Quality Management and Integrated Systems Case Assignment

Quality Management and Integrated Systems Case Assignment

Complete Text Page 313 Practice Exercise 9: Improvement Case Study

Complete your work using a word processor and save it in pdf file format. Quality Management and Integrated Systems Case Assignment

Present your work with question #, statement, and answer.

Question 2

  1. When members were recruited for the improvement project, they were clearly told that the team’s work would be additional to their regular work responsibilities but that they had to treat it as a high priority. They were expected to complete team assignments on time and were required to attend meetings. Despite being aware of these clear expectations, by the third week of the project, team members started arriving late to meetings, making excuses for not having completed their assigned tasks, and neglecting to return the leader’s phone calls.

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If you were the team leader of the group described in the above case study, how would you refocus and remotivate the team toward the improvement goal? Give a complete analysis and provide a complete answer to the case analysis.  Quality Management and Integrated Systems Case Assignment

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Question 3

MyHealthcare manufactures and sells blood pressure measurement and control products. Last year the company began selling its products online. Online sales have exceeded the company’s expectations, and management is now considering strategies to increase sales even further. To learn more about the online customers, a sample of 50 transactions was selected from the previous month’s sales. Data for these transactions include the day of the week each transaction was made, the time each customer spent on the website, and the amount of money each customer spent. MyHealthcare would like to gain a general understanding of customers’ buying patterns. The company uses the sample data to determine if online customers who spend more time also spend more money during their visits to the website. The company would also like to investigate the effect that day of the week has on sales.

1. The following table shows the frequency and the average dollar amount spent per transaction for each day of the week. What observations/interpretations can you make about MyHealthcare’s business based on the day of the week?

 

2. Using the information derived from the scatter plot and correlation coefficientPatrice L. Spath Diane L. Kelly fo u rth Editio n Applying Quality Management in HeAltHcAre A S ySt E m S Ap p roAch AUPHA/HAP Editorial Board for Graduate Studies Nir Menachemi, PhD, Chairman Indiana University LTC Lee W. Bewley, PhD, FACHE University of Louisville Jan Clement, PhD Virginia Commonwealth University Michael Counte, PhD St. Louis University Joseph F. Crosby Jr., PhD Armstrong Atlantic State University Mark L. Diana, PhD Tulane University Peter D. Jacobson, JD University of Michigan Brian J. Nickerson, PhD Icahn School of Medicine at Mount Sinai Mark A. Norrell, FACHE Indiana University Maia Platt, PhD University of Detroit Mercy Debra Scammon, PhD University of Utah Tina Smith University of Toronto Carla Stebbins, PhD Des Moines University Cynda M. Tipple, FACHE Marymount University Health Administration Press, Chicago, Illinois Association of University Programs in Health Administration, Washington, DC Your board, staff, or clients may also benefit from this book’s insight. For more information on quantity discounts, contact the Health Administration Press Marketing Manager at (312) 424-9450. Quality Management and Integrated Systems Case Assignment

This publication is intended to provide accurate and authoritative information in regard to the subject matter covered. It is sold, or otherwise provided, with the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. The statements and opinions contained in this book are strictly those of the authors and do not represent the official positions of the American College of Healthcare Executives, the Foundation of the American College of Healthcare Executives, or the Association of University Programs in Health Administration. Copyright © 2017 by the Foundation of the American College of Healthcare Executives. Printed in the United States of America. All rights reserved. This book or parts thereof may not be reproduced in any form without written permission of the publisher. 21 20 19 18 17 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Names: Spath, Patrice L., author. | Kelly, Diane L., author. Title: Applying quality management in healthcare : a systems approach / Patrice L. Spath, Diane L. Kelly. Description: Fourth edition. | Chicago, Illinois : Health Administration Press ; Washington, DC : Association of University Programs in Health Administration, [2017] | Revision of: Applying quality management in healthcare / Diane L. Kelly. | Includes bibliographical references and index. Identifiers: LCCN 2016055038 (print) | LCCN 2017001695 (ebook) | ISBN 9781567938814 (print : alk. paper) | ISBN 9781567938821 (Ebook) | ISBN 9781567938838 (Xml) | ISBN 9781567938845 ( Epub) | ISBN 9781567938852 (Mobi) Subjects: LCSH: Medical care—Quality control. | Health services administration. | Total quality management. Classification: LCC R A399.A1 K455 2017 (print) | LCC R A399.A1 (ebook) | DDC 362.1068—dc23 LC record available at https://lccn.loc.gov/2016055038 The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI Z39.48-1984. ∞ ™ Acquisitions editor: Jennette E. McClain; Project manager: Theresa L. Rothschadl; Cover designer: James Slate; Layout: Virginia Byrne Found an error or a typo? Quality Management and Integrated Systems Case Assignment

