System Innovation: Concord Hospital

Uhlig, Paul N.; Brown, Jeffrey P.; Nason, Anne K.; Camelio, Addie; Kendall, E. J. C.

doi:10.1016/s1070-3241(02)28072-4

Cited by 60 publications

(49 citation statements)

References 4 publications

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“…These have been referred to as glitches (Uhlig et al 2002), operational failures (Tucker 2004, Tucker andSpear 2006), performance obstacles (Gurses and Carayon 2007), hassles (Beaudoin and Edgar 2003), blockages (Rathert et al 2012), and situational constraints O'Connor 1980, Villanova andRoman 1993). In this paper, we refer to them as operational failures.…”

Section: Prior Research On Operational Failures and Lean Manufacturinmentioning

confidence: 99%

Lean in healthcare – history and recent developments

Sloan¹,

Fitzgerald²,

Hayes³

et al. 2014

Journal of Health Organization and Management

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Abstract:The performance gap between hospital spending and outcomes is indicative of inefficient care delivery. Operational failures-breakdowns in internal supply chains that prevent work from being completed-contribute to inefficiency by consuming 10% of nurses' time (Hendrich et al. 2008, Tucker 2004. This paper seeks to identify organizational factors associated with operational failures, with a goal of providing insight into effective strategies for removal. We observed nurses on medical/ surgical units at two hospitals, shadowed support staff who provided materials, and interviewed employees about their internal supply chain's performance. These activities created a database of 120 operational failures and the organizational factors that contributed to them. We found that employees believed their department's performance was satisfactory, but poorly trained employees in other departments caused the failures. However, only 14% of the operational failures arose from errors or training. They stemmed instead from multiple organizationally-driven factors: insufficient workspace (29%), poor process design (23%), and a lack of integration in the internal supply chains (23%). Our findings thus suggest that employees are unlikely to discern the role that their department's routines play in operational failures, which hinders solution efforts. Furthermore, in contrast to the "Pareto Principle" which advocates addressing "large" problems that contribute a disproportionate share of the cumulative negative impact of problems, the failures and causes were dispersed over a wide range of factors. Thus, removing failures will require deliberate crossfunctional efforts to redesign workspaces and processes so they are better integrated with patients' needs.

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Section: Prior Research On Operational Failures and Lean Manufacturinmentioning

confidence: 99%

Lean in healthcare – history and recent developments

Sloan¹,

Fitzgerald²,

Hayes³

et al. 2014

Journal of Health Organization and Management

View full text Add to dashboard Cite

show abstract

“…It is generally accepted that the traditional hierarchical power relationships which were described by Stein (1967) are detrimental to patient outcomes and nurse job satisfaction. Numerous articles have been written in the last six years with the focus on key collaborative communication strategies as a method to minimize errors in care (Uhlig, Brown, Nason, Camelio, & Kendall, 2002;Wachter, 2004;Zwarenstein & Reeves, 2002). As attitudes influence behaviors, it is important to understand attitudes toward collaboration and how they might be affected by organizational culture.…”

Section: Recommendations For Future Researchmentioning

confidence: 99%

Nurse-physician collaboration in an acute care community hospital

Hughes

Fitzpatrick

2010

Journal of Interprofessional Care

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Despite the evidence from the literature of the benefits of collaboration, a collaborative practice model in the acute-care setting remains the exception rather than the dominant practice. The purpose of this study was to evaluate attitudes toward collaboration among nurses and physicians practicing in an acute care community hospital. The sample included 118 nurses and 53 physicians. Background variables of gender, age, education, experience, practice setting, cultural background, and time to interact were examined to determine if they influenced attitudes towards collaboration. The results indicated that both physicians and nurses expressed positive attitudes towards collaboration but that there was a significant difference on two of the underlying factors: shared education and physician authority. The study may serve as a baseline for future research, specifically focused on interventions to enhance collaboration.

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“…Using similar ''before-and-after'' study designs, others have found an association between the implementation of formal teamwork and communication strategies and better clinical outcomes in emergency departments, operating rooms, intensive care units, and hospital wards. 22,[28][29][30][31] This growing body of evidence suggests that improvements in team training may be able to decrease adverse events, and thus also decrease medical malpractice rates.…”

Section: How Team Training Can Decrease Malpractice Riskmentioning

confidence: 99%

Team Approach to Care in Labor and Delivery

Mann

Pratt²

2008

Clinical Obstetrics &Amp; Gynecology

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Changing to a teamwork culture in labor and delivery requires a real commitment. The skills involved can be taught to all healthcare providers. The benefits of a teamwork culture may include improved patient outcomes, less medical errors, and improved patient and staff satisfaction. Malpractice claim reduction may possibly occur through these improved outcomes and better communication with our patients.

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System Innovation: Concord Hospital

Cited by 60 publications

References 4 publications

Lean in healthcare – history and recent developments

Lean in healthcare – history and recent developments

Nurse-physician collaboration in an acute care community hospital

Team Approach to Care in Labor and Delivery

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