Process Improvement in Surgery

2015 ◽  
Author(s):  
Frederick H Millham
Keyword(s):  
Health Care ◽  
Control Chart ◽  
Process Improvement ◽  
Control Charts ◽  
Multidisciplinary Care ◽  
Payoff Matrix ◽  
Flow Maps ◽  
History Of ◽  
Improvement Programs ◽  
Definition Of

Process improvement is a skill all physicians need to be familiar with. This is particularly true for surgeons, who work in complex systems requiring multidisciplinary care in the health care system’s most expensive location: the operating room. Surgical leaders need to be familiar with the techniques and themes of process improvement. The current literature suggests that formal process improvement programs can be effective in improving clinical, operational, and financial performance of hospitals. This review outlines a general approach to process improvement, in addition to providing evidence for the efficacy of process improvement in health care, a definition of processes, and the history of process improvement. Tables outline forms of waste applied to health care and heuristic approaches to project improvement. Figures include a project charter, control chart, X-bar control chart, Pareto table and chart, Fishbone cause-and-effect diagram, diagrams of the Plan-Do-Study-Act process and cost/payoff matrix, statistical software control charts, and process flow maps. This review contains 10 figures, 2 tables, and 22 references.

Process Improvement in Surgery

2015 ◽  
Author(s):  
Frederick H Millham
Keyword(s):  
Health Care ◽  
Control Chart ◽  
Process Improvement ◽  
Control Charts ◽  
Multidisciplinary Care ◽  
Payoff Matrix ◽  
Flow Maps ◽  
History Of ◽  
Improvement Programs ◽  
Definition Of

Process improvement is a skill all physicians need to be familiar with. This is particularly true for surgeons, who work in complex systems requiring multidisciplinary care in the health care system’s most expensive location: the operating room. Surgical leaders need to be familiar with the techniques and themes of process improvement. The current literature suggests that formal process improvement programs can be effective in improving clinical, operational, and financial performance of hospitals. This review outlines a general approach to process improvement, in addition to providing evidence for the efficacy of process improvement in health care, a definition of processes, and the history of process improvement. Tables outline forms of waste applied to health care and heuristic approaches to project improvement. Figures include a project charter, control chart, X-bar control chart, Pareto table and chart, Fishbone cause-and-effect diagram, diagrams of the Plan-Do-Study-Act process and cost/payoff matrix, statistical software control charts, and process flow maps. This review contains 10 figures, 2 tables, and 22 references.

Process Improvement in Surgery

2017 ◽  
Author(s):  
Frederick H Millham
Keyword(s):  
Health Care ◽  
Control Chart ◽  
Process Improvement ◽  
Control Charts ◽  
Multidisciplinary Care ◽  
Payoff Matrix ◽  
Flow Maps ◽  
History Of ◽  
Improvement Programs ◽  
Definition Of

Process improvement is a skill all physicians need to be familiar with. This is particularly true for surgeons, who work in complex systems requiring multidisciplinary care in the health care system’s most expensive location: the operating room. Surgical leaders need to be familiar with the techniques and themes of process improvement. The current literature suggests that formal process improvement programs can be effective in improving clinical, operational, and financial performance of hospitals. This review outlines a general approach to process improvement, in addition to providing evidence for the efficacy of process improvement in health care, a definition of processes, and the history of process improvement. Tables outline forms of waste applied to health care and heuristic approaches to project improvement. Figures include a project charter, control chart, X-bar control chart, Pareto table and chart, Fishbone cause-and-effect diagram, diagrams of the Plan-Do-Study-Act process and cost/payoff matrix, statistical software control charts, and process flow maps. This review contains 10 figures, 2 tables, and 22 references.

Statistical methods as a problem-solving strategy in health care.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 279-279
Author(s):  
Diane Schaub ◽  
James Terrell
Keyword(s):  
Health Care ◽  
Process Improvement ◽  
Control Charts ◽  
Complex Analysis ◽  
Manufacturing Sector ◽  
Multivariable Analysis ◽  
The United States ◽  
Cancer Center ◽  
Statistical Tools ◽  
Md Anderson

