QUALITY CRITICAL PATH

Transcription

1 QUALITY CRITICAL PATH - The path with the longest duration and becomes the expected length of time for your project to finish. Delays to the critical path delay the project and shortened critical path reduces project duration. SELECTING PROJECTS What is the frequency of occurrence of the disease, condition? What is the likelihood of success? (e.g. is there broad evidence based clinical research to support a new care process?) How large is the performance gap to be closed? (today versus the ideal) PROJECT MANAGEMENT ELEMENTS

2 PROJECT MANAGEMENT STEPS Project Initiation defining scope, identifying stakeholders, project sponsor, team members, charter doc signed Planning Identify tasks, estimate resources, costs, and time, develop responsibility grid (see below example) Scheduling identify critical path, constraints, graph with gannt chart Project Control & Communications monitor project & reevaluate periodically Risk Management Identify risks and propose solutions Procurement contracting & selecting vendors Project Management Office & Project Closure WHAT FACOTRS DETERMINE COST IN PROJECT MANAGEMENT? WHAT ENABLES HEALTHCARE PROVIDERS TO IMPROVE CARE? WHAT HOLDS PROVIDERS ACCOUNTABLE?

3 QUALITY DOTS Also pneumonic STEEEP T for timeliness. SCOPE OF REGULATORY OVERSIGHT

4 ISSUING AGENCIES OF REGULATIONS AND GUIDANCE (FED & STATE) *Thousand of pages of laws, regulations and sub-regulatory are communicated from federal and state agencies and monitored to determine if actionable or informational. ENVIRONMENT OF CARE IS MADE OF 3 MAIN COMPONENTS The Building how it is arranged, and special features to protect patients Equipment used to operate the building or supportive or treat patients People anyone who enters the environment ENVIRONMENT OF CARE MANAGEMENT PLAN COMPONENTS Leadership appointed safety officer Fire Safety - NFPA publishes several hundred standards covering a broad range of fire safety subjects. Hospitals use these manuals and others as their guide to proper fire safety Hazardous Material & Waste - Ensure your EVS leadership is maintaining good documentation of the waste from cradle to grave. Medical Equipment & Utilities Management (redundancy is best i.e. generators) Emergency Management Life Safety CPR etc. COMPREHENSIVE ACCREDITATION MANUAL HOSPITALS (CAMH) Contain Elements of Performance (EPs) your Facility Manager& Director needs to know and apply WHAT ARE DIFFERENT TYPES OF VARIATION? Random variation is considered natural variation and hard to reduce

5 Special cause variation is not random and should be investigated for cause WHAT DOES A CONTROL CHART TELL US? Process mean changes over time Process variability over time When special causes are present provides opportunity to learn about process When no special causes are present process is predictable Tells the when of the story, but not the why WHEN IS THE PROCESS OUT OF CONTROL? >0 points falls outside LCL or UCL (A below) Note: LCL & UCL are 3 std devs from mean 2 out of 3 successive points are in area at least 2 std devs from mean (B below) WHAT TO DO IF PROCESS IS OUT OF CONTROL? Identify assignable (special) causes Establish the reason for the special cause and confirm that the cause is abnormal Delete the special cause data Recalculate control limits PROCESS METRICS Capacity of a process: the maximum possible amount of output (goods or services) that a process or resource can produce or transform. Throughput time: the average time a unit spends in the entire process. It includes both processing time, waiting time and transport time, and is determined by the

6 critical (longest) path through the process. In healthcare this begins when a patient first checks in. Process time: the average time to complete a process step (task). Does not consider the # of FTEs Cycle time (task): process time / # FTEs Bottleneck: the process step with the longest cycle time on the critical path Value-added time: the time a unit spends in the process where value is actually being added to the unit. FYI:

7 Non-value-added time: the time a unit spends in the process where no value is being added. Wait time is non-value-added time. Takt time: The speed with which customers. must be served to satisfy demand for the service. Workers required: total process time / takt time Utilization: the proportion of capacity actually being used You don t want to be at full capacity because you ll have now flexibility Also, waiting time increases as you approach 100% utilization. WHAT ARE THE STRATEGIC ADVATAGES OF FORECASTING? Supply-Chain Management Good supplier relations, advantages in product innovation, cost and speed to market Human Resources Hiring, training, laying off workers Capacity Capacity shortages can result in undependable delivery, loss of customers, loss of market share TWO TYPES OF FORECASTING? Qualitative Used when situation is vague and little data exist o New products o New technology Involves intuition, experience Example: Delphi Method

8 Quantitative Used when situation is stable and historical data exist o Existing products o Current technology Involves mathematical techniques, i.e. regression, weighted averages:

9 WHAT CAN BE DONE TO IMPROVE WAIT TIMES? Don t do Single Server Single phase! Implement this:

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11 PROCESS IMPROVEMENT TOOLS

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13 Attribution: All content adapted from course lecture notes, and Joshi, M. S., Ransom, E. R., Nash, D. B. & Ransom, S. B., eds. (2014). The Healthcare Quality Book: Vision, Strategy, and Tools (3rd Edition). Chicago, Illinois: Health Administration Press.