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Why did you choose that program and why do you think that program is most effective?
1. There is a specific division for quality of care. Hospital is accredited by JCIA.so hospital follow the guidelines implemented by JCIA
2. Insurance carrier.
3. I was not involved in the decision process for that but it was driven first by clogged ED's that needed a more efficient way to get patients taken care of more quickly and more appropriately for the problem they were there for.
4. System choice to be spread over 12 facilities
5. Six Sigma is the program most totted by the administration to improve quality, quanity and access to care. However, I have not had the opportunity to investigat the literature on this topic
6. do not know why it was chosen. It may not be the most effective program.
7. Six Sigma. i am a trained Six Sigma Black Belt, however the organization does not recognize the process
8. Our CEO chose that program based on it's goal of both eliminating waste and improving quality through the improvement of processes.
9. We are a member of PCHI(part of Mass General Hospital) which has a program for quality that we follow.
10. higher headquarters decision
11. Selected by senior managers and medical executive committee. Have doubts about it being most effective.
12. None of the proprietary programs seemed to be the right fit for the organization. Therefore, we opted to use various aspects from many of them and develop a program that appears to meet the needs of the organization and the medical staff. Having them participate in the creation of the program gave them ownership and made "buy-in" a little easier.
13. Chosen by the organization.
14. i didn't choose it; it seems very slow
15. It is the most appropriate to our set-up. We practice outside USA.
16. not sure
17. It is a collaborative effort involving most health care providers in Minnesota, and is funded by the major health plans rather than by the providers.
18. Program was chosen over a decade ago. I'm not sure it's the most effective, but I don't believe there is sound evidence to support any particular program as the most effective. It's generally better to use one process well than to react to the latest attention-getter.
19. The results of this progarm were only partially implemented and the way the whole program was run was somewhat less than optimum. Not enough input from clinicians or nursing staff and very little observation was done on SOME of the projects. Others were well run. There was great variance in this though.
20. It is based on what is already working and focusing on the good and what is positive and building on that
21. Chosen by administration.
22. GOOD TRACK RECORD.
23. Its what we can do.
24. easy to teach and utilize
25. It was not my decision. The CEO is outcome measure oriented and Six Sigma was felt to be consistent with this outlook.
26. I am not in a place to comment of this question
27. In my former organization I started the PI with lean processes, an easier, cheaper way to improve processes, improve health and decrease costs. In my present org. six sigma is used but not for all PI.
28. We needed a simple approach that could be implemented quickly and woudl diffuse through the organization quickly.
29. Others chose. MB chosen as a good tool to improve processes and quality. Now will start with more lean and 6 sigma. Don't know why chosen. Appeal of 6 sigma is the financial benefit tie-in.
30. Applicable to OR efficiency tasks
31. The program was chosen without input from the medical staff, and appears to be relatively ineffective (after a year).
32. experience
33. Although we are now evaluating lean application at our organization--I think we may be sophisticated enough now.
34. Lean and Toyota have been well accepted and have helped us be consistant in reviewing ineffiencies at all levels of the organization
35. The organization adopted that process to reduce overhead and improve patient flow (and hopefully satisfaction) while improving physician efficiency so they can see more patients within a gvien time period.
36. We chose the programs because they provide us the appropriate mix of flexibility and cost. Personally, I don't necessarily think that this program is the most effective, but one has to pick and choose which battles to fight.
37. A philosophy, a process and continuous process improvement
38. n/a
39. We partnered with a vendor to build an all digital specialty hospital and we have been successfull in obtaining actionable data from our efforts.
40. I'm currently in solo practice. I do not have the resources to implement any of the above. I simply try to employ what I have learned at ACPE and through the Core Curriculum that I have taken to this point.
41. This is a program that strives to reengineer care around front line empowerment, the point of actual care
42. SCIP,Puget sound business alliance, JACHO, and several others depending on areas in the hospital. The bottem line is that no body knows if any of this stuff works. THe Six Sigma at wone local hospital is a diaster, plan and simple.
43. ihi success stats
44. I was not involved in the decision making process.
45. The hospital is part of a "for profit" company and the use of the company developed or contracted solutions are implemented.
46. Cost
47. This was dictated from echelons above my leadership position.
48. Looking at Lean
49. Combinations of the above provide comparative data
50. Regulatory compliance.
51. Dept of Defense chose LEAN as an initiative
52. They are all the same. They just have different names. They are all the scientific method applied to care processes. Six Sigma better for processes that occur at a high rate.
