it tastes—and what our bodies are designed to do. Dr. Ian wrote Clean & Lean to put what he knows about nutrition and physiology in one place, and to motivate you to: --Use intermittent fasting to discover your optimal eating times each day --Explore clean eating with 30 (!) fresh, real foods that you can combine endlessly for meals and snacks --Try his day-by-day 30-day diet plan that tells you just what to eat, while still giving you loads of options --Get up and move: customized exercise plans for all fitness levels won’t wear you out, but will energize you and accelerate your results --Take off up to 15 pounds in 30 days!