Index – HC Operations Management

Accountable care organization (ACO), 374

Activity-based costing (ABC), 370–72

Actual cost of work performed (ACWP), 116–17

Advanced access patient scheduling, 329–34; fears of, 334; implementa­tion of, 330–33

Advanced access patient scheduling, 318; metrics for, 333–34

Agency for Healthcare Research and Quality (AHRQ), 6

Alternative Quality Contract (AQC), 43

American Recovery and Reinvestment Act, 51

Andon, 251–252, 399

Archimedes model, 60–61

Assembly lines, 22–23

Asset utilization, 74

Autoregressive integrated moving aver­age (ARIMA) models, 348

Back orders, 352

Balanced scorecard, 66–94, 375, 396; case study, 92–94; customer per­spective, 74–77; data warehousing and, 89–90, 91; elements of, 71–72; financial perspective of, 73–74; four perspectives of, 70; goals of, 66; healthcare and, 70–80; implementa­tion of, 71, 85–86, 88–89; initiatives, 80–84; internal business process per­spective, 77–78; learning/growing perspective, 78–80; links, 85; modi­fications of, 88; performance indica­tors, 75, 76; performance indicators, 81; project management and, 98–99; results, 86; review of, 86–89; stra­tegic management systems and, 71; strategies of, 72; strategy maps, 82, 88, 93; template sample, 87

Balanced Scorecard: Translating Strategy into Action, The, 69

Balancing feedback, 11–12

Baldrige Award. See Malcolm Baldrige National Quality Award

Bayes’ theorem, 183

Benchmarking, 226, 398

Budget at completion (BAC), 117

Budgeted cost of work performed (BCWP), 116–17

Budgeted cost of work scheduled (BCWS), 115–17

Building a Better Delivery System: A New Engineering/Health Care Part­nership, 8, 261

Bundled payments, 373–74

Business intelligence, 90

Capacity of a process, 295

Capacity utilization, 141, 295

Care paths, 250

Carrying costs, 351

Cause-and-effect diagram, 143–47

Center for Performance Excellence, 65

Centers for Medicare & Medicaid Ser­vices (CMS), 52, 56–57

Central limit theorem, 184–86

Change control, 396

Check sheets, 168

Checklist Manifesto, The, 251

Chronic care model, 50

Chronic disease management, 49–50

Clinical decision support systems, 58–60

Clinical microsystems, 9

Clinical systems, 8–12

Coefficient of determination, 193

Coefficient of variation (CV), 176

Comparative effective research, 51–52

Conditional probability, 180–84

Confidence interval (CI), 184–87

Consumer-directed healthcare, 8

Contingency tables, 181–182

Continuous quality improvement (CQI), 34–35

Control limits, 216

Control systems, 392, 401

Correlation coefficient, 193

Cost of quality, 204–05

Cost performance index (CPI), 117

Cost reduction, 73

Cost reimbursement contracts, 121

Cost-volume-profit (CVP) analysis, 391–92

Critical index, 117

Critical path method (CPM), 26, 112–13, 297

Critical ratio (CR), 325

Cross-functional process map, 141–43

Crossing the Quality Chasm—A New Health System for the 21st Century, 5, 7, 204

Custom patient care, 46–47

Customer measures, 75

Customer perspective, 74–77

Cycle time, 242

Data: mathematic descriptions, 173–76; collection techniques, 401; graphic tools, 168–73; measures of central tendency, 173–74; measures of vari­ability, 174–76

Data analysis, 166–98

Data mining, 90

Data warehouse, 89–90, 91

Decision analysis, 156–60

Decision making; analytical tools, 151–62; barriers, 136; framework, 134–37; mapping, 137–40; measure of process, 140–41; problem identifi­cation tools, 143–51

Decision Traps: The Ten Barriers to Bril­liant Decision-Making and How to Overcome Them, 134, 135, 136