53. State verison of the Baldrige Award program -- choosen because it link the major components (quality, safety, financial)together and looks at the organization as a whole.
54. Chosen by our CEO and executive committee based on its proven effectiveness in other multispecialty clinics.
55. Excellent collaboration among hospitals with best practices
56. We just recently went to this program and are still reviewing its effect on hospital policies and procedures.
57. proven efficacy
58. Corporate decision
59. We chose Patients First because it is supported and promoted by the State Hospital Association. The program has a broad agenda of safety, political advocacy, and transparency features. It includes the NQF 30 Safe Practices, and the IHI bundles.
60. We regularly use six sigma, lean and proprietary, and homegrown processes. We have many black belts within the hospital's ranks.
61. financial contraints payer programs available
62. 3M
63. I did not choose the program, my choice would have been Six Sigma or Lean
64. Midas is our present program-not sure it is the best. Six Sigma was used by one of our support services recently. There is much discussion on how best, what is best and is there a better system out there.
65. Integration withexisting so;ftware and ability to track measures and identify potential solutions
66. Has largely depended on a physician champion to lobby for a product or approach to improve quality. Admin has been supportive and encouraging docs to think of pt safety first, but programs have not been successful w/o physician advocacy.
67. Corporate decision
68. in use when I arrived in job
69. None that I am aware of - as a part time consultant medical director involved in medical management, such initiatives may in fact be in place that I'm unaware of.
70. If you can measure it, you can manage it.
71. Easier to implement across multiple and diverse practice settings. A Kaizen type of process.
72. Because we are leading, planning healthcare organization, and not clinical setting. Our effect on decision making and initiate health programmes
73. We use a toolbox with Lean, PDCA, and Rapid Decision Making geared to the level of complexity of the problem. However, Six Sigma is our anchor tool and we have internal training in our organization from a National Expert. It is effective where used - and use is increasing. The program is effective because we are continually increasing the number of individuals trained, and recognizing them for being trained
74. Major leaders skilled in it and efefctive in using it in our organization
75. the program was chosen by the CEO, not I. i have been, in the past , his change agent, of sorts. the balanced scorecard is where he lit, and we shall see how that improves us all.
76. It works.
77. not sure i had nothing to do with this
78. Required of all system facilities and monitoring is perfomed of effectiveness
79. Actually, we use both six sigma and lean processes and FMEA's and CQI Plus depending upon the intiative being addressed. Each works very well in different areas. There is no one fits all program.
80. Medicare reimbursement
81. Important to customers of health plans
82. We have been to organizations that embraced Lean and the results are transformational.
83. Experience and results - it works
84. Chosen by the hospital
85. An additional tool to explore. There is not agreement that one tool is the most effective.
86. chosen by administration
87. We didn't choose it, it is the default in an organization that really believes that we are the best and that the numbers just don't recognize that.
88. don't know
89. System-wide initiative to improve quality as well as reduce costs.
90. Standardization will result to efficient and safe work environment.
91. NCQA standard
92. It focuses on both quality and process
93. N/A
94. It is simple and works well for us.
95. Partner with GE
96. corporate determination -- still undergoing refinements
97. Making the error rate lower by reliable processes and the ways to go from level 1 - level 3-5 is critical from our perspectiv -
98. National VHA initiative
99. We chose to do it that way because wwe wanted to use a proven strategy that actually addresses variation in clinical care
100. ??
101. have not been convinced of the need to change but we are actively looking at "lean" as an option.
102. Standarized data sets and wide spread applicability.
103. We are still looking for the best answer, while trying to deal with the programs imposed upon us
104. We work closely with a health plan and incorporate internal disease management and quality monitoring processes and then implement corrective actions as indicated. It is a cooperative effort between physician organization, healthplan, and management company.
105. It has just been chosen by the organization and it is being used in other venues besides quality (marketing, growth, process redesign). It is too early to tell but I do not believe it will prove to be effective as it is too complicated and expensive. Time will tell. Ask me in a year.
106. Our processes seem to need the greatest attention.
107. Chosen by corporate. Until recently it was a cumbersome program, but has been leaned down to three areas. This mainly applies to staff and not physicians.
108. Didn't choose it. I've been trying to develop BOTH Lean and Six Sigma venues without sgnificant success because of the cultural resistance to change.
