Healthcare Update

In This Issue

• Focus on the Best of 2010: Read a note from ASQ Healthcare Market Manager Ray Zielke about the year in healthcare and the contents of this issue—a recap of the best of what Healthcare Update offered in 2010. 
• Guest Essay: Review—or read for the first time—the three most popular Guest Essays of 2010.
• This Issue’s Announcements: Learn more about upcoming trainings and the annual conference. 
• Quality News: Current news stories about quality tools and trends in the healthcare field, as well as issues facing the healthcare industry.

Focus On the Best of 2010

Dear Healthcare Update Reader,

This year may have included some of most significant change in the United State’s healthcare landscape. The fiercely debated Patient Protection and Affordable Care Act, combined with the Health Care and Education Reconciliation Act, could change how healthcare is accessed, purchased and delivered. But even with the passage of those legislative acts, the fierce debate will continue. Additionally, the impact of the healthcare components of the American Recovery and Reinvestment Act of 2009 began to be realized in 2010—most notably in the area of health IT.

Not to be lost in the legislation is the role and importance of quality, efficiency and value. Our readers, ASQ members and the healthcare quality community continue to demonstrate a commitment to quality as a personal and professional imperative—not just a response to legislation. The articles, Guest Essays and case studies delivered in Healthcare Update highlight that commitment.

This year-end edition of Healthcare Update highlights its most-read articles of 2010. Expectedly, the topics related to health IT, basic quality auditing, quality in a physician practice and lean in emergency departments were among the most-read articles. When it comes to the Healthcare Update: Tools and Application edition, readers were most interested in core quality topics, such as control plans and lean applications.

Starting with the January issue, 2011 will usher in a new and improved Healthcare Update. The ASQ editorial team will collaborate with the ASQ Healthcare Division (HCD) to produce a joint publication. Readers will find more and richer editorial content, as well as the HCD’s latest news and updates. The HCD has been publishing a newsletter in Patient Safety & Healthcare Quality (PSHQ). HCD members who wish to continue receiving a free copy of PSHQ should subscribe to the publication.

We hope you continue to find value in the Healthcare Update, and we welcome your input and ideas on methods and approaches to improve healthcare quality and value.

—Ray Zielke, ASQ healthcare market manager

The five most popular Healthcare Update articles of 2010:

1. The 2009 ASQ 21st Century Healthcare Caucus Forum (September issue on health IT)
The ASQ Healthcare Division’s slideshow presentation includes five articles on health IT for the 21st century, such as:

• “Getting Ready for Health IT: It’s Like Prepping to Paint a House.”
• “Preparing for Health IT in a Federally Qualified Health Center: Getting it Right the First Time!”
• “Bringing Health IT to an Employer Health System: The Best Laid Plans of Mice and Men.”
• “Introducing Health IT in the E.D.: Done Right, It is a Thing of Beauty!”
• “Implementing Health IT in a Community Hospital: What You Don’t Prepare For Can Hurt You!”

View the slideshow presentation.

2. 10 Auditing Rules (May issue on auditing)
This Quality Progress article describes the guidelines to follow to make auditing results more useful to management.

3. FMEA—the Cure for Medical Errors (August issue on facility, evidence-based design )

Failure mode and effects analysis (FMEA) can be a valuable tool in healthcare facility design. According to this Quality Progress article, St. Joseph’s Hospital in West Bend, WI, used FMEA to create a replacement facility aimed at reducing errors and promoting patient safety and satisfaction through design.

4. Discovering the “Cost of Current Quality” in a Family Medicine Practice (April issue on physician/primary care practice)

This case study presentation from ASQ’s Healthcare Division describes how an improvement team helped St. John’s Family Medical Associates staff used quality tools to improve processes, patient satisfaction and cut costs.

