Life In The ‘Lean’ Lane: Performance Improvement At Denver Health

Meyer, Harris

doi:10.1377/hlthaff.2010.0810

Cited by 26 publications

(17 citation statements)

References 3 publications

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“…More than 300 "rapid improvement events"-mechanisms for making radical changes to current processes and activities within a very short time frame-occurred in these focus areas during the past five years. 7 This comprehensive, broad, and multifaceted approach to "perfecting the patient experience" created the physical spaces and a culture on which specific quality and safety efforts could be built. Having the right people, and having them focused on doing work in the right manner to support each other and the patients, nurtured a culture of respect and commitment to improvement and quality.…”

Section: Right Communicationmentioning

confidence: 99%

A Broad And Structured Approach To Improving Patient Safety And Quality: Lessons From Denver Health

Gabow

Mehler

2011

Health Affairs

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America's health care systems have not achieved the desired level of quality and safety. This may be due, in part, to the lack of clear and robust approaches for institutions to follow. Denver Health, an integrated, public safety-net institution, developed a multifaceted, structured approach to quality and safety improvement that has produced positive outcomes. For example, in 2010 Denver Health ranked first of 112 US academic medical centers in terms of actual mortality observed relative to the national mortality rate. Given these results, we argue that regulatory bodies should refocus their oversight to consider an institution's overall structured approach to quality improvement and safety, instead of monitoring individual small outcomes, such as a patient's receipt of antibiotics for pneumonia within six hours of arriving in the emergency department.

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Section: Right Communicationmentioning

confidence: 99%

A Broad And Structured Approach To Improving Patient Safety And Quality: Lessons From Denver Health

Gabow

Mehler

2011

Health Affairs

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“…However, the evidence on the potential effectiveness of these approaches in health care is relatively weak 13,18 and consists primarily of single-site studies. [19][20][21] To address this gap in knowledge, we present a new framework and instrument for defining key management dimensions and for measuring them on a large scale in health care organizations. We describe the variation in management practices among a large sample of hospitals; assess its association with processes of care, readmissions, and mortality for patients with acute myocardial infarction (AMI); and suggest specific directions for the testing and dissemination of health care management approaches.…”

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confidence: 99%

Management Practices and the Quality of Care in Cardiac Units

McConnell¹,

Lindrooth²,

Wholey³

et al. 2013

JAMA Intern Med

100

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“…Lean management principles, its philosophy or approach, may be applied at several points in health care practices, namely in the redefinition of internal processes;13,19 in the standardization of diagnostic systems;20,22 in the standardization of work;20 in communication processes;10,22 in the preparation of preventive programs;20,22 and overall in health care programs23,24 aimed at the general public 25,26…”

Section: Lean Management Approaches In Health Care Systemsmentioning

confidence: 99%

A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service

Carvalho¹,

Ramos²,

Paixão³

2013

RMHP

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Lean practices and thinking have increased substantially in the last few years. Applications of lean practices to health care are found worldwide. Despite that, new contributions are required because the application of lean thinking to hospitals has a long way to go. Lean practices and thinking do not include, in the literature or practice programs, any references to triage systems in health care units. The common triage systems require physical presence, but there are alternative methods to avoid the need to move patients: these alternative triage systems, given their characteristics, may be included in the spectrum of lean practices. Currently, patients that are already known to suffer from cancer are encouraged to go to hospital (public or private, with an oncological focus) when facing side effects from chemotherapy or radiation treatments; they are then submitted to a triage system (present themselves to the hospital for examination). The authors of this paper propose the introduction of telephone or email triage for impaired patients as a valid substitute for moving them physically, thereby often avoiding several unnecessary moves. This approach has, in fact, characteristics similar to a lean practice in that it reduces costs and maintains, if done properly, the overall service offered. The proposed ‘remote’ triage emerged from the results of a large survey sent to patients and also as the outcome of a set of semistructured interviews conducted with hospital nurses. With the results they obtained, the authors felt comfortable proposing this approach both to public and private hospitals, because the study was conducted in the most important, largest, and best-known oncological unit in Spain. As a final result, the health care unit studied is now taking the first steps to implement a remote triage system by telephone, and has begun to reduce the previously necessary movement of impaired patients.

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Life In The ‘Lean’ Lane: Performance Improvement At Denver Health

Cited by 26 publications

References 3 publications

A Broad And Structured Approach To Improving Patient Safety And Quality: Lessons From Denver Health

A Broad And Structured Approach To Improving Patient Safety And Quality: Lessons From Denver Health

Management Practices and the Quality of Care in Cardiac Units

A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service

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