Optimizing Emergency Department Throughput Operations Management Solutions for Health Care Decision Makers 1st Edition by John Shiver, David Eitel 1420083775 9781420083774

Optimizing Emergency Department Throughput Operations Management Solutions for Health Care Decision Makers 1st Edition by John Shiver, David Eitel  – Ebook PDF Instant Download/Delivery: 1420083775, 9781420083774

Full download Optimizing Emergency Department Throughput Operations Management Solutions for Health Care Decision Makers 1st Edition after payment

Product details:

ISBN 10: 1420083775

ISBN 13: 9781420083774

Author: John M. Shiver; David Eitel

Across the country ambulances are turned away from emergency departments (EDs) and patients are waiting hours and sometimes days to be admitted to a hospital room. Hospitals are finding it hard to get specialist physicians to come to treat emergency patients. Our EDs demand a new way of thinking. They are not at a tipping point; they are at a break

Optimizing Emergency Department Throughput Operations Management Solutions for Health Care Decision Makers 1st Table of contents:

1 Fixing the Front End: Why Would an Emergency Department Medical Director or Nursing Supervisor Wish to Install Emergency Severity Index (ESI) Triage?

Real-Time Management of Emergency Department (ED) Flow: Streaming and Not Just Sorting

Communicating ED Workload to Others

ESI Case Mix Data and Predictive Management

Forecasting Demand Combined with “Capacity to Serve” Planning

Statistical Forecasting

Emergency Department Workflow Analysis Including Lean and Six Sigma Improvement Methods

ESI Service Mix Data and Lean-Six Sigma: All Patients Are Not the Same

Dynamic Modeling: Simulation Modeling

Variation

Interdependency (Interconnectedness) and Capacity to Serve

Complexity

Simulation Modeling in the Emergency Department: All Patients Are Not the Same

Process Simulation Modeling and ESI Case Mix Data Summary

References

2 Process Mapping and Workflow Diagramming in Health Care

What Is a Process?

“Seeing” a Process

Workflow Analysis Is Relevant in the Absence of a Problem

Workflow Analysis for Problem Resolution

Before Creating a Flowchart, Some Things to Consider

About Observing the Process

Don’t Rely on Memory of the Process

Who Should Observe the Process?

Keep Out of the Process

Who Should be Observed?

Level of Detail

What are We Looking For?

Silos

Make ’em Ugly

How to Capture the Initial Observations

Sticky Notes Technique

Transfer to an Electronic Document

Which type of flowchart is best?

Flow Chart Symbols (See Figure 2.3)

Including Personal Names

Color Coding Activity Steps

Color Coding “Off-Page” References

Date the Documents

Watch for Scope Creep

Work Sessions and Interactive Meetings

Validate the Diagrams

Discussion

Conclusion

References

3 What Is Lean Six Sigma? An Introduction to Lean and Six Sigma for the Health Care Novice

Why Lean?

What Is Lean?

Word Associations

Lean Principles

Six Sigma

What Is a Sigma?

Defects Per Million Opportunities: DPMO Thinking Applied to Health Care

Acknowledgment

References

4 Using Lean Six Sigma to Accelerate Emergency Department Results

Cases in Point

Morton Plant Medical Center, Clearwater, Florida

St. Vincent’s Medical Center, Jacksonville, Florida

Dr. P. Phillips Hospital, Orlando, Florida

How Did They Get There? The Elements of an Effective Quality System

Big Quality Strategic Approach (versus Little Quality Project Mindset)

Big Q Goal-Setting Process

Setting Goals Using a Six Sigma Approach

Accountability Structure

Use of Accelerating Quality Concepts

Prioritizing Subprocess Improvement Opportunities

Lean Change Concepts

Rapid Cycle Testing Process

Lean Six Sigma and Cost Recovery

When and How to Start the Journey

When to Start

How to Align the Team

Starting Slow (Being Patient)

Organize for Success

Next Steps

Summary

References

5 Queuing Models for Hospital Emergency Departments

Introduction

Queuing Theory

The Queuing Model

Measures of Queuing System Performance

An Example of Emergency Department Performance Evaluation

ED Scenario

Solution to the ED Congestion Problem

Nonurgent Service Line

Urgent Service Line

Acute Service Line

Summary

References

6 The Nursing Perspective and Role in Planning a Simulation Modeling Project: Historical, Experiential, and Future Applications of Complex Adaptive Systems Thinking

Introduction

The Role and Relevance of Nursing

Nursing and Complex Adaptive Systems Thinking: Introduction

Nursing and Complex Adaptive Systems Thinking

The Theory of Nursing Knowledge and Nursing Practice

Improvement Tools: Simulation Modeling

Simulation Modeling: What It Is, and How It Applies to the Nurse’s Role in the CAS of the ED

