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Lean Behavioral Health: The Kings County Hospital Story is the first lean book that focuses entirely on behavioral health. Using the principles of the Toyota Production System, or lean, the contributors in this groundbreaking volume share their experience in transforming a major safety net public hospital after a tragic and internationally publicized event. As the largest municipal hospital system in the United States, the New York City Health & Hospitals Corporation adopted lean as the transformational approach for all of its hospitals and clinics. Kings County Hospital Center, one of the largest providers of behavioral health care in the country, continues on its transformational journey utilizing lean's techniques. While not every event was fully successful, most were and every event, including failures, increased the knowledge base about how to continually improve quality and safety. Having made major changes, Kings County Hospital Center is now recognized as a center for transformation and quality receiving high marks from oversight agencies. This volume begins by describing the basic principles of the lean approach-adding value, eliminating waste, and tapping the organization's line staff to create and sustain dramatic change. An overview of the use of lean from a quality improvement perspective follows. Lean tools are applied to many services that comprise the behavioral health value stream and these stories are highlighted. The experts in identifying waste and adding value are the line staff whose voices are captured in the clinical chapters. Insights learned by event participants are emphasized as teaching points to provide context for what has worked or has not worked at Kings County Hospital Center. While the burning platform at Kings County Hospital Center was white hot and while the Department of Justice scrutinized its quality of patient care, the application of lean methods and tools has transformed the hospital into a potential model for behavioral health programs facing the challenges of the present healthcare environment. It is a must-have story for clinicians, administrators and other leaders in the mental health field devoted to improving quality and safety at their hospitals and clinics.
Lean Behavioral Health: The Kings County Hospital Story is the first lean book that focuses entirely on behavioral health. Using the principles of the Toyota Production System, or lean, the contributors in this groundbreaking volume share their experience in transforming a major safety net public hospital after a tragic and internationally publicized event. As the largest municipal hospital system in the United States, the New York City Health & Hospitals Corporation adopted lean as the transformational approach for all of its hospitals and clinics. Kings County Hospital Center, one of the largest providers of behavioral health care in the country, continues on its transformational journey utilizing lean's techniques. While not every event was fully successful, most were and every event, including failures, increased the knowledge base about how to continually improve quality and safety. Having made major changes, Kings County Hospital Center is now recognized as a center for transformation and quality receiving high marks from oversight agencies. This volume begins by describing the basic principles of the lean approach-adding value, eliminating waste, and tapping the organization's line staff to create and sustain dramatic change. An overview of the use of lean from a quality improvement perspective follows. Lean tools are applied to many services that comprise the behavioral health value stream and these stories are highlighted. The experts in identifying waste and adding value are the line staff whose voices are captured in the clinical chapters. Insights learned by event participants are emphasized as teaching points to provide context for what has worked or has not worked at Kings County Hospital Center. While the burning platform at Kings County Hospital Center was white hot and while the Department of Justice scrutinized its quality of patient care, the application of lean methods and tools has transformed the hospital into a potential model for behavioral health programs facing the challenges of the present healthcare environment. It is a must-have story for clinicians, administrators and other leaders in the mental health field devoted to improving quality and safety at their hospitals and clinics.
As the largest public healthcare system in the US, the New York City Health et Hospitals Corporation adopted the principles of the Toyota Production System, or lean, as the transformational approach for all of its hospitals and clinics. Having made major changes, and been scrutinised by the Department of Justice on its quality of patient care, Kings County Hospital Center is now recognised as a standard for transformation and quality, receiving high marks from oversight agencies. This resource describes the basic principles of the lean approach.
Includes bibliographical references and index.
One in five U.S. adults experiences a mental illness within a given year. With more than 550,000 people working to support this underserved community, the mental healthcare system has grappled with inadequacies and shortcomings in safety, quality, and care delivery. There is a wide range of problems, from access-to-care issues and errors, to complications stemming from poor care. Our country is also on an unsustainable path as our healthcare expenditure keeps growing. To add to all of this, we are facing a rampant epidemic of burnout among healthcare workers. Modern advancements introduced with many promises—such as electronic medical records, newer medications, or advanced treatments—have created unique challenges when ushered into a highly regulated healthcare system. What does it take to provide patients with everything they need—the right quality of care, at the right time, and at the right cost—to keep them healthy? Which process steps add value? Which steps are wasteful? A widely accepted fact is that a conservative 30-50% of every step in the mental healthcare process does not help patients feel better or stay better. When considering delays in care, workarounds, excessive documentation, and an overuse of auditing, the care system has moved highly skilled clinicians away from providing value, as administrative tasks continue to encroach on their time. There is a clear need to rethink and redesign the system of care. This book is a primer for understanding the current state of the mental health system and the performance improvement skills and leadership acumen needed to address existing challenges. Sheppard Pratt, the award-winning, leading institution for mental healthcare in America, provided the focus on mental healthcare and became the laboratory for this body of work over the course of eight years. It hired a seasoned systems thinker with improvement expertise to work with mental health professionals and solve some of their most complex and chronic problems. The book is a result of the collaboration between a practicing psychiatrist in a leadership role and the systems engineer. Working together, they demonstrate how to think about redesigning care and redefining the nature of work to enhance value for both the people served and the healthcare workforce. They crafted a multi-pronged approach towards culture change at Sheppard Pratt, including implementing a course on "Learning to Improve," which introduced staff to a performance improvement methodology. There are several vignettes interwoven throughout the book that describe the complexities and constraints of the system. Solving some of these challenges creates a new paradigm of work while minimizing waste and enhancing value.
