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Patient Safety

Visualizing conversation structure across time: Insights into effective doctor-patient consultations

This study uses a highly efficient and time economic automated computer visualization measurement technique called Discursis to analyze conversational behavior in consultations.

Can lean tools help crack the medication safety code?

Joanie Ching, RN MN, Administrative Director of Quality and Safety, blogs about how Virginia Mason Hospital in Seattle is abandoning batch administration of medications to improve patient safety. By going to just-in-time medication administration, nursing workload has been leveled, medication errors have been reduced, and nurses are better able to respond to patient needs.

Editor's note: Workload leveling and smaller batch size, like many other "lean tools", are industrial engineering concepts that have been well understood for many decades. It appears that a lean approach has helped Virginia Mason to discover the benefits in this novel application.

The importance of communication for patient satisfaction

This research investigates the effect of communication complexity level on patients' perceived quality. The amount of communication was measured by self reports regarding the patient's visit.

Bound for flight: Elevating organizational excellence using lean leadership

This engaging presentation at the 2013 Healthcare Systems Process Improvement Conference in New Orleans, describes an actionable transformational leadership roadmap for navigating common organizational obstacles using a non-biased Lean approach at Advocate Condell Medical Center in the Greater Chicago area. As a result of embracing an innovative transformational roadmap, the organization experienced a significant turnaround both financially and culturally, including a $50 million dollar financial swing and a top percentile workforce satisfaction rank.

Patient experience and physician productivity: Debunking the mythical divide at HealthPartners Clinics

It is a common presumption that patients satisfaction and physician productivity are somewhat exclusive. This study in the Permanente Journal helps dispel commonly held myths about the exclusivity of productivity and patient satisfaction, suggesting that 1) there are many physicians who excel in both areas simultaneously, and 2) there are different characteristics associated with varying levels of performance.

Kaiser Permanente's healthcare IT journey

This presentation (large download) at the 2012 World of Health IT Conference describes how Kaiser Permanente is successfully leveraging IT resources to improve patient care.

Barnes-Jewish Hospital projects show patient safety and quality success 

A recent article in Becker's Quality Control and Infection Control describe how Lean Management drives continuous improvement at 1,100-bed Barnes-Jewish Hospital. In the article, Hospital Chief Medical Officer, John Lynch, M.D., describes how physicians have embraced Lean at Barnes-Jewish. He also describes how Lean Management projects have reduced central line infections, pressure ulcers, and diabetes medication errors, and improved patient coordination between different levels of care.

Aviation crew resource management: A flight plan to patient safety

In this presentation at the SHS Healthcare Systems Process Improvement Conference 2012, the authors discuss how aircraft accidents and patient safety failures are generally related to a lack of communicating and decision making skills in dynamic environments. Crew resource management (CRM) was developed by the aviation industry resulting in dramatic improvement in airline safety. Based on this success, CRM training and methods are being adopted by healthcare organizations throughout the world to improve patient safety.

Hunterdon hospital cleans up infections

The Wall Street Journal recently featured an article on how Hunterdon Medical Center reduced hospital-acquired infections with a number of high-impact interventions aimed at improved hospital cleaning. The 178- bed hospital in New Jersey was able to reduce different types of infection by between 66 percent to 79 percent between 2006 and 2011.

Students at Kettering University use industrial engineering principles to help prevent patient falls at local healthcare facilities

By applying core industrial engineering principles, students in Dr. Matthew Sanders' senior capstone class helped Genesys Hospital in Flint, Mich., evaluate and streamline its visual cueing system to better alert hospital staff, visitors and patients about fall risks.

Central line infection reduction using Lean Sigma at Presbyterian Healthcare Services, Albuquerque, N.M.

A multidisciplinary group at Presbyterian Healthcare Services teamed together to meet the Joint Commission National Patient Safety Goal and to reduce the central line infection rate to less than 1 per 1,000 patient days. The team used a Lean Sigma improvement methodology to identify a number of countermeasures including checklists, education, defined observer, and a standardized central line kit. In the first six months of the project, the central line infection rate was reduced to .22 infections per 1,000 patient days.

Industrial and systems engineers cure some of healthcare's ills - Watson Institute for Systems Excellence at Binghamton University

A recent feature in Binghamton's Watson Review describes ongoing healthcare improvement research at the Watson Institute for Systems Excellence (WISE). Ongoing healthcare research at WISE includes research in ED throughput and supply chain. WISE researchers collaborate with a number of hospital systems including Vitua, Mayo, and Wilson and Binghamton General Hospitals. Thirteen research assistants in the WISE program have recently been placed in healthcare organizations.

