A Lean Action Workbook from the Lean Enterprise Academy, a affiliate of the Lean Global Network and the Lean Enterprise Institute For the first time, Making Hospitals Work provides a practical road map for healthcare leaders seeking to create truly lean hospitals. It outlines a clear framework for focusing improvement activities on the most important challenges facing each hospital. It uses the same evidence-based, scientific method as clinicians use to diagnose and treat medical problems to analyze and redesign the core emergency and elective patient journeys from arrival to discharge. It opens everyone's eyes to the big win-win-win opportunities to eliminate unnecessary waiting time for patients, to synchronize activities so clinical staff can spend more time caring for patients, and to free up capacity by reducing length of stay and cut the overtime and agency budget. It also introduces the key new role of the value-stream manager in gaining agreement on what needs to be done by whom in every department across the hospital. Every step described in Making Hospitals Work has been tried and tested in the three years' action research that led to this workbook. It is the critical breakthrough to take the next steps on the lean healthcare journey.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

This book contains a series of essays and empirical case studies exploring the nature of institutional work.

Organizations around the world are using Lean to redesign care and improve processes in a way that achieves and sustains meaningful results for patients, staff, physicians, and health systems. Lean Hospitals, Third Edition explains how to use the Lean methodology and mindsets to improve safety, quality, access, and morale while reducing costs, increasing capacity, and strengthening the long-term bottom line. This updated edition of a Shingo Research Award recipient begins with an overview of Lean methods. It explains how Lean practices can help reduce various frustrations for caregivers, prevent delays and harm for patients, and improve the long-term health of your organization. The second edition of this book presented new material on identifying waste, A3 problem solving, engaging employees in continuous improvement, and strategy deployment. This third edition adds new sections on structured Lean problem solving methods (including Toyota Kata), Lean Design, and other topics. Additional examples, case studies, and explanations are also included throughout the book. Mark Graban is also the co-author, with Joe Swartz, of the book Healthcare Kaizen: Engaging Frontline Staff in Sustainable Continuous Improvements, which is also a Shingo Research Award recipient. Mark and Joe also wrote The Executive’s Guide to Healthcare Kaizen.

New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.

Argues for more transparent, democratic and safer healthcare practices to keep patients better informed and hold poor-performing doctors and flawed systems accountable.

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

Nursing is typically understood, and understands itself, as a care-giving occupation. It is through its relationships with patients – whether these are absent, present, good, bad or indifferent – that modern day nursing is defined. Yet nursing work extends far beyond direct patient care activities. Across the spectrum of locales in which they are employed, nurses, in numerous ways, support and sustain the delivery and organisation of health services. In recent history, however, this wider work has generally been regarded as at best an adjunct to the core nursing function, and at worse responsible for taking nurses away from their ‘real work’ with patients. Beyond its identity as the ‘other’ to care-giving, little is known about this element of nursing practice. Drawing on extensive observational research of the everyday work in a UK hospital, and insights from practice-based approaches and actor network theory, the aim of this book is to lay the empirical and theoretical foundations for a reappraisal of the nursing contribution to society by shining a light on this invisible aspect of nurses’ work. Nurses, it is argued, can be understood as focal actors in health systems and through myriad processes of ‘translational mobilisation’ sustain the networks through which care is organised. Not only is this work an essential driver of action, it also operates as a powerful countervailing force to the centrifugal tendencies inherent in healthcare organisations which, for all their gloss of order and rationality, are in reality very loose arrangements. The Invisible Work of Nurses will be interest to academics and students across a number of fields, including nursing, medical sociology, organisational studies, health management, science and technology studies, and improvement science.

Hospitals have long relied on the heroics of one brilliant nurse or doctor to save the day. Such heroics often result in temporary workarounds and quick fixes that leave not only patients and quality care at risk, but also increase costs. This is the story of an organization breaking that habit. Like a growing number of healthcare organizations around the world, ThedaCare, Inc. has been using lean thinking and the principles of the Toyota Production System to improve quality of care, reduce waste, and become more reliable. But lean thinking was incompatible with ThedaCare’s old top-down, hero-based system of management. Kim Barnas, former SVP of ThedaCare, shows us how she and her team created a management system that is stable and lean, to spur continuous improvement. Beyond Heroes shows the reader, step by step, how ThedaCare teams developed the system, using the stories of its doctors, nurses and administrators to illustrate. The book explores each of the eight essential components of the lean system, from front-line problem solving with the scientific method to daily team huddles and creating standard work for leaders all the way to the top of an organization. Finally, the author introduces four executives from healthcare systems across North America who have implemented ThedaCare’s system and share the lessons they learned along the way. Beyond Heroes is not just a call to action or an argument for a better healthcare system. It is a necessary roadmap through the rocky terrain ahead, one that healthcare leaders can customize to their special needs.

A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.