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Category Archives: Delivery

Improving Health Care Quality Through Clinician Level Integrated Performance Measurement with PCPI

We recently held a webinar with PCPI that discussed: PCPI’s role in quality management Utilizing clinician level performance measurement for process improvement PCPI’s  current policy work in various areas, including interoperability and physician fee schedules Closing the referral loop in ambulatory care PCPI® is a consortium of diverse organizations dedicated to improving healthcare quality, safety, and […]

Closing The Gateway From Surgery To Persistent Opioid Use

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Fifty million Americans have surgery each year. Approximately 2 million of these surgical patients will develop persistent opioid use (meaning they continue to use opioids 90–180 days after surgery). For far too many people, surgery is a critical gateway to the tragedy of opioid addiction. As a practicing anesthesiologist, I’ve been administering opioids for 20 years to […]

Improving Reliability in Healthcare

Abstract: It is well known that health-care performance is highly variable and not reliable. To address this issue, a number of health-care leaders have been experimenting with operational methods derived from non–health-care industries. Leaders at Stanford Hospital and Clinics, Stanford Children’s Hospital at Stanford, and ThedaCare have been studying and applying principles from consistently high-performing […]

The Problem with Plan-Do-Study-Adjust Cycles

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Quality improvement (QI) methods have been introduced to healthcare to support the delivery of care that is safe, timely, effective, efficient, equitable and cost effective. Of the many QI tools and methods, the Plan-Do-Study-Act (PDSA) cycle is one of the few that focuses on the crux of change, the translation of ideas and intentions into […]

Assessing the Relationship of the Human Resource, Finance, and Information Technology Functions on Reported Performance in Hospitals Using the Lean Management System

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Given pressures to control costs and improve quality of care, one of the most prevalent transformational performance improvement approaches in health care is Lean management. However, the roles of support functions such as human resource (HR), finance, and information technology (IT) in Lean management and the relationships of these support functions with performance are unknown. […]

Creating a Culture of Continuous Improvement

A number of health systems have scored impressive gains in improving outcomes and patient satisfaction and lower costs by applying the Toyota Production System (TPS) to redesign “lean” clinical and administrative processes, eliminating waste and boosting quality. But in all too many cases, when the leader who championed TPS left his or her organization, these efforts began […]

Leadership Survey: Organizational Culture Is the Key to Better Health Care

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Organizational culture is the essential element in meeting health care goals, according to Stephen Swensen, MD, Professor Emeritus at the Mayo Clinic College of Medicine and Senior Fellow at the Institute for Healthcare Improvement. “Culture, more than anything else, drives performance,” he says. “Culture is the way in which organizations make decisions about what they […]

Grey Dube, Another Lean Healthcare CEO from South Africa

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Mark Granabn’s Lean Blog Episode #338 is Mr. Grey Dube, the Chief Executive Officer at Leratong Hospital. He has over 40 years’ experience in the public service, including time as CEO at the hospital since 2005. Leratong Hospital is an 855 bedded regional hospital with over 1700 staff members, located in Mogale City, Krugersdorp, South Africa (just […]