109. This decision was made from the top down.
110. six sigma is marketing hype, no real substance
111. basic, inexpensive, understandable
112. Not involved in the process. Just started as VPMA
113. We are a small multispeciality practice. These approaches are more suited to our size and scope of practice.
114. Ease of implementation
115. emr upgrade will allow us to move more closely to "best practices" guidelines
116. It was an institutional decision. I don't think it is helpful - too complicated and process-oriented.
117. previous experience
118. Defined realtionships among stakeholders, use of an expert as a facilitator (Black Belt), defined approach to defining, measureing, analyzizng, and improving quality or reducing cost.
119. AHR an outside group focusing on utilization review focusing on length of stay, documentation to support case mix index is used. The findings are then used to focus in house monitoring such as record legibility.
120. Mandated by Department of Veterans Affairs
121. I didn't...I don't!
122. We did some pilot Lean projects that seemed to be effective. These have had some impact on improving some of the cultural problems we have faced. We did not do 6 sigma programs because the infrastructure costs were too high, and our problem is getting to 1-2 sigma, not refining our processes and eliminating errors. In other words we need to work on standardizing our processes which is more of a lean function rather than refining our processes which would be a 6 sigma function.
123. We are JUST beginning the Lean process and have already decided to have teh first several projects NOT involve physician dependent processes at all due to low buy-in/input. The reason for choosing Lean was that it would be less costly to implement than 6 Sigma and that it incorporated the Rapid Cycle change that IHI supports.
124. This has been in place for years and I was not involved in the decision, so can not answer the question about why this method was chosen. It does provide a good framework to ensure all issues are considered and improvements are maintained.
125. Industrial experience with these initiatives hasve show marked increaswe in quality and simultaneous decrease in cost of care and LOS
126. It is a longstanding approach for us.
127. It was very effective, required relatively few resources, and easy to implement. And it works!
128. not my decision, I don't know how it was made.
129. an incetivevfrom system office
130. The Office of Quality Management explored quality program options and chose Six Sigma because it was the best adaptable to a public mental health system of care.
131. Started in 1996 w/FOCUS-PDCA and have stuck with it.
132. They emphasize patient safety and satisfaction, or they benchmark quality indicators. Life Wings teaches a teamwork approach to patient safety.
133. keystone (MHS + Hopkins) core measures satisfaction - patient and associate
134. Proven effectiveness and national initiatives.
135. Easiest to understand. No special language surrounding it.
136. Quality leadership positions have been vacant for over a year.
137. I din't choose it and I am not sure that is is the best program. I have no evidence one way or the other.
138. We use six sigma and lean but I don't know enough about the processes to comment.
139. Chosen by corporate head
140. System initiative....I think there are some healthcare processes that lend themselves to improvement using 6-Sigma. I think that some hospital processes - those with wide variation in volume that cannot be controlled - are now well suited to 6-Sigma.
141. The major part of the program is the PDCA program of the JCAHO. It has been in place for many years. Other things, Lean & Six Sigma, are being grafted on to it because others have had success in decreasing cost with those tools. Only a handful of the leaders believe that improving quality will reduce cost. This means that the quality initiatives are given few resources.
142. Worked elsewhere, should work here.
143. We participated in the MHA-Keystone Center Initiative, were part of the IHI 100,000 Lives Campaign, and are a part of Ascension Health with the Call to Action for Healthcare that is Safe using the Priorities for Action. This kept us busy with institution of best practices and data collection of several focused initiatives.
144. Both methodologies have their strengths and weaknesses. When the applied, both are effective in addressing quality concerns
145. We felt we could taylor it to our specific needs. i.e. concentrate on those areas where the need was greatest and coul derive the greatest benefits.
146. Belong to ICSI - a MN based group composed of physicians, hospitals and insurance plans
147. REGIONAL AND PHYSICIAN AND 3RD PARTY DRIVEN WITH PATIENT SAFETY AT THE TOP AND FOLLOWING THE 6 AIMS
148. chosen by administration as best option for acceptance as best / fastest hospital improvement measures
149. Targets issues we have. Too early to assess efficacy.
150. I was not part of the decision team, thus I am not sure.
151. Involvement through ICSI. Program effectiveness related to strength of QI staff and the ongoing support from ICSI.
152. Products with lots of local input more likely to be adopted.
153. Involvement of entire organization.
154. Chosen by administration.
155. We are implementing lean six sigma. We needed to focus on improving our data and making logical decisions with the information that we have.