279 Background: Clinical personnel in healthcare are being challenged to improve quality and increase productivity in order to lower healthcare costs in the United States. With the effort to become more cost conscious, there is an ever increasing need to analyze processes and make them more efficient. The complexity of these processes and the data associated with them require more complex analysis and more sophisticated statistical tools. Unfortunately the statistical training of many health care employees is not adequate for the more complex tools and processes. Methods: At the University of Texas MD Anderson Cancer Center, we use Minitab software, widely used in the manufacturing sector, as our primary statistical analysis software. It is on this platform that the Office of Performance Improvement is creating training courses to assist in raising the statistical literacy level of clinical employees. This software is fairly easy to use, and contains tools for visualizing data such as control charts and box plots, as well as performing multivariable analysis such as regression or ANOVA (Analysis of Variance). Results: Early adopters of the methodology to utilize statistical tools in process improvement studies has been extremely positive. They enjoy being able to quantify their improvement results, document them, and share them with others. Conclusions: Process Improvement leaders need to improve their skills in several areas of statistical methodology. Specifically, they should be able to select the correct graphic to show the critical information in their data, they should be able to select the proper tools and perform analysis to interpret the data, and they should have a technical vocabulary to share and communicate their key learning with others. Minitab is a widely accepted software package for process improvement here at MD Anderson Cancer Center. There are many other very good software packages on the market but it is helpful for support, teaching, and consistency if an institution settles on a package as a basic standard.

Development of fuzzy U control chart for monitoring defects

2014 ◽  
Vol 31 (7) ◽  
pp. 811-821 ◽  
Author(s):  
Soroush Avakh Darestani ◽  
Azam Moradi Tadi ◽  
Somayeh Taheri ◽  
Maryam Raeiszadeh
Keyword(s):  
Control Chart ◽  
Fuzzy Number ◽  
Control Charts ◽  
Statistical Process ◽  
Content Type ◽  
Trapezoidal Fuzzy Number ◽  
Defect Sensitivity ◽  
Control Patterns ◽  
Definition Of

Purpose – Shewhart's control charts are the most important statistical process control tools that play a role in inspecting and producing quality control. The purpose of this paper is to investigate the attributes of fuzzy U control chart. Design/methodology/approach – If the data were uncertain, they were converted into trapezoidal fuzzy number and the fuzzy upper and lower control limits were trapezoidal fuzzy number calculated using fuzzy mode approach. The result was grouped into four categories (in control, out of control, rather in control, rather out of control). Finally, a case study was presented and the method coding was done in MATLAB software using design U control chart; then, the results were verified. Findings – The definition of fuzzy numbers for each type of defect sensitivity and the unit can be classified into four groups: in-control and out-of-control, rather in-control and rather out-of-control which represent the actual quality of the products. It can be concluded that fuzzy control chart is more sensitive on recognition out of control patterns. Originality/value – This paper studies the use of control charts, specifically the attributes of a fuzzy U control chart, for monitoring defects in the format of a case study.

Use of Acupuncture by 1970s Revolutionaries of Color: The South Bronx “Toolkit Care” Concept

2021 ◽  
pp. e1-e11
Author(s):  
Eana Meng
Keyword(s):  
Health Care ◽  
New York ◽  
The South ◽  
South Bronx ◽  
Holistic Model ◽  
The People ◽  
Medical Institutions ◽  
History Of ◽  
Body And Soul ◽  
Definition Of

Failed by mainstream medical institutions, 1970s revolutionaries of color sought to take health care into their own hands. A lesser-known phenomenon was their use of acupuncture. In 1970, an alliance of Black, Latinx, and White members at Lincoln Detox, a drug treatment program in the South Bronx area of New York City, learned of acupuncture as an alternative to methadone. In Oakland, California, Tolbert Small, MD, used acupuncture for pain management following his exposure to the practice as part of a 1972 Black Panther Party delegation to China. Unaware of one another then, the Lincoln team and Small were similarly driven to “serve the people, body and soul.” They enacted “toolkit care,”—self-assembled, essential community care—in response to dire situations such as the intensifying drug crisis. These stories challenge the traditional American history of acupuncture and contribute innovations to and far beyond the addiction field by presenting a holistic model of prevention and care. They advance a nuanced definition of integrative medicine as one that combines medical and social practices, and their legacies are currently carried out by thousands of health care practitioners globally. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e11. https://doi.org/10.2105/AJPH.2020.306080 )

scholarly journals Interdisciplinary versus multidisciplinary care teams: do we understand the difference?

2007 ◽  
Vol 31 (3) ◽  
pp. 330 ◽  
Author(s):  
Rebecca L Jessup
Keyword(s):  
Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Multidisciplinary Care ◽  
Interdisciplinary Teams ◽  
Multidisciplinary Teams ◽  
Health Staff ◽  
Health Care Environment ◽  
The Difference ◽  
Definition Of

AS A MANAGER OF allied health staff in a major metropolitan health care service, I am responsible for recruitment to a variety of different disciplines. One of the questions I regularly ask at interview centres around the applicant?s understanding of interdisciplinary teams in the health care environment. Anecdotally, I would estimate that only around one in ten individuals can provide an accurate definition of the role of an interdisciplinary team. The remainder default to a description of multidisciplinary teams, and some even utilise the terms interchangeably.