5. Emergency Department Prescribes Lean for Process Improvement (July issue on emergency departments)

With emergency department patient satisfaction scores slipping into the unhealthy 30th percentile, leaders at Mercy Medical Center in Cedar Rapids, IA, wrote a prescription for process improvement, which ultimately reduced the length of stay for patients receiving emergency care. This case study describes how those leaders turned to lean for process improvement. For instance, after a cross-functional team completed value stream mapping to identify and eliminate nonvalue added steps in the department, which caused satisfaction scores to quickly rise to the 95th percentile.

The five most popular tools and applications from 2010 issues of Healthcare Update: Tools and Applications are:

• Control plan: See an example of a control plan created at SMDC Health System’s Duluth Clinic-Ashland Laboratory as part of a successful project to improve the handling of add-on laboratory test orders.
• Process flow mapping: Read a case study that shows how the University of Toledo Medical Center used a process flowchart during the beginning of a Six Sigma effort to reduce the time it takes to qualify patients for kidney transplants.
• Spaghetti diagram: The diagram in this example reflects a study done by a health department administrative office. The intent of the study was to identify ways to shorten the walking time from one activity to another for a frequently performed task.  
• SIPOC+CM: A suppliers, inputs, processes, outputs, customers (SIPOC) diagram offers a high-level view of the as-is state of a process under investigation. The +C stands for constraints facing the system and the +M for the measures to be used.  
• Kaizen blitz: In this case study, “Taking Process Improvement Beyond the Quality Department,” see how Genesis Health System has used kaizen blitz teams to increase performance, reduce variability and improve services and outcomes.

Guest Essay

A Look Back at the Best of 2010
These three Guest Essays were the most-read Guest Essays in 2010. Review them or read them for the first time:

1. Lessons Learned: A Systems Approach to Lean and Evidence-Based Design
This article, by Patricia Morrill and Kate Taege of Kahler Slater, provides lessons learned from using lean and Six Sigma as well as evidence-based design in healthcare. More

2. Planning and Implementation: a Multidimensional Hand-Hygiene Program
In 2004, South Dakota’s Rapid City Regional Hospital’s hand-hygiene compliance stood at 57%. Understanding that poor hand hygiene can adversely affect healthcare institutions and cause serious risk of healthcare-associated infections, the hospital undertook a program to improve hand-washing compliance. More

3. Applying the Kano Satisfaction Model to Emergency Care
Mark Reiter, M.D., CEO of Emergency Excellence, writes how customer satisfaction expert Noriaki Kano’s work offers a useful model to maximize ED patient satisfaction. Kano’s model categorizes satisfaction characteristics into three service categories: extraordinary, differentiable and expected. More

Guest Essay is an ongoing Healthcare Update feature in which authors from the healthcare field explore the role quality tools and methods play in delivering better care and driving down costs.

If you would like to submit a Guest Essay for consideration, send an e-mail to Healthcare Update editor Nicole Adrian.

This Issue’s Announcements

Lean Six Sigma Green, Black Belt Trainings Set
In February, ASQ will offer two lean Six Sigma belt trainings—one for Six Sigma Black Belt and the other for Six Sigma Green Belt—in blended formats. This flexible format combines interactive and on-demand web-based learning with instructor-led classes, support and coaching.

The Lean Six Sigma Black Belt training begins Feb. 1, and the Lean Six Sigma Green Belt training begins Feb. 3.

Mark Your Calendars: QIHC Scheduled for May
The 2011 Quality Institute for Healthcare (QIHC) is set for May 16-18 in Pittsburgh. The event will follow the theme, “First Do No Harm, Then Make No Waste:
Proven Methods and Tools for Safe and Efficient Global Healthcare.”

QIHC focus areas include:

• Building and sustaining a quality culture.
• Efficiency.
• Patient and customer satisfaction.
• Patient safety.
• Quality systems and organizational excellence.
• Technology and quality improvement.

Continue to check the QIHC website for more details or follow QIHC on Twitter.

Quality News

Hospital Leaves Patient Data in the Open
According to this Quality News Today article, officials at the University of Tennessee Medical Center are alerting about 8,000 patients that hospital reports containing their private information were not properly disposed of and could pose a privacy breach risk. More