We want to know! Please e-mail it to [email protected], mentioning the book’s title and putting “Book Error” in the subject line. For photocopying and copyright information, please contact Copyright Clearance Center at www.copyright.com or at (978) 750-8400. Health Administration Press A division of the Foundation of the American College of Healthcare Executives One North Franklin Street, Suite 1700 Chicago, IL 60606-3529 (312) 424-2800 Association of University Programs in Health Administration 1730 M Street, NW Suite 407 Washington, DC 20036 (202) 763-7283 To my lifelong friend and companion, my husband Robert O. Brown. —P. S. To Isabella. —D. K. BRIEF CONTENTS A Note from Diane L. Kelly………………………………………………………………xv Preface………………………………………………………………………………………..xvii Acknowledgments…………………………………………………………………………..xxi Section 1 Quality Management: A Systems Approach…………………………… 1 Chapter 1. Chapter 2. Chapter 3. Chapter 4. Chapter 5. Section 2 Setting the Stage for Success…………………………………………….81 Chapter 6. Chapter 7. Chapter 8. Section 3 Quality Management Fundamentals…………………………… 3 Role of Policy in Advancing Quality…………………………. 17 Characteristics of Complex Systems…………………………. 33 Understanding System Behavior……………………………… 49 Visualizing System Relationships……………………………… 65 Establishing System Direction…………………………………. 83 Setting Improvement Goals in Complex Systems……… 107 Fostering a Culture of Collaboration and Teamwork…. 125 Achieving Quality Results in Complex Systems………………….. 147 Chapter 9. Chapter 10. Chapter 11. Chapter 12. Chapter 13. Measuring Process and System Performance……………. 149 Using Data Analytics Techniques to Evaluate Performance……………………………………… 167 Designing and Implementing Improvements ………….. 203 Using Improvement Teams and Tools…………………….. 229 Making Healthcare Safer for Patients……………………… 253 Section 4 Practice Lab………………………………………………………………….. 283 Practice Exercise 1. Reflective Journal ……………………………………285 Practice Exercise 2. The Manager’s Role…………………………………287 Practice Exercise 3. Dynamic Complexity………………………………..289 Practice Exercise 4. System Relationships………………………………..291 Practice Exercise 5. Meeting Customer Expectations…………………293 vii viii B rief Co n t ents Organizational Self-Assessment…………………..295 Improving a Performance Gap in Your Organization……………………………301 Practice Exercise 8. Teamwork and Patient Safety……………………..309 Practice Exercise 9. Improvement Case Study………………………….313 Practice Exercise 10. Systems Error Case Study and Analysis………..319 Practice Exercise 11. Failure Mode and Effects Analysis………………321 Practice Exercise 6. Practice Exercise 7. Quality Management and Integrated Systems Case Assignment Glossary……………………………………………………………………………………..325 Index…………………………………………………………………………………………335 About the Authors…………………………………………………………………………353 About the Contributor…………………………………………………………………..355 DETAILED CONTENTS A Note from Diane L. Kelly………………………………………………………………xv Preface………………………………………………………………………………………..xvii Acknowledgments…………………………………………………………………………..xxi Section 1 Quality Management: A Systems Approach…………………………… 1 Chapter 1. Quality Management Fundamentals ……………………………. 3 Learning Objectives ………………………………………………….3 Why Focus on Managing Systems?………………………………..4 What Are Quality and Safety?………………………………………5 Creating a Common Understanding of Quality Methods….7 Three Principles of Total Quality………………………………….9 Quality Continuum for Organizations…………………………12 Summary……………………………………………………………….14 Companion Readings……………………………………………….15 Web Resources………………………………………………………..15 References………………………………………………………………15 Chapter 2. Role of Policy in Advancing Quality…………………………… 17 Learning Objectives…………………………………………………17 External Stakeholders Affecting Quality ………………………18 Federal Health Policies and Oversight…………………………20 Private Health Policies and Oversight………………………….26 Summary……………………………………………………………….28 Companion Readings……………………………………………….29 Web Resources………………………………………………………..29 References………………………………………………………………31 Chapter 3. Characteristics of Complex Systems……………………………. 33 Learning Objectives…………………………………………………33 Systems Thinking…………………………………………………….35 Dynamic Complexity………………………………………………..37 ix x Det a iled Co n te n ts Summary……………………………………………………………….44 Companion Readings ………………………………………………45 Web Resources………………………………………………………..46 References………………………………………………………………46 Chapter 4. Understanding System Behavior…………………………………49 Learning Objectives…………………………………………………49 A Systems Metaphor for Organizations………………………..49 Lessons for Healthcare Managers………………………………..52 Going Below the Waterline………………………………………..56 Summary……………………………………………………………….61 Companion Readings……………………………………………….62 Web Resources………………………………………………………..62 References………………………………………………………………63 Chapter 5. Visualizing System Relationships………………………………..65 Learning Objectives…………………………………………………65 Interconnected Systems Model…………………………………..67 Three Core Process Model………………………………………..68 Baldrige Performance Excellence Program Framework ………………………………………………………..71 Socioecological Framework……………………………………….74 Summary……………………………………………………………….76 Companion Readings……………………………………………….78 Web Resource…………………………………………………………78 References………………………………………………………………78 Section 2 Setting the Stage for Success…………………………………………….81 Chapter 6. Establishing System Direction……………………………………83 Learning Objectives…………………………………………………83 Purpose………………………………………………………………….84 The Purpose Principle………………………………………………90 Vision……………………………………………………………………96 Context………………………………………………………………….99 Summary……………………………………………………………..102 Companion Readings……………………………………………..103 Web Resources………………………………………………………104 References…………………………………………………………….104 D etailed C ontents Chapter 7. Setting Improvement Goals in Complex Systems…………107 Learning Objectives……………………………………………….107 Relationship Between Goals and Results…………………….109 Setting Improvement Goals in Complex Systems…………111 Types of Goal Statements………………………………………..114 Critiquing Goal Statements……………………………………..115 SMART Goals and Complex Systems………………………..119 Corollaries to Purpose and Goals………………………………120 Summary……………………………………………………………..121 Companion Readings……………………………………………..123 Web Resources………………………………………………………123 References…………………………………………………………….123 Chapter 8. Fostering a Culture of Collaboration and Teamwork…….125 Learning Objectives……………………………………………….125 Creating a Supportive Culture………………………………….126 Teams in Healthcare……………………………………………….128 Collaboration and Teamwork…………………………………..129 Mental Models Affecting Team Design………………………129 Mental Models About Work Team Differences……………131 Tools for Effective Teams………………………………………..134 Summary……………………………………………………………..137 Companion Readings……………………………………………..141 Web Resources………………………………………………………142 References…………………………………………………………….143 Section 3 Achieving Quality Results in Complex Systems………………….. 147 Chapter 9. Measuring Process and System Performance……………….149 Learning Objectives……………………………………………….149 Quality Measures and Their Uses……………………………..150 Selecting Performance Measures……………………………….151 Choosing a Comprehensive Set of Measures……………….156 Performance Measures and the Quality Continuum……..160