156. Trying to institute a quality culture and not just a program that may come and go like so many of the others.
157. easy to implement
158. We don't have the financial resources
159. Baldrige incorporates broad organizational activity and behavior. Leapfrog is promoted by our State Hosptal Association as part of its "Patients First" program. We are a Magnet Hospital.
160. Both well-established national quality/safety collaboratives
161. Lean process is used because of past experience of members of senior management in administration. Most effective because we have seen it work well.
162. Association with major industrial payer
163. System-wide decision. I am not convinced that it is the most effective. I would prefer Six Sigma.
164. Been burned out with formal QI programs, eg Deming, Six Sigma. Find that our personnel work best with self motivation using standard QI processes.
165. No choice. I have never seen a side by side comparison.
166. I don't know if a particular product is being used or not
167. No prepackaged quality products fit our needs and financial means. We started on quality early, and have won state awards with our-home grown system
168. It was chosen because it was initiated by physicians in an effort to marry financial data with clinically important outcomes. The reports generated by this analysis are comprehensive, relevant, applicable to each unit of service, and lend themselves to analysis and action that then are tracked for appropriate changes.
169. I was not with the organization at the time of program selection. They have a couple programs in place - one is the format used by the QI committee - a "peel back" approach which means from what I am learning, a peeling back of the identified problem to its source. The organization has in place an EMR system that is capable of conducting quality analyses. I have not seen this done, except to evaluate incomplete records by the nursing staff. The principle focus of "quality" at the organization is lead by the CFO - looking at average daily census, cost containment, and other traditional financial measures of quality. I only started with the organization in January 2007. My hope is to bring the same scrutiny to the clinical arena to maximize the quality of patient care.
170. Realtionship existed with Premier which continues at present time.
171. chosen by our ER
172. GE is located in our state and is a primary initiator of Six Sigma
173. It empowers employees and seeks their active involment
174. I think it has just evolved. Quality and safety are a primary focus of our activities.
175. Our approaches do not commit the capital outlays that the proprietary producsts do. Our results have been quiite satisfactory
176. Do not utilize any single methodology
177. We have done Six sigma and find it too cumbersome and time consuming. Lean seems a better fit with quicker fixes to our problems.
178. not my choice
179. We are also starting Lean processes. Six sigma has been very good to help define the proceses and deal with the complexity of care.
180. Both lean and Six Sigma
181. IHI is the clear healthcare leader in Q and Reliability and has more success within our industry. The others are excellent tools that may be used for given processes to which they might best apply...but most of the stories in healthcare come out of IHI and their methodology which is simple.
182. Adapted from electronics industry and seemed most applicable.
183. Six Sigma is a reference point and goal, but we feel difficult to apply universally at this time. we have an active quality and safety agenda that benchmarks against national data and regularly report indicators to senior management and the Board
184. Standard tool
185. Early in implmentation....efficacy not yet clear
186. I didn't choose it. Nothing seems to be effective in this organization.
187. Kaiser Permanente has had a long history of evaluating our care based on medical evidence. We have not found the other systems to be superior to what we have developed over 50+ years.
188. Superiority and effectualness.
189. Computerized processes to improve patient flow, staffing, etc.
190. Our system (CHE) chose it.
191. Our institution is an Air Force medical treatment facility. The Air Force has adopted AFSO 21 as its official process improvement methodology. AFSO 21 is built on "Lean Signma" principles.
192. Favored because it dually focuses on production and quality.
193. Just picking one and getting a focus is more important than debating which program is superior. We chose Lean because of the expertise of our Dirctor of Quality Improvement.
194. nationally recognized and accepted
195. Management lacks insight and vision do anything else.
196. WE have several initiatives going on at any one time to improve quality. We have used Lean and Six Sigma but those are not commonly used. PDSA seems to be effective and easy to use
197. I did not make the choice - was made by Admin
198. no comment
199. I didn't choose it, and I think some of them are silly and cannot be supported based on DATA....
200. This system is used by our hospital and allows us to use their department and set-ups to look at certain issues.
201. enthusiasm of leadership for program
202. program of the year. We try them all.....
203. I work in a government facility and i'm not sure why it was chosen. It hasn't been in place long enough to assess results.