Decision tree, 156; examples, 157, 158

Decision-making process, 395

Define-measure-analyze-improve-con­trol (DMAIC) cycle, 208, 212–14, 397–98

Deming, W. Edwards, 27–29, 29–31

Dependent demand, 352

Descartes, René, 21

Diagnosis-related groups (DRGs), 54, 152, 153–55, 156

Discrete event simulation (DES), 270–82, 400; details of, 276–80

DMAIC. See define-measure-analyze-improve-control cycle

Donabedian, Avedis, 33–34

Dot plot, 171

Earliest due date (EDD), 325

Earned value analysis, 115–17

Economic order quantity (EOQ), 351

Empirical probability, 177

Employees; motivation of, 80; skills/abilities, 79

Enterprise resources planning (ERP), 360

Equal variance t-test, 188–89

Estimate at completion (EAC), 116–17

ETL (extract, transform, and load), 90

Evidence-based medicine (EBM), 6, 44, 45–57, 401, 402; barriers to, 45–46; chronic disease management and, 49–50; comparative effective research and, 51–52; criticisms of, 46–47; financial gains from, 48–49; future of, 60–61; guidelines of, 45; tools for, 52–56

Exploration in Quality Assessment and Monitoring, 33

Failure mode and effects analysis (FMEA), 147–49, 395; steps for, 148

Fee for service, 370–72

Feedback, 10–12

Financial improvement: defined, 367

Financial management; improvement of, 365–83; improvement tools, 366–67; systems approach to, 368, 369–76

First come, first served (FCFS), 325

Fishbone diagram, 145

Five Ss, 245–46, 399

Five whys technique, 144

Fixed price contract, 121

Force field analysis, 160–62, 396

Ford, Henry, 22

Forecasting, 401

Four perspectives, 396

Framing, 395

F-test, 195–196

Full capitation, 375

Full-time equivalents (FTEs), 389

Futurescan: Healthcare Trends and Implications 2012–2017, 12

Galilei, Galileo, 21

Gantt chart, 110

Gantt, Henry, 26

Gilbreth, Frank, 25

Gilbreth, Lillian, 25

Global payments, 376

Graphic display of data, 401

Health information technologies (HIT), 73

Health Information Technology for Economic and Clinical Health (HITECH) Act, 8

Health savings accounts (HSAs), 8

Healthcare Benchmarks and Quality Improvement, 226

Healthcare Finance: An Introduction to Accounting and Financial Manage­ment, 388

Healthcare home, 50–51

Healthcare Quality Book: Vision, Strat­egy, and Tools, The, 4

Heijunka, 254–55, 399

Histograms, 170–71

Holding costs, 351

Human resource (HR): planning, 388–90, 400

Human Resources in Healthcare—Man­aging for Success, 388

Hypothesis testing, 186–91

If Japan Can, Why Can’t We, 28

iList, 58

Independent demand, 352

Industrial Revolution, 22

Information technology (IT): necessary, 79

Innovation process, 77–78

Institute for Clinical Systems Improve­ment, 58–60

Institute of Medicine (IOM), 5–6; health system goals of, 5; quality chasm, 7

Intermountain Healthcare System (IHC), 47

Internal business process perspective, 77–78

International Organization for Stan­dardization (ISO) 9000 series, 206–07

Inventory; classification system, 343–44; management, 343–49, 351–58; strat­egy, 74; systems, 358–60; tracking systems, 343–49

ISO 9000, 35

ISO. See International Organization for Standardization

Jidoka, 251–52, 399

Job/operation scheduling, 324–28

Juran, Joseph, 27, 29, 31–32; Quality Trilogy, 32

Juran’s Quality Handbook, 32

Just-in-Time (JIT), 36–38, 359

Kaizen event, 246, 248–49

Kaizen, 239–40, 399

Kanban, 252–53, 399

Kant, Immanuel, 21

Kaplan, Robert, 69–70

Key process indicators (KPIs), 166

Knowledge hierarchy, 19, 20

Knowledge-based management (KBM), 8, 19–21

Lagging indicators, 81

Lead time, 351

Leading indicator, 81

Lean manufacturing, 37–38

Lean Production House, 237

Lean, 235–57, 398–99; andon, 251–52; heijunka, 254–55; jidoka, 251–52; kaizen, 239–40; kanban, 252–53; measures and tools, 242–55; muda, 238–39; philosophy of, 236–38; pro­cess improvement and, 300–01; rapid changeover, 253–54; Six Sigma and, 255–57; standardized work, 250–51; waste, 238–39

