Process redesign for health care using lean thinking - a guide for improvin

Part 1: Process Redesign – the complete method Chapter 1: Introduction: An accidental redesigner Why redesign? Learning about Lean A decade later Chapter 2: Craft, Flow, Mass British manufacturing: the extension of the craft work system The American method of production Moving to mass Chapter 3: Taiichi Ohno and the Birth of Lean Toyota and Taiichi Ohno Waste and flow Push and pull Workers as problem solvers: the challenge for managers Chapter 4: The Principles of Lean Thinking The process viewpoint: the golden thread of Lean The Lean principles Principle 1: specify value from the standpoint of the end-customer Principle 2: identify the value stream for each product family Principle 3: eliminate waste and make the product flow Principle 4: so that the customer can pull Principle 5: as you manage towards perfection Chapter 5: Healthcare is not manufacturing The Lean principles are very important – but Placing an order: customers and raw materials Redesign double vision Complicated: or complex and adaptive? Chapter 6: Knowledge work Knowledge work Knowledge workers own their knowledge capital Design Or Redesign Chapter 7: Redesigning care: authorization, permission, teams and governance Authorization and permission The redesign team Governance The workgroup and the improvement event Chapter 8: The virtuous circle of Process Redesign and the A3 Chapter 9: Identifying the problem Primary purpose, problems and concerns Problem statements What kind of problem, and where to start? Chapter 10: Defining the scope The benefits of starting with scope Scope and scoping: an evolving task Chapter 11: Diagnosis (1) Mapping – the Big Picture The process of Big Picture Mapping: a social intervention Setting up and undertaking a Big Picture Mapping Chapter 12: Diagnosis (2) Direct observation External or internal redesign capacity? The structure of the learning to see phase Tracking patients or tracking specific process steps Analysis Chapter 13: The real problem (1): Identifying the real problem Root cause analysis, the five whys and effect-and-cause analysis Chapter 14: The real problem (2): Measurement Measurement for redesign-types of measurement The basic triad of analysis design Measurement focus: releasing time or improving outcomes (or both) Measuring processes or outcomes Chapter 15: Goals, the scientific method and the future state Experiments and the Plan-Do-Study-Act cycle Goals Chapter 16: Value stream, batching and flow improvement Making the process viable Splitting into value streams Flow Takt time Batching Improving flow: eliminate, combine, reduce, simplify Chapter 17: Targeted interventions – 5s, visual management and visual systems 5s Visual management The ideal visual management system Chapter 18: Queues, prioritizing, capacity and demand Acknowledging Erlang – the Calling population Queue discipline – First in, first out Queue discipline: planned work, short term queue, shortest service time Capacity lost, demand moves forward Queues and priorities Analysis of capacity and demand Exponential growth in queue length Impossible jobs Chapter 19: Embedding and sustaining Measure, monitor, evaluate A formal decision to adopt the new way The front-line manager A culture of continuous improvement Part 2: Case Studies Chapter 20: Case Study 1: Redesigning Emergency Department flows The problem Scoping Diagnosis The real problem Intervention ED works Evaluation Embedding and sustaining Chapter 21: Case Study 2: The Care-After-Hours Program The problem Authorization and permission Scoping Diagnosis Four major-work streams The real problem Intervention The Electronic Medical Task Board Evaluation Embedding and sustaining Continuity of information Chapter 22: Case Study 3: Visual Management The Patient Journey Boards Scoping Diagnosis-tracking The real problem Intervention Evaluation Discharge traffic lights and blue dots Chapter 23: Case Study 4: Redesigning podiatry care The problem Diagnosis The real problem Interventions Evaluations Chapter 24: Conclusion – Redesigning Process Redesign