204. Not aware of the processes of these programs, which haven't been explained, voted on, and tried.
205. The nursing administration chose it.
206. Proven system to improve quality
207. well stablished and frequently used by us.
208. we do a lot every day in many areas of quality and report extensively to the public/admin./docs/BOD
209. no comment
210. That is what is being done by our administration and it is very much not the most effective.
211. Easy to obtain &get trainig & support services.
212. Physicians had very little input in the choice.
213. Not involved in this administrative decision
214. Has a combination of quick and slower methodology for a variety of different issues.
215. wired into communication structure
216. low price
217. It was promoted by leadership for ? reasons.
218. We feel that being able to deploy specific methodologies targeted to specific problems is effective. We have been successful with all three.
219. It was chosen by the Surgeon General of the Army and we have to use it
220. CEo manages the choices and I am not aware if any of the above or other being used.
221. Generally applicable, not just numbers w/o true and lasting change, we are near Pittsburg so could easily participate in Perfecting Patient Care training.
222. N/A
223. Lack of skills and failure to try alternatives. New admin team will be utilizing multiple initiatives around Lean Six Sigma
224. xxxxxxxxx
225. Just starting to use it
226. Safety is a national priority for our organization
227. Rapid medical evaluation program very effective in decreasing LWBS rates in ED due to improved front end assessment of patients, and improving data collection through use of advanced triage nursing guidelines
228. Local generation produced the most buy-in to patient safety
229. I'm not privy to that information.
230. This is not which I think is most effective (not the question you asked above, it is the one we have historically used as a health system.
231. long established and consistent use leading for familiarity, positive results, easir to adopt
232. The CEO has chosen to focus efficiency initiatives using Lean techniques. To date none of the Lean techniques have been used to improve clnical quality. The techniques have been used to improve various operational issues. The techniques used to address clinical quality have been either Proprietary or home-grown. There has not been one consistent appraoch.
233. chose it because of strategic alliance with GE. effective because it's a structured and proven methodology but very timeconsuming and benefit is still uncertain
234. It was felt we had the expertise on staff
235. none
236. not involved in that decision
237. Lean Six Sima is what we are using. PGM has "good hype" behind it, and good track record
238. No Comment
239. Limited resources prevent adopting a national program. Physician invlovement better when they are part of the design process.
240. cost effect on org.
241. Six Sigma is used to define the problem, choose the metric and establish control. PDSA is used for the rapid cycle change process in the Improve stage. I think this is the most effective process as it is metric driven
242. I just started in this field and will be looking at various products
243. There is little control by the clinicalproviders interms of what program of continuing improvement can be utilized
244. Best practice linked to six sigma, althoug best practice not a paradigm favored by physicians.
245. I didn't choose.
246. see above
247. Proponents of these processes came to us to use as an incubator as they cut their teeth in healthcare.
248. Although many of us are trained in TQM or CQI, we have been unable to prioritize it as a central process to improve our clinical measures.
249. integrated with EMR and focused on P4P.
250. Ease of access through local university resources. I believe Lean processes are more directly applicable to medicine than Six Sigma and others.
251. They are easy to follow, specific to medicine, and hospitals share their successes as well as their challenges.
252. the programs are choosen and developed at the corperate level with little input from front line physicians & QM staff, therefore most programs are not particularly effective
253. Is the best known by the quality team, and all the trainning has been done on that
254. VHA - comes with the territory - why reinvent the wheel? Greeley - heard at conferences and then invited to address the med staff
255. It is the foundation for all others. Far less expensive and no proven additional benefit from the others
256. actually are using six sigma as well, depending on the situation. Lean is good for entire process revisions.
257. Why? Need for culture change and a focus on quality (using the six principles of the IOM as our foundation), and efficiency-and believing that quality and efficiency are intertwined. Why most effective? Broad by-in, collaborative inclusive approach, broad commitment to principles.
258. Scientific rigor of Six Sigma with practical waste reduction approach of Lean.
259. We were in front of the curve with such a system
260. We have a multitude of quality initiatives that we call our quality wheel. By using five key result areas and tailoring national quality programs in conjunction with those locally developed we are able to more rapidly effect change that is measurable and specific to the problem area. As a result we achieve goals espoused by specific programs you mention like Six Sigma, IHI rapid change cycles, CMS pay for performance, etc.