Transforming care at the bedside: increasing patient satisfaction through employee engagement and teamwork at Our Lady of Lourdes Medical Center, Camden, New Jersey

Nursing leaders at Our Lady of Lourdes Medical Center in Camden, New Jersey, engaged staff to improve patient and employee satisfaction and reduce staff turnover on a medical-surgical unit using the Transforming Care at the Bedside (TCAB) model developed by Robert Woods Johnson Foundation and the Institute for Healthcare Improvement. The team focused on a set of directed methodologies and conducted a number of experiments that resulted in dramatic improvement.

What makes a hospital great

In a recent New York Times article, Pauline W. Chen, M.D. makes a case that organizational culture is more important than technique and technology in providing quality healthcare. 

Cowboys and pit crews: 2011 Harvard Medical School commencement address

Popular author and speaker Atul Gawande challenged the 200 graduates of the 2011 Harvard Medical School to pursue a more systematic approach to delivering healthcare. He used pit crews and cowboys as examples of working as a system.

How to ace your joint commission survey with lean

In this Ezine article author Gerald Leone describes how lean tools and principles were successfully applied in preparation for a Joint Commission Survey.

The journey to eliminating preventable harm - Nationwide Children's Hospital

In this presentation at the 2011 Society for Health Systems conference, Cindy Hafer provides a comprehensive look at how Nationwide Children's Hospital in Cincinnati is moving to eliminating all preventable harm to patients through a comprehensive safety initiative.

University of Windsor Industrial and Manufacturing Systems Engineering students help to improve lab processes in the ED at Sunnybrook Health Sciences Centre

Sunnybrook Health Sciences Centre is considering implementing recommendations made by three fourth-year students at the University of Windsor Industrial and Manufacturing Systems Engineering as part of their capstone project. Ben de Mendonca, Josh Vandermeer and Andrew Phibbs, conducted an intensive examination of the system used by the emergency department to collect and label patient blood samples.

Indiana hospital pharmacy saves $1 million annually with lean improvements

Pharmacy leaders at Elkhart General Hospital, in Elkhart, Ind., applied a number of lean concepts resulting in lower operational costs and improved patient care. Examples of improvements cited in the Modern Medicine e-zine article were to redeploy two pharmacists to clinical roles, consolidate unit medications, and reduce batching of IV medications.

Human factors engineering to reduce patient falls

In a recent presentation at the 2011 SHS Conference, Brian H. Fillipo delivered a presentation on a comprehensive approach to reducing patient falls across seven Bon Secours hospitals in Virginia.

Purdue industrial engineering researchers investigate using surgeon hand gestures to improve surgery

Vision based recognition of hand gestures is being researched at Purdue University to control a robotic scrub nurse and access images during surgical cases. The research could lead to short case lengths and reduced infections according to the Purdue University News website.

The art of implementing Lean from AORN Management Connections

A recent article in AORN Management Connections by Carina Stanton describes how three healthcare organizations are implementing lean.

Video presentation on models, measurement techniques, and tests for analyzing adherence and performance of evidenced based medicine

In this 2010 presentation at the Dartmouth School of Engineering, SHS contributor and past president, James Benneyan, Ph.D., from the School of Mechanical, Industrial and Manufacturing Engineering at Northeastern University discusses that challenges of measuring performance of evidenced-based medicine and provides solutions to address these challenges.

Audible alarms and workplace noise in nursing units: An envioronmental factors case study

A case study for reducing workplace noise on a pediatric nursing unit and maintaining appropriate noise levels.

University of Wisconsin-Madison researchers post final report on Industrial and Systems Engineering (ISyE) in Health Care

In research sponsored by the Agency for Healthcare Research and Quality (AHRQ), UW researchers summarize findings and associated research from a 2009 conference in a report entitled Industrial and Systems Engineering and Health Care: Critical Areas of Research.

Using Lean to Identify Process Improvement Opportunities and Improve Effectiveness of Transfusion Professionals

Susan F. South, senior consultant, ValuMetrix® Services and Jo Ann S. Hegarty, worldwide marketing director, ValuMetrix® Services provide a description of improvements in blood transfusion processing by applying lean concepts at 14 different laboratories in three different countries. The average savings per site was more than $190,000, excluding savings associated with improved inventory management.

Lesson from the Trenches: Implementation of an Automated Patient Safety System 

In this presentation given at the 2010 SHS/ASQ Healthcare Division Conference, the authors describe how a Baldrige Award-winning hospital implemented a paperless continuous improvement patient safety system. The system is used for collecting patient safety events as well as analysis, performance improvement, classification, and organizational knowledge building involving every employee in the healthcare system. The automated patient system has dramatically improved event reporting and streamlined the analysis and follow-up.

Using your Head(wall) - Advances in Patient Room Design

IE students at Clemson University have been involved in a multiyear study on patient room headwall design. The study included the School of Nursing at Clemson and staff and facilities at Spartanburg Regional Healthcare System.



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