Learning/growing perspective, 78–80

Linear programming, 153–55, 321

Linear regression. See simple linear regression

Linear relationship, 194

Little’s law, 273–74, 299

Locke, John, 21

Machine That Changed the World, The, 37, 237

Malcolm Baldrige National Quality Award, 36, 38, 65; criteria for, 207–08

Managerial accounting, 390–92, 401

Mapping, 137–40, 168, 395

Marshfield Clinic, 58

Mass production, 22–23

Material requirements planning (MRP), 359–60

Mathematic descriptions of data, 401

Mathematical programming, 151–53

McLaughlin, Daniel B., 94

Mean, 173

Mean absolute deviation (MAD), 175, 348

Mean squared error (MSE), 348

Measures of central tendency, 173–74

Measures of variability, 174–76

Median, 174

Medicare bundled payments, 373

Medicare PGP Demonstration Project, 58

Medicare prospective payment, 373

Medicare value purchasing program, 56–57

Metrics, 166, 396

Microsoft Project software, 109

Milestones, 107

Mind mapping, 137, 138

Mitigation plan, 120

Mode, 174

Monte Carlo simulation, 264–66, 390, 400

Muda, 238–39

Network diagram, 110

New Economics for Industry, Govern­ment, Education, The, 29

Nightingale, Florence, 17–18

Non-value-added time, 295

Norton, David, 69–70

Observed probability, 177

Operational excellence scale, 401–02

Operations management: defined, 17

Optimization, 151–53

Ordering costs, 352

Organizational infrastructure, 9

Out of the Crisis, 28–31

Outliers, 176

Overhead expenses, 376–78; consoli­dated activities, 376–77; departmen­tal activities, 378; facility and capital costs, 378; meetings/reports, 377; process improvement, 376; staffing layers, 377

P4P. See Pay-for-performance

Pareto diagrams, 171

Pareto principle, 32

Patient care microsystem, 9

Patient Centered Outcomes Research Institute, 51–52

Patient flow, 290–91

Patient Protection and Affordable Care Act (ACA), xv, 3, 4, 67

Pay-for-performance (P4P), 53–56, 61, 390, 402; issues in, 54–56; methods of, 53–54

Payment reform, 53–55

Per diem, 373

Performance driver, 81

Performance metrics, 65

Permanente, Kaiser, 60

Plan-do-check-act (PDCA), 27

Plan-do-check-act process, 134

Poka-yoke, 226–227, 398

Poor performance contributors, 67

Post-service systems, 78, 79

Poudre Valley Health System (PVHS), 65

Practical significance, 190–191

Precisiontree, 157

Prevention quality indicators (PQIs), 48–49

Principles of Scientific Management, 21–22, 23–24

Probability, 176–84; additive property of, 180; bounds on, 178; conditional, 180–84; determination of, 177–78; multiplicative property of, 178–80; properties of, 178–84

Probability distribution, 173

Process capability, 219–21, 398

Process improvement teams, 375

Process improvement, 287–315; approaches, 292–99; Lean and, 300–01; measurements, 295; problem types, 289–92; simulation and, 301; Six Sigma and, 300; tools, 295–99

Process map, 138–40, 292–94; cross-functional, 141–43; example of, 142; service blueprinting, 143; steps for creating, 139–40

Program evaluation and review tech­nique (PERT), 26, 107

Project charter, 98–105, 105–06, 396; document, 103, 105

Project management, 26–27, 95–129, 396–97; agility of, 124–25; matrix, 100; process, 99; tools, 105