261. Six sigma is being used but it remains unproven (in my mind)
262. I have used PDSA for over 15 years. I believe most programs are variation on the scientific method.I don't like fads and useless acronyms.
263. Client required it by contract. It is not very effective.
264. We use a variety of PI techniques including DMAIC, Lean, rapid cycle, etc.
265. i don't know what the hospital does
266. I don't know that it is the most effective, but it doesn't look good if your organization is not involved.
267. Administration seem to think accredidation is extremely important.
268. We have been doing this since working with the Joiner group in 1986. This is the original industrial model of QI modified for healthcare
269. Currently re-evaluating to select a better system.
270. wasn't involved in the choice though I agree with the decision
271. Physician and medical community adoption of the program.
272. Followed local VM lead and success
273. It has worked in other institutions.
274. Gets rid of wasted activity and contributes to less variation.
275. fit for easy transformation from current structure.
276. I had no say
277. There has been no attempt to improve quality beyond peer review amongst the physicians. The thought of bringing in outside "experts" or utilizing internal knowledgeable individuals is foreign to the administration. One of the things I learned at the recent ACPE conference on Medical Staff Leadership was that the medical staff does not need the administration to begin this process and we will indeed do so in the near future amongst ourselves. We will be following LEAN processes due to the availability of training for the medical staff leadership locally.
278. Chosen several years ago before many of the more recently programs were developed. Works well and organization is oriented to it.
279. Beginning to introduce a web-based confidential adverse event reporting system.
280. More reflective of news of our public health orientation
281. Utilizes teams of physicians, nurses, operations officers and front line managers to jointly coordinate quality improvement efforts.
282. The Medical Director made the choice because of a proven track record elsewhere but it is not effectivein our organization.
283. Minimal cost,JCAHO required compliance
284. This was chosen by the senior administrative team in the past. I have little insight into the process for that decision
285. Corporate decision
286. The program was chosen by our parent hospital organization.
287. Favorable reviews in literature and membership in large multihospital consortium that is using it
288. Too much trouble to fill in these boxes!
289. Good track record. Reasonableness
290. We use Lean Six Sigma TeamSTEPPS in High risk areas CPGs and Pt care bundles to proscribe care in certain DRGs No one single program is the key but the creation of a "patient safe culture" is the key
291. Our "institution" is a self-owned/managed medical group. All resources directed at quality are developed and financed by our physician owner-members. Our program is more aimed at individual behavior than departmental behavior with two exceptions, lab and ancillary services that get more traditional quality controls.
292. A process with measurable outcomes.
293. Something practical that we could integrate into our quality improvement efforts
294. I was not involved in the choice, but having studied Six Sigma, I feel it should work for us.
295. Unknown
296. We can't afford Six Sigma. And in my specialty Pediatrics and Peds Urgent Care. The low hanging fruit such as not writing antibiotics for sore throats has been eliminated. Even witm EMR, significant automation. It still cost money and time to measure and we are not paid any more by the insurance company.
297. covers a broader range of how we do business
298. studer group. prescriptive basic processes for clinical leaders like nurse managers moved into mangement
299. I didn't choose any of them.
300. State required
301. Tracers because they work extremely well to at once identify quality issues and sort through the complexities of health care decisions in a manner of which monitors are incapable.
302. local expertise -- effective because is directly involves front line staff and can demonstrate prompt benefits
303. Statistically driven
304. it was chosen by the hospital in which we work but not our specific group
305. Corporate required
306. Six Sigma provides the needed tools to improve safety. It let's one validate decisions that should be based on the correct organization, interpretation, and display of data. We don't always apply Six Sigma as well as we could!!
307. Seem to fit best woth organization
308. It was chosen by hospital administration
309. Part of our overall relationship with vendor, it allows us to use clincal and financial date from the same wharehouse
310. I did not choose it and it is not being effective because it is not being properly implemented
311. I didn't choose it!
312. Recommended by a trusted consultant
313. Economic reasons.
314. IHI program most effective because of the infrastructure around it.
315. We are a small stem cell company and subject to multiple regulatory/quality control agencies in NY state.
316. It provides real time data that can be shown to physicians to educate them
317. internal algorithms most useful to our complex organization. External review compliance with HEDIS & NCQA as benchmark performance and for marketing.