Towards the digital land reclamation

2020 ◽  
pp. 5-9
Author(s):  
Sergey Vasil'ev ◽  
Vyacheslav Schedrin ◽  
Aleksandra Slabunova ◽  
Vladimir Slabunov
Keyword(s):  
Retrospective Analysis ◽  
Land Reclamation ◽  
Practical Experience ◽  
Maximum Effect ◽  
Optimal Management ◽  
Scientific Potential ◽  
History Of ◽  
Definition Of ◽  
Further Development ◽  
Full Cooperation

The aim of the research is a retrospective analysis of the history and stages of development of digital land reclamation in Russia, the definition of «Digital land reclamation» and trends in its further development. In the framework of the retrospective analysis the main stages of melioration formation are determined. To achieve the maximum effect of the «digital reclamation» requires full cooperation of practical experience and scientific potential accumulated throughout the history of the reclamation complex, and the latest achievements of science and technology, which is currently possible only through the full digitalization of reclamation activities. The introduction of «digital reclamation» will achieve greater potential and effect in the modernization of the reclamation industry in the «hightech industry», through the use of innovative developments and optimal management decisions.

Vyshnivetsky Castle Library of Prince Mychailo Servaty Vyshnivetsky – Historical Book Heritage and Object of Bibliological and Historical Reconstruction

2014 ◽  
Vol 3 ◽  
pp. 166-182
Author(s):  
Iryna Tsiborovska-Rymarovych
Keyword(s):  
18Th Century ◽  
Historical Analysis ◽  
Cultural Significance ◽  
Historical Sources ◽  
Cultural Images ◽  
The Enlightenment ◽  
Printed Books ◽  
History Of ◽  
Grand Duchy Of Lithuania ◽  
Definition Of

The article has as its object the elucidation of the history of the Vyshnivetsky Castle Library, definition of the content of its fund, its historical and cultural significance, correlation of the founder of the Library Mychailo Servaty Vyshnivetsky with the Book.The Vyshnivetsky Castle Library was formed in the Ukrainian historical region of Volyn’, in the Vyshnivets town – “family nest” of the old Ukrainian noble family of the Vyshnivetskies under the “Korybut” coat of arm. The founder of the Library was Prince Mychailo Servaty Vyshnivetsky (1680–1744) – Grand Hetman and Grand Chancellor of the Grand Duchy of Lithuania, Vilno Voievoda. He was a politician, an erudite and great bibliophile. In the 30th–40th of the 18th century the main Prince’s residence Vyshnivets became an important centre of magnate’s culture in Rich Pospolyta. M. S. Vyshnivetsky’s contemporaries from the noble class and clergy knew quite well about his library and really appreciated it. According to historical documents 5 periods are defined in the Library’s history. In the historical sources the first place is occupied by old-printed books of Library collection and 7 Library manuscript catalogues dating from 1745 up to the 1835 which give information about quantity and topical structures of Library collection.The Library is a historical and cultural symbol of the Enlightenment epoch. The Enlightenment and those particular concepts and cultural images pertaining to that epoch had their effect on the formation of Library’s fund. Its main features are as follow: comprehensive nature of the stock, predominance of French eighteenth century editions, presence of academic books and editions on orientalistics as well as works of the ideologues of the Enlightenment and new kinds of literature, which generated as a result of this movement – encyclopaedias, encyclopaedian dictionaries, almanacs, etc. Besides the universal nature of its stock books on history, social and political thought, fiction were dominating.The reconstruction of the history of Vyshnivetsky’s Library, the historical analysis of the provenances in its editions give us better understanding of the personality of its owners and in some cases their philanthropic activities, and a better ability to identify the role of this Library in the culture life of society in a certain epoch.

E-health developments in the system of health services in Hungary and the European Union

2014 ◽  
Vol 155 (21) ◽  
pp. 822-827
Author(s):  
Ágnes Váradi
Keyword(s):  
Health Care ◽  
European Union ◽  
Public Discourse ◽  
Action Plan ◽  
Fundamental Rights ◽  
Public Health Care ◽  
The European Union ◽  
Contemporary Issue ◽  
Definition Of ◽  
Basic Features

The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which – if accepted – would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems. Orv. Hetil., 2014, 155(21), 822–827.

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