Your organization has all the systems, structures and competences, but you're not achieving maximum results? Performance behavior expert Neil C.W. Webers reveals the secret of improving performance driven by a sustainable behavioral organizational change. He discloses how to make behavior measurable and explains different behavioral profiles, the steering and accountability structure and action indicators - crucial factors necessary in facilitating the measurement and steering of behavior. This unique approach sets the new standard in creating ownership, discipline, and responsibility to continuously improve your company's results. This management bestseller is now available in a complete updated U.S. version. With more than 25% new content, this book is set to be your best investment this year. "Knowledge is power," they say. [...] The objective of performance behavior is to anchor the behavior that brought about the desired performance. For this reason it is not surprising that performance behavior is the essential part of the well-known Lean method. Peter de Roode (www.pderoode.com) The world has changed since Taylor - greatly changed. In the early days of manufacturing, employees could only be judged on their output. However, in a knowledge driven economy, that is more difficult. In this kind of economy, behavior is a factor that is not to be underestimated. Webers enriches the topic of behavior with his approach, and gives an extra dimension to Lean.
In 2001, ProAct Safety introduced Lean BBS(R) as a major update to traditional behavior-based safety (BBS) models with a focus on providing new value with more efficient, safer work. Simply put, Lean BBS focuses on adding value to employees rather than trying to control them. Lean BBS addresses the four major issues found within the average behavior-based safety process: 1.BBS provides successful results for many organizations, but they are looking for a way to take the process to the next level. The Lean BBS methodology takes them there. 2.Some are adamantly against BBS for a number of reasons (union resistance, questionable implementations, cookie-cutter and inflexible approaches, etc.). Lean BBS gains bargaining unit support, is fit-for-purpose and customized to the realities of each organization. 3.Organizations with vastly different processes from site to site want to bring uniformity across the company. Simply changing from one methodology to another is not appealing nor rational. Implementing a more efficient Lean BBS model was both appealing and a rational solution to encourage the processes to evolve towards value-add. 4.Some hesitate to pursue BBS due to high costs and demand on internal resources to operate the process. Lean BBS provides an alternative that addresses these concerns due to the hyper focus on efficiency and ensuring value-add. While several version of BBS have been around since the 1980s, few of them have truly adapted to the changing environment in which they must operate. The Lean BBS process has not only evolved, but continues to do so with each customized implementation. Making BBS fit your culture, operations and logistical realities, rather than trying to make your company fit some idealistic model, is a key to success in today's realities. From the authors of bestselling books on the future of safety excellence, safety strategy, culture and leadership, explore how to put the principles of Lean BBS to work in your operations. Discover the new realities of behavior-based safety.
Lean Thinking for Emerging Healthcare Leaders: How to Develop Yourself and Implement Process Improvements aims to solve the issues in modern day healthcare by handing over the reins of the improvement process to healthcare professionals. Putting those who are doing the work and are closest to the actual situation in the lead. The purpose of this book is to help you understand how to develop yourself and your leadership in such a way that will best benefit your team and your patients. This includes change management practices that will help to build commitment with your team members, colleagues, management, patients, and other stakeholders. This book educates you, as a leading medical professional, in the principles and values of Lean leadership and management. It will teach you how to improve healthcare from the inside, making it safer, better, faster, more accessible, and more affordable. With this book we want to inspire, motivate, and stimulate you to lead continuous improvement—while being respectful to people—on your way to ideal care for every patient. The primary target audience for the book are medical professionals who have (recently) acquired leadership, management, or business responsibilities. The book will also be of high value to those who obtained temporary leadership positions, like project leaders, problem solvers, change managers, and innovators. Because most of the teachings in the book are meta skills and ways of thinking, the book is easily relatable and transferable to other disciplines and even sectors.
This book provides a detailed description of how to apply Lean Six Sigma in the health care industry, with a special emphasis on process improvement and operations management in hospitals. The book begins with a description of the Enterprise Performance Excellence (EPE) improvement methodology developed by the author that links several methodologies including systems thinking, theory of constraints, Lean and Six Sigma to provide an enterprise-wide prioritization and value-chain view of health care. The EPE methodology helps to improve flow at the macro or value-chain level, and then identifies Lean Six Sigma detailed improvements that can further improve processes within the value-chain. The book also provides real-world health care applications of the EPE and Lean Six Sigma methodologies that showed significant results on throughput, capacity, operational and financial performance. The Enterprise Performance Excellence methodology is described, and also the Six Sigma DMAIC (Define-Measure-Analyze-Improve-Control) problem solving approach which is used to solve problems for health care processes as they are applied to real world cases. The case studies include a wide variety of processes and problems including: emergency department throughput improvement; operating room turnaround; operating room organization; CT imaging diagnostic test reduction in an emergency department; linen process improvement; implementing sepsis protocols in an emergency department; critical success factors of an enterprise performance excellence program.
This thesis research sought to determine whether Lean principles and practices make applicable heuristics for evaluating electronic health record (EHR) usability for behavioral health providers. Over the past 10, years EHRs have quickly become part of standard practice in health care yet there is serious concern regarding their direct impact on provider efficiency, job satisfaction and burnout. A review of the literature highlights a notable lack of content regarding the EHR usability needs of behavioral health providers. I utilized contextual inquiry and qualitative analysis to identify the EHR usability needs of behavioral health providers. Furthermore, my research followed a validated domain-specific usability heuristic development methodology to attempt to establish Lean heuristics. The results of this study formed a set of EHR usability heuristics for behavioral health providers. Findings concluded that Lean principles and practices contributed significantly to specific and applicable rules in the resulting heuristics to improve EHR usability.