318. Evidence based, lots of support and resources available.
319. That decision was made prior to my coming to this position.
320. Reimbursement issues drive the use of proprietary QA products. Most of the Six Sigma and Lean processes require significant commitment of time and resources among our providers and our nursing staff who already feel overwhelmed with workload and feel they cannot take on one more "paperwork" challenge.
321. Medicare publishes and pays
322. I was not involved in that decision.
323. Effective and recognizes that human processes likely cannot get to 6 sigma levels of performance.
324. We are in the process of getting personnel trained in 6 sigma.
325. Plan is to initiate a strong leadership directly responsible to the VPMA to coordiate all pateint quality and safety issues at the hospital
326. we just monitor and do PDSA
327. We have locally trained 6 sigma black belts from a GE facility.
328. We are currently using PDSA but it has not been able to result in cultural change. We are looking at Lean processes as a new model for change and improvement but have not yet decided to go in that direction.
329. Easier to train others in this process
330. It was chosen by the quality improvement department with a directive from the health care system for all affiliated hospitals.
331. We practice over a 13 county area, where the majority of the care is provided by advanced practice nurses under strict protocol. Having a group review the consistency of care following protocol guidelines has been effective in assuring compliance with accepted practice guidelines.
332. Locally relevant
333. In place for a long time and working.
334. I did not choose
335. Senior administration decided. Verdict is still out.
336. System picked this program. Effective because involves mutiple levels to the carr team and validates small change process.
337. We are using Lean and Six Sigma to move more toward being results oriented organization . We currently have two ouside vendors on site helping with supply costs and documentaion projects.
338. We use the Crosby methodology with our CPI process.
339. Collaboratives have good but sometime limited focus success.
340. Microsystems are a cross-speciality approach to looking at systems that the patient encounters. By addressing issues from the patient's perspective and by involving front-line staff, greater buy-in and support for change is obtained. This buy-in leads to sustainability of changes.
341. I'm in lab, and we are considering six sigma or lean.
342. Each approach has its own strengths/weaknesses. We feel a combo utilizes the strengths of each.
343. It works.
344. Was in place when I joined the organization; do not know how it was chosen. The program is mainly focused on customer service.
345. System program
346. nationally recognized, good and I don't necessarily think it is the most effective--that is why we are pursuing change
347. It will change our culture, and give us the opportunity to become the best community hospital anywhere.
348. As an Ascension Health Ministry, we subscribe to the Ascension Health approach to quality and patient safety, which is collaborative with the Institute for Healthcare Improvement.
349. we also use Six Sigma - LEAN is better as it takes far less time to do.
350. It's on a trial at this time ...more to come later
351. Several involved in leadership of the program had prior experience with this quality tool.
352. The central office of our organization has developed an office of quality management, and has been collecting information on performance measures for more than ten years. Patient safety has a similar office. Together, they work with the local facilities to make sure that they are having sustained quality improvement efforts. As well, we perform root cause analyses whenever systems break down. The flow improvement collaborative is another example of how we are seeking to improve patient care. We will likely incorporate principles from lean six sigma in the future.
353. We have chosen the Sullivan Group to help improve our perioperative Servies, and The Studer Group for imporving the hospital's whole cultural environment. Decision was based on the Administration's and Bjoard best judgement after looking a several different approaches. We are also members of VHA.
354. human factors training was supported by our parent organization and we received premium credit for piloting it.
355. Our hospital is primarily engaged in revenue generating activities.
356. works the best with our newer staff who have exposure to this style of process in other jobs or family members who work with this.
357. I am not involved in the choice.
358. That's what I've been asking!
359. more operationaly focused
360. Members of our group have had previous experience with Six Sigma and decided to stick with the famliar.
361. Pushed by parent. Previous use of TQM was working fairly well.
362. We have many specialty areas. These provide an excellent level of care. By using the "Lean" approach, the leaders on that level and area are able to affect change to decrease errors and maximize patient care. An example is standard orders and putting orders in to the pharmacy on the computer.
363. Our organization views quality improvement as a marketing arm. Issues are chosen on how they can be spun for economic advantage. True quality improvement is viewed as a naive, unrealistic endeavor by physicians who are not team players.
364. I did not have a choice nor input.
365. Leadership not willing to tie to program that may require consultant or training resources or reprint educational documents that move from rapid cycle silo projects to overarching program across the insitituion; lip service is sometimes played to 'lean' or 'six sigma' for various audiences.
