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Contents Preface Acknowledgments Part I_U.S. Healthcare System Problems and Solutions Chapter 1_U.S. Healthcare System Problems Rising Health Insurance Premiums Why Double-Digit Health Insurance Increases? 46.6 Million Americans (Almost 1 in 6) Are Without Health Insurance Motivating Healthcare Providers to Reduce Cost and Improve Quality Waste in Healthcare Excess Healthcare Administrative and Overhead Costs Excess Insurance Company Administrative and Overhead Costs U.S. Health Expenditures Are a Growing Percentage of GDP U.S. Spends Twice as Much on Healthcare But Ranks 37th in Health System Performance Quality Problems in U.S. Healthcare Failure of Continuous Quality Improvement and Total Quality Management Redesigning the U.S. Healthcare System Chapter 2_Respect for Employees Part II_Reduce Healthcare Cost and Improve Quality by Using Toyota Lean Production Methods Chapter 3_46 Steps to Improve Cost and Quality in the U.S. Healthcare System Step 1_Define Value from the Perspective of the Patient (Customer) Step 2_Map the Patient's Value Stream Step 3_Walk Through All Your Core Processes, and Observe How They Work in Detail Step 4_Implement Toyota-Style Lean Production Methods Step 5_Train Administrators, Managers, and Supervisors to Be Lean Leaders Step 6_Provide Empathetic "Change Management" to Ease the Transition to Lean Step 7_Change "Quality Improvement Department" to "Quality and Cost Improvement Department" Step 8_Change the Name "Quality Improvement Manual" to "Quality and Cost Improvement Manual" Step 9_Educate Every Employee about the Basic Strategic Plan of the Organization Step 10_Establish an Improvement Plan with Goals to Be Accomplished by Specific People and Dates Step 11_Implement a Simple Scorecard for the Entire Healthcare Organization Step 12_Use a Simple Scorecard to Monitor Each Department Step 13_The Board of Directors Initiates Selected Strategic Quality and Cost Improvement Goals Step 14_Publish an Annual Quality Report for Simultaneous Review with the Annual Financial Report Step 15_Create a Rapid Improvement Team to Make Quick Cost and Quality Improvements Step 16_Encourage RIT Members to Implement Toyota-Style Work Teams Step 17_Implement Rapid Improvement Circles of Employees Step 18_Implement a Permanent Organizational Structure for Quality and Cost Improvement Step 19_Set a Goal for Each RIC Member to Produce One to Five New Suggestions per Month Step 20_Have a Clear Reward and Recognition Program, and Communicate Negative Consequences Step 21_Adopt and Teach Continuous Improvement to as Many People as Possible in the Organization Step 22_The Rapid Improvement Team Quickly Implements a 5S Program Step 23_Identify Unnecessary Items Using Red Tags Step 24_Promote Visual Control Throughout the Workplace and Organization Step 25_Eliminate All Forms of Waste Step 26_Reduce Specific Examples of Potential Waste Step 27_Sequence Work and Standardize It Step 28_Eliminate Bottlenecks to Improve Continuous Flow Step 29_Document All Important Processes in the Organization or Department Step 30_Implement and Maintain Continuous Improvement Step 31_Consider Radical Improvement Where Appropriate Step 32_Videotape Each Step of Entire Work Processes Step 33_Use Flowcharts to Improve Core Processes Step 34_Use Spaghetti Diagrams to Trace the Path of a Patient, Employee, or Product Step 35_Measure Process Cycle Times Step 36_Implement Quick Changeovers Within a Process Step 37_Lean Complements Nursing Care Delivery Models Step 38_Challenge and Work with your Extended Network of Suppliers and Partners Step 39_Automate Processes to Further Improve Quality and Cost Step 40_Learn from Benchmark Nonhealthcare Organizations Step 41_Learn from Other Benchmark Healthcare Organizations Step 42_Learn from the Institute for Healthcare Improvement Step 43_Hold on to the Gains You've Achieved Step 44_Reduce Administrative Overhead Costs Step 45_Avoid Insurance Company Overhead Costs Step 46_Take a Total Systems View of Healthcare for Lean Improvement Chapter 4_A Capsule Summary of a Lean Toyota-like Production System for Healthcare Chapter 5_A Short To-Do List to Nationally Improve U.S. Healthcare Cost and Quality Appendix A_Automaker Benchmarks Appendix B_Seattle Children's Hospital Improvement Example Appendix C_5-S Catches on at the VA Pittsburgh Health System Appendix D_Error-free Pathology: Applying Lean Production Methods to Anatomic Pathology at the University of Pittsburgh Shadyside Hospital Appendix E_Going Lean in Healthcare Appendix F_Creating Lean Healthcare Appendix G_Fixing Healthcare from the Inside, Today Appendix H_Lean and Healthy Appendix I No Satisfaction at Toyota: What Drives Toyota? The Presumption of Imperfection-and a Distinctly American Refusal to Accept It Notes Bibliography Index
Library of Congress Subject Headings for this publication:
Toyota Jidêaosha Kabushiki Kaisha.
Medical care -- Cost control.
Medical care -- Quality control.
Medical care -- Cost effectiveness.
Health Care Costs -- United States.
Cost Control -- methods -- United States.
Health Care Reform -- economics -- United States.
Quality of Health Care -- economics -- United States.