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Summary……………………………………………………………..163 Companion Readings……………………………………………..163 Web Resources………………………………………………………164 References…………………………………………………………….164 xi xii Det a iled Co n te n ts Chapter 10. Using Data Analytics Techniques to Evaluate Performance…………………………………………167 Learning Objectives……………………………………………….167 What Is Data Analytics?…………………………………………..168 Introduction to Data Analytics Techniques…………………169 Types of Data ……………………………………………………….170 Applying Descriptive Statistics Techniques………………….171 Graphical Methods…………………………………………………172 Predictive Analytics………………………………………………..179 Numerical Summary Measures…………………………………180 Using Graphical and Numerical Methods to Analyze Process Performance…………………………………………..186 Bundling and Unbundling Data According to the User’s Purpose……………………………………………………………191 Summary……………………………………………………………..197 Companion Readings……………………………………………..200 Web Resource……………………………………………………….201 References…………………………………………………………….201 Chapter 11. Designing and Implementing Improvements ……………..203 Learning Objectives……………………………………………….203 Systematic Critical Thinking in Designing Improvements…………………………………………………..204 Implementing Improvements…………………………………..212 Summary……………………………………………………………..219 Companion Readings……………………………………………..222 Web Resources………………………………………………………222 References…………………………………………………………….222 Appendix 11.1………………………………………………………225 Chapter 12. Using Improvement Teams and Tools……………………….229 Learning Objectives……………………………………………….229 Charter Improvement Projects…………………………………230 Performance Improvement Teams…………………………….232 Improvement Tools and Techniques………………………….235 Summary……………………………………………………………..246 Companion Readings……………………………………………..247 Web Resources………………………………………………………248 References…………………………………………………………….248 Appendix 12.1………………………………………………………250 D etailed C ontents Chapter 13. Making Healthcare Safer for Patients…………………………253 Learning Objectives……………………………………………….253 Systems Model of Organizational Accidents………………..254 Creating High Reliability…………………………………………258 Measuring and Evaluating Safe Performance……………….262 Designing and Implementing Safety Improvements……..268 Summary……………………………………………………………..273 Companion Readings……………………………………………..276 Web Resources………………………………………………………278 References…………………………………………………………….278 Section 4 Practice Lab………………………………………………………………….. 283 Practice Exercise 1. Reflective Journal ……………………………………285 Practice Exercise 2. The Manager’s Role…………………………………287 Practice Exercise 3. Dynamic Complexity……………………………….289 Practice Exercise 4. System Relationships………………………………..291 Practice Exercise 5. Meeting Customer Expectations………………..293 Practice Exercise 6. Organizational Self-Assessment………………….295 Practice Exercise 7. Improving a Performance Gap in Your Organization……………………………………..301 Practice Exercise 8. Teamwork and Patient Safety…………………….309 Practice Exercise 9. Improvement Case Study………………………….313 Practice Exercise 10. Systems Error Case Study and Analysis………..319 Practice Exercise 11. Failure Mode and Effects Analysis………………321 Glossary……………………………………………………………………………………..325 Index…………………………………………………………………………………………335 About the Authors…………………………………………………………………………353 About the Contributor…………………………………………………………………..355 xiii A NOTE FROM DIANE L. KELLY T he quality landscape has changed dramatically since the first edition of Applying Quality Management in Healthcare: A Process for Improvement (2003). Quality Management and Integrated Systems Case Assignment