Understanding the Tools

Understanding the Simulation Project

Steps to Plan a Model

Data (Clinical, Operational, Architectural)

Scope and What-Ifs

Design of Experiments

Working with Engineers

Putting It All Together (Using an ED Case Study)

Purpose of Model

Model Layout

Database

Animation

Notebook (Figure 6.23)

Experimentation

Experience

Lessons Learned

Future: Summary and Discussion

References

Appendix

Acknowledgments

Dedication

7 The Physiology of Service Capacity

Introduction

Variability and Capacity

Patterns

Demand Patterns and Confidence Intervals

Understanding Variability: An Introduction to Queuing Theory and Simulation

Analytic Queuing Models and Discrete Event Simulation

The Way the World Works: A Primer on Variability, Interdependencies, and Process Simulation

Variability in and between Processes

Interdependencies

Changes over Time

What-Ifs and Predictive Analytics

“Up –Down–Up” and Hospital Service Capacity

Demand and Capacity Matching

The Physiology of Service Capacity

Granularity

HODDOW WOMSOY

Forming a Dynamic Resource Allocation

The Point of Appropriate Time Stamps

Dynamic Capacity Matching, System Balance, and Serious Play

System Balance and Critical Common Resources

DES and System Balance

Physiology Revisited and Summary

Notes

8 The Door-to-Doc Toolkit: Planning Emergency Department Capacity for Delivering Safe Care

Introduction

Background

Objectives

Methods

Participants

Implementation

People

Process

Measurement

Results and Interpretation

Discussion

D2D Toolkit

Conclusions

Acknowledgments

References

9 Forecasting the Demand for Emergency Department Services

Introduction

Getting a Handle on ED Arrivals

Case Study: York Hospital, York, Pennsylvania, Calendar Years 1997–2006

Background

Classification of ED Demand by Triage Level (Using ESI v. 3)

Forecasting Using Regression Analysis

Forecasting Annual Visits for Strategic Planning: Physical Capacity Needs

Forecasting Monthly Visits for Tactical Planning: Staffing and Budgeting

Forecasting Daily Visits for Operational Planning: Staffing and Scheduling

Forecasting Hourly Visits for Operational Planning: Scheduling

Using Forecast Prediction Intervals

Discussion

Limitations

Model-Specific Considerations

Data-Specific Considerations

Software Considerations

Acknowledgments

References

10 Improving Fairness in Nurse Scheduling: Introducing a New Approach Using Auctions and Integer Programming Optimization

Introduction

Literature Review

Methods: General Discussion

Setting Up the Auction Stage

Creating the Optimization Model

The Schedule Completion Stage

A Case Study

Problem (Constraints) Definition

Optimization Models

Case Study Results

Conclusions

Acknowledgments

References

11 Establishing Engineered Nurse Staffing Requirements in the Emergency Department

Purpose of Engineered Staffing Ratios

Arrival Rate of Patients

Acuity of Patients

Benefits to an Acuity System

Service Times

Treatment Profiles

Factors Affecting the Expenditure of Time in the Emergency Department

Methodologies for Developing Engineered Nurse Staffing Requirements

Detailed Zero-Based Staffing

Use of Predetermined Treatment Profiles

Work Sampling

Conclusion

12 Patient Safety Organizations: A New Paradigm in Quality Management and Communication Systems in Health Care

Becoming a Learning Organization

A National Patient Safety System from the Grassroots

The Patient Safety and Quality Improvement Act of 2005

Lessons Learned in Other Industries

Beyond Safety Reporting

Building the PSO as an Integrated Quality Management and Communication System

Notes

References

13 Alternative Emergency Care Settings

Introduction

Freestanding Emergency Centers

Federally Qualified Health Centers

Urgent Care Centers

Convenient Care Clinics

Challenges to Establishing Alternative Emergency Care Settings

Notes and References

Appendix: Case Study—Surviving and Thriving in Emergency Department Chaos

Purpose of Case Study

Definitions of Significant Terms

Background of the Problem

Methods and Procedures

Results and Conclusions

Conclusions and Recommendations

Selected Bibliography

Periodicals

Books and Pamphlets

People also search for Optimizing Emergency Department Throughput Operations Management Solutions for Health Care Decision Makers 1st: 

optimizing emergency department front-end operations

throughput emergency department

optimizing patient experience in the emergency department

qso emergency preparedness

Tags:

John Shiver,David Eitel,Optimizing,Emergency