366. we use a mix of many programs. quality initiatives are disjointed and independent with a lack of hospital wide cohesion right now. Professional organization projects, uhc, and independent measures are the primary programs we use.
367. Program chosen by higher level administrators
368. Hosptial picked it out
369. re-iteration of QA cycle
370. I have no idea-must be the latest consultant!
371. It is one of several that we use. We also use the Improvement Model (PDSA) and a little Six Sigma. The Lean process is very structured with intrinsic accountability. We also were impressed with other organizations who are using the Lean approach (Thedacare, Virginia Mason).
372. I was not involved in the choice of program, but I believe the program was chosen because it was most "cost-effective" - i.e. a computer-based data analysis program that was a one-time capital item, without any consideration of the ongoing resources needed to continually monitor quality
373. Supported by a vendor--a trend in the laboratory industry
374. We are focussing on diabetes, stroke and sepsis currently.
375. It is more advanced than any other nationally program available
376. Just started the Six Sigma with the Juran Corp.
377. 1. Time availability. 2. Outcome of our strategic planning process for quality promotion.
378. Appeals to medical personnel...developed by an individual who "grew up" in the medical field.
379. It was a corporate decision and I believe personally that this is a poor model for hospitals.
380. The toolbox offers ways to address a wide variety of change and improvement opportunities.
381. State requiremnt.
382. Physicians like it because it's good science and they are more accepting of the changes in process.
383. It has national outpatient acceptance and validity and my personal involvement over the past 20 years.
384. again, quality is secondary to finaincail production quality requires adherance to standards many here do not play well by any rules
385. Lean focuses on processes and improving and streamlining inefficient processes.
386. GA Tech has been involved in Lean processes in medicine and used our hospital for some test processes a couple of times. We have also used the Delta Group to evaluate and trim our processes.
387. It helps us discover and remove the so-called "hidden factories" that make seemingly efficient processes inefficient. This lowers cost, increases available time and, ultimately, improves quality.
388. Chose because we are trying to work in a "six sigma" model. Don't really know if it is most effective
389. Plan Do Check Act
390. Why? We want to be the best, and multiple tools bring different qualities to the processes.
391. I was not a part of that decision and cannot speak confidently as to why it was chosen.
392. I work with many organziations so it varies
393. I don't think this is the most effective. I would prefer Six Sigma. It not only gives a method, but it gives a way of thinking, or mind-set, about quality.
394. Most appropriate to our organization
395. JCAHO, chosen by the Dean of the Medical College
396. It was rapidly deployed, easy to interface with and had a track record.
397. Fits our culture and values. Gives every employee a role and responsibility and authority.
398. I did not choose it. I only know that it is functioning at the organization.
399. We don't believe in one size fits all and will use what ever modle fits the com;extiy and size of the problem.
400. In addition to the Department of Veterans Affairs "homegrown programs", we have utilized IHI programs effectively. The programs are very well oriented to the medical staff, are evidenced based, well rooted in healthcare, and have a proven track record of results. We are currently utilizing IHI programs to address flow and efficiency issues.
401. Its is cheap and not effective
402. These initiatives fit our organization and are able to be implemented. The measures are successful at this time, and improving with time.
403. simple, easy to understand and implement
404. Was instituted in the 1990's and the best way to get a group to work on process. The consensus building has been the most successful part as long as no one's ox is gorged!
405. I sure as hell didn't choose this. Furthermore the Hospital and associated Medical School are entities with independent governance. The Hospital has embraced Six Sigma (at a huge cost paid for by largely by mandated personnel reductions) but Six Sigma is actively shunned by the Medical Center leadership making implementation of even the rare, good proposal, nearly impossible.
406. The hospital at which the majority of our physicians are on staff is involved with the Baldrige process and lean six sigma, so we have chosen a similar approach in our organization to provide continuity of effort.
407. Historical. Now evaluating Six Sigma and Lean.
408. was chosen by administration
409. One outside vendor to help with compliance/missed revenue issues. We hired a fulltime organizational development specialists to help guide our organization through the necessary culture shift that current industry trends require of us.
410. Programs offered at no cost to the organization by commercial vendors allows the organization to compare its experience with a particular product to that of similar organizations using the product
411. It evolved and has been effective in a smaller specialty hospital
412. don't know
413. Covers front line work processes, as well as corporate culture. Intuitive and respectful of employees creativity. Well understood and proven to be effective.