At that time, the Institute of Medicine reports To Err Is Human (1999) and Crossing the Quality Chasm (2001) were still relatively new and patient safety was in its early stages. The Premier Hospital Quality Incentive Demonstration, the precursor to today’s value-based purchasing initiatives, was just getting started. Transparency was in its infancy. Fast-forward to today. The concept of systems is widely embraced in healthcare and has become a cornerstone for driving improvements toward achieving the Institute for Healthcare Improvement’s Triple Aim. Perverse financial incentives, which punished organizations for reducing utilization by improving care, are being challenged with a wide array of innovative payment models that reward improvements in quality, safety, and health promotion. The numerous and often disparate parts of the US healthcare system are working together to improve the health of populations, not just to care for sick individuals. The quality, safety, and systems concepts discussed in this book have become foundational, essential, and timeless. They may be applied to any type, size, level, or complexity of organizational forms. I would like to thank the many students whom I have had the privilege to get to know, work with, and learn from as a result of writing and teaching with this text. I would also like to thank my mentor and friend, Dr. Arnold Kaluzny. Quality Management and Integrated Systems Case Assignment

I am delighted that Patrice Spath is collaborating on this fourth edition so that the book may continue to bring value to future students. Diane L. Kelly, DrPH, MBA, RN Principal Consultant Quantix Health Capital Columbus, OH xv PREFACE S everal years ago, I partnered with a physician, Dr. William Minogue, to respond to an article in a medical journal that bemoaned the lack of successful patient safety improvement initiatives. The article’s authors suggested a new model was needed for conducting patient safety investigations because the current way of doing things was not working. At the time, I was facilitating training workshops for the Maryland Patient Safety Center, where Dr. Minogue was the medical director. We both agreed that a new safety investigation model was not the answer. This belief resulted in our coauthoring an article on the subject for WebM&M, an online case-based forum on patient safety sponsored by the Agency for Healthcare Research and Quality. Our article began by reminding readers of the insights of Louis Pasteur, who, throughout his career, “insisted that germs were the cause of disease, not the body.” Near the end of his life, Pasteur changed his opinion and “declined treatment for potentially curable pneumonia, reportedly saying, ‘It is the soil, not the seed.’ In other words, a germ (the seed) causes disease when our bodies (the soil) provide a hospitable environment” (Spath and Minogue 2008). Quality Management and Integrated Systems Case Assignment

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