Richard J. Banchs - The Quality Improvement Challenge

Dr. Banchs compiles his improvement knowledge and years of clinical experience in the front lines into a road map for healthcare practitioners to achieve success in their quality improvement projects. By being on both sides of the equation, he can offer a global perspective on the nature of improvement work and the best strategies to overcome the barriers to improvement in healthcare. In this book, he shares his knowledge and expertise with any physician wishing to successfully improve the practice of medicine.

Since 2013, Dr. Banchs has been teaching improvement methodology to staff, residents, and faculty at the University of Illinois Hospital in Chicago. He has served as the senior director of the Organizational Process Improvement (OPI) office, and is currently the Associate Head for Quality and Safety for the Department of Anesthesiology.

Michael R. Pop, SSMBB, MBAis a Lean Six Sigma Master Black Belt. He is an accomplished Quality Professional with 30 years of experience enhancing operations and leading teams through the implementation of effective solutions to permanently resolve quality issues. He is currently the director of Business Process Improvement for the Omron Automation Americas group. Prior to his current role, he was a senior consultant with Illinois Business Innovation Services spending the majority of his career providing Quality Systems Management, Lean, Six‐Sigma, Quality Management, and Quality Engineering support to various industries, including diversified manufacturers, education, healthcare, government and not‐for‐profits.

He has assisted multiple hospitals and clinics in implementing Lean Six Sigma Operations and has coached and mentored numerous healthcare leaders in the use of Statistical Process Control techniques to improve both process and healthcare services. As a quality consultant, Mr. Pop has assisted numerous organizations with becoming registered to ISO 9001, a set of international standards on quality management and quality assurance. He has trained over 200 Lean Six Sigma Black Belts and 500+ Green Belt students, helping them implement effective, efficient, and cost‐effective processes resulting in more than $20 million in savings for their organizations.

Michael R. Pop has a Master of Business Administration and a bachelor’s degree in Mechanical Engineering Technology, both from Purdue University, and is a Certified Six Sigma Master Black Belt, Certified Quality Engineer, and a Certified Quality Auditor. He is currently a senior member of the American Society for Quality (ASQ).

Stories from the Front Lines of Healthcare

Martha Sanchez, the Head of Housekeeping ( Chapter 4)

Turn‐Around Time for X‐rays in the ED ( Chapter 5)

Andrea, the QI Project Manager ( Chapter 10)

Wait Time in the Orthopedic Outpatient Clinic ( Chapter 18)

The Early Discharge QI Project at Memorial Hospital ( Chapter 23)

The NICU Team at St. Agnes Hospital ( Chapter 25)

Brandon, the Ambulatory Clinic manager ( Chapter 26)

“Make It Happen” ( Chapter 29)

Examples

First‐Case On‐Time‐Start Accuracy at Fond‐du‐Lac Medical Center ( Chapter 4)

Patient Arrival‐to‐Departure Time at the PCP Clinic ( Chapter 4)

A SIPOC diagram for St. Barnabas Preoperative Evaluation Clinic ( Chapter 7)

The “Customer” of a STAT Arterial Blood Gas (ABG) ( Chapter 8)

Supply Chain Management for Patient Care Units ( Chapter 8)

Patient Satisfaction with UI Health Outpatient Care Center ( Chapter 8)

Improving the Organization of Medical Supplies in the EDRR ( Chapter 8)

Improving MRI Patient Throughput ( Chapter 9)

Improving STAT Chest X‐Rays in the ICU ( Chapter 12)

Temperature Management on Arrival to the ED ( Chapter 13)

Stratification Factors for “Time from Order to Arrival of TPN Bag” ( Chapter 13)

Order‐to‐Result Time at Mercy Hospital ( Chapter 15)

Narcotic Discrepancies at Chicago Med ( Chapter 15)

C‐section Rate at London Memorial ( Chapter 15)

The Individuals and Moving Range (I‐mR) Chart of a Patient’s SBP ( Chapter 16)

Door‐to‐Infusion Time at Huron Medical Center ( Chapter 16)

Improving DVT Prophylaxis ( Chapter 17)

Medication Error before Initiating CPB ( Chapter 18)

Patient Satisfaction with the ED Visit ( Chapter 18)

Exercises

A Problem Statement and Project Charter for Your QI project ( Chapter 4)

The QI team at Heart Medical Center ( Chapter 6)

CTQs for the New Women’s Center ( Chapter 8)

Mapping “Ordering Blood from the Blood Bank” ( Chapter 10)

Identifying “Waste” in the Pediatric Unit ( Chapter 11)

In‐training Examination at Mass General Hospital ( Chapter 18)

Case Studies

Improving RTA Time at St. Michaels Hospital ( Chapter 14)

Door‐to‐Infusion Time at Huron Medical Center ( Chapter 16)

The New Balloon Angioplasty Catheter at UIC ( Chapter 17)

Decreasing Unplanned Readmissions after Tonsillectomy ( Chapter 20)

This book is accompanied by a companion website:

www.wiley.com/go/banchs/quality

The website includes:

Powerpoints of supplementary material of project templates and forms.

Scan this QR code to visit the companion website.

In the last 20 years, science has made a number of transformational changes that have impacted the way we think about healthcare. Targeted cancer therapy, drug‐eluting cardiac stents, 3D printing, and the human genome project are but a few of the advances that have revolutionized medicine. Yet how we deliver care and the healthcare experience have not improved at the same rate. Despite significant efforts, regulatory mandates, and the sacrifice of many in the front line we have not achieved our goals of providing safe, efficient, and cost‐effective care for all. Standards and benchmarks often lag or fail to be followed, best‐practices have been slow to spread, and quality differences have persisted among providers and geographic areas. These accounts, coupled with highly publicized medical malpractice litigation, have eroded patients’ trust in the healthcare system.

The current crisis isn’t new. It has evolved over the last 30 years to the current level of intensity that we now face and can no longer ignore. Reports including the Institute of Medicine’s “To Err Is Human” (Kohn 2000), “Crossing the Quality Chasm” (IOM 2001), and “Transforming Healthcare: A Safety Imperative” (Leape 2009) have highlighted the inability of the healthcare system to reliably provide safe, high quality, cost‐effective patient care. The crisis has deepened by rising expectations of patients who are accustomed to a retail setting, where services are customer‐driven, efficient, and accessible 24/7 through mobile connectivity, and are demanding the same from healthcare. A true “patient‐to‐consumer revolution” (Wyman 2014) is demanding increased access, service, personalization, and speed from a healthcare system that is slow, inconvenient, confusing and difficult to navigate. Competition among healthcare organizations is no longer based solely on reputation, but on service, value, and price.

In this environment, healthcare organizations face a significant pressure to provide high‐quality, state‐of‐the‐art patient care while lowering costs and improving patients’ care experiences. These demands exist in the context of heightened accreditation requirements, uncertain governmental mandates, decreasing reimbursement, and overwhelmed clinicians and administrators. The negative results are experienced by both patients and healthcare professionals.