Project Management Body of Knowl­edge (PMBOK), 97

Project management office (PMO), 123–24

Project management professionals, 96

Project plan, 98

Project scope, 100, 105–09; document, 105–09; mathematic expression of, 100; statement, 98, 105–06

Project: change control, 117–18; char­ter, 98–105; closure, 124; commu­nications, 118; contracting, 121–23; control, 114–18; crashing, 113–14; definition of, 97–98; earned value analysis, 115–17; feasibility, 102; monitoring, 115; procurement sys­tem, 121–23; quality management, 121–24; risk management, 119–20; scheduling, 109–14; selection, 98–05; stakeholders, 101–02; team, 125–27

Proportions, 189–90

Public reporting, 52

Quality, 397–98; cost of, 204–05; definition of, 203–04; improvement, 291–92; management, 201–30; pro­grams, 206–21

Quality Assurance Project, 204

Quality bonuses/penalties, 375–76

Quality function deployment (QFD), 222–25

Quality function deployment, 398

Quality management, 121–24

Quality trilogy, 32

Queue discipline, 271

Queuing theory, 271–76, 299; nota­tion, 272; solutions, 272–74

Radio frequency identification (RFID), 345

Range chart, 216

Range, 174

Rapid changeover, 253–54

RASIC (responsible, approval, support, informed, consult), 109, 110

R-charts, 216

Regression analyses, 401

Reinforcing feedback, 10

Relative frequency, 177

Request for information (RFI), 122

Request for proposal (RFP), 122

Responding to Reform: A Strategy Guide for Healthcare Leaders, 94

Revenue cycle, 379

Revenue growth, 73

Revenue, 379

Risk adjustment, 52–53

Risk management, 74, 119–20, 396

Risk mitigation plan, 120

Risk register, 120

Rolled throughput yield (RTY), 221

Root-cause analysis (RCA), 143–47; tools, 395

Rough cut capacity planning, 319–20

Safety stock, 355–57

Scatter plots, 171–73

Scheduling, 317–35, 396; advanced access, 329–34; job/operational, 324–28; patient appointments mod­els, 328–29; projects 109–14; staff, 321–24

Schedule performance index (SPI), 117

Scientific management, 21–27

Senge, Peter, 9–10

Sensitivity analysis, 155–56

Sequencing rules, 325

Service blueprint, 143, 151

Service cycle, 295

Service level, 356

Service time, 295

Service typologies, 38

Shared savings model, 374

Shewhart, Walter, 27

Shewhart’s Rule, 176

Shingo, Shigeo, 253

Shortage costs, 352

Shortest processing time (SPT), 325

Simple linear regression, 191–97, 348; assumptions of, 196–97; coefficients and, 193–95; interpretation of, 193; transformations, 197

Simple moving average (SMA), 346

Simulation, 259–83, 399–00; discrete event simulation (DES), 270–82; model development, 263; model vali­dation, 263; Monte Carlo method, 264–66; output analysis, 263; pro­cess improvement and, 301; process, 262–63; queuing theory, 271–76; uses of, 261–62

Single-minute exchange of die (SMED), 253–54, 399

Six Sigma, 34–35, 38, 208–21, 397–98; case study, 227–30; culture, 209; define-measure-analyze-improve-control (DMAIC) cycle, 208, 212–14; infrastructure and training, 210–12; leadership, 209–10; Lean and, 255–57; process capability, 219–21; process improvement and, 300; statistical process control (SPC), 215–19; strategy and measurement, 209; tools, 215

Slack, 112–13

Slack time remaining (STR), 325

Smith, Adam, 22

Spaghetti diagram, 246, 399

Stakeholder identification, 101–02

Stakeholders, 101–02

Standard deviation, 175

Standardized work, 399

Statement of work (SOW), 122

Statistical process control (SPC), 27, 215–19, 398