第四篇——Addressing the Issues at Doctors Hospital of Augusta
本帖最后由 小编H 于 2011-2-28 11:23 编辑
大家好，我是小编H。组员们对第四篇文章翻译有什么意见或者建议，请跟帖回复讨论，以便对文章翻译进行最后的确认。
Addressing the Issues at Doctors Hospital of Augusta
奥古斯特医生医院的问题解决之道 Implementing Six Sigma has allowed Doctors Hospital of Augusta to begin winning the battles with the familiar healthcare issues related to quality, resource constraints and ensuring optimal, accessible services for the community. By Sondra Smith众所周知，医疗界在医疗质量，资源，便捷优化的社区医疗保障的提供方面面临诸多问题，而奥古斯特医生医院却在这场战斗中旗开得胜，这其中的原因要归功于六西格玛的实施。桑德拉·史密斯Like most healthcare providers, Doctors Hospital in Augusta, Georgia, USA, has struggled with familiar issues related to quality, resource constraints and ensuring optimal, accessible services for the community. Implementing Six Sigma has allowed the hospital to begin winning the battles with these issues.众所周知，医疗界在医疗质量，资源，便捷优化的社区医疗保障的提供方面面临诸多问题，而位于美国乔治亚州的奥古斯特的医生医院也和大多数医疗单位一样为此付出了巨大的努力。六西格玛的推行使得该医院在这场战斗中旗开得胜。In 2004, the hospital's leadership team decided to launch a new initiative aimed at improving performance throughout the organization. This effort included project-based education in Six Sigma and change management.2004年，该医院的领导班子决定实行一项新举措，旨在改进整个组织的绩效。而这其中就包括六西格玛项目培训和变革管理。
The first wave of Green Belt training began in May 2004, with 16 people selected from the hospital's staff. Initial projects targeted outpatient CT scan cycle time, wound center turnaround time, emergency department cycle time from the patient's experience, wound center accounts receivable billing, operating room turnaround time and MRI cycle time.2004年5月，院方选派了16名代表，开始进行第一批绿带培训。最初的项目包括：门诊CT扫描的时间周期，伤员中心的周转周期，基于病人经验的急诊室时间周期，伤员中心应收账款账单，手术室的周转时间以及做MRI（核磁共振）的时间周期。
To a certain degree, the improvement initiative at Doctors Hospital was a test case for Hospital Corporation of America, the hospital's parent organization. So far, the hospital's leadership team has been pleased with the progress and achievements.从某种程度上看，医生医院的改善举措也是美国医疗公司（院方的主办机构）的一个试验实例。截至目前，院方领导对取得的进展和业绩很满意。"Much of the excitement generated during our Six Sigma experience has actually come not only from the accomplishments of the teams, but also from the experience of getting together and attacking opportunities together," Shayne George, president and CEO at Doctors Hospital, said. "We have been able to gain a great deal of value during the journey, as well as the destination."“在推行六西格玛的过程中，有很多让人兴奋的地方，不仅来自于团队取得的成就，更来自于共同工作、共同争取机会的经历”,医院的总裁兼首席执行官沙恩•乔治说,“在这个过程和成就中，我们收获了很多宝贵的价值。”Linking Six Sigma with Strategic Plans六西格玛与全局战略计划Doctors Hospital creates a strategic plan every year, and for 2004, driving Six Sigma and achieving culture change were major themes within the plan. The hospital concentrated on establishing a clear communication plan to keep everyone informed, making sure people received training and instilling the process as the way they would work going forward. 每年，医院都会建立一个全局战略计划，而2004年计划的主题是，推进六西格玛并实现文化变革。医院集中精力建立了一个的沟通明确计划，确保信息在人与人之间的沟通，确保每个人得到培训，并逐步将这个过程贯穿到工作推进进程中。Six Sigma has been viewed as supporting the organization's strategic plan in several ways:六西格玛对全局战略计划起到了支持作用，表现在以下几个方面：
Human resources - The project-based training helped to drive a specific strategy listed under human resources retention and productivity.人力资源方面--基于项目的训练有助于推动人力资源保持力和生产力具体策略的建立。Efficiency and growth - At the division level, the hospital has an outpatient imaging and surgery taskforce focused on driving efficiency and strategic growth. One objective is to effectively compete against freestanding imaging centers by improving the customer's experience. Projects in CT and MRI specifically addressed cycle time, aimed at reducing lengthy waits, which are a major source of dissatisfaction for patients. Another objective was to increase capacity in the operating room by striving for turnaround times found in ambulatory surgery centers. 效率与增长方面—在医院的每个区域，都设有门诊监控录像和诊室特别工作小组，以集中提高效率，促进全局战略增长。这样做的一个目的是提升客户体验，以与独立成像中心展开有效竞争。而CT和MRI核磁共振项目则将重点放在了时间周期上，目标是缩短过长的等待时间，而这是客人不满意的主要原因。这样做的另一个目的是，通过缩短流动外科中心的周转时间来提高手术室的容纳能力。Emergency department performance - Another strategy targeted the improvement of emergency room performance metrics, including throughput time. 急诊室业绩方面—又一个旨在改善急诊室工作节奏增加单位时间内接待人数的全局性战略计划。Patient satisfaction - The hospital measures customer satisfaction each quarter using an independent survey company. In the outpatient test and treatment areas, one of the strongest drivers of satisfaction is wait time. The team knew that reducing cycle time with the CT, MRI and wound center projects would help improve satisfaction by shortening the wait time.
患者满意度方面— 每个季度，医院都会雇佣独立的咨询公司，对客户满意度进行评估。在门诊检查和治疗区，最强一个满意驱动力就是等待时间。团队了解到，缩短等待时间，减少CT、MRI和创伤中心项目的时间周期，将有助于改善满意度。Teamwork and SolutionsBeyond specific projects and measurable results in key areas, an important byproduct of this effort has been greater proficiency, collaboration and communication among the team. Challenges that face the staff on a daily basis are being addressed through a common set of tools, and the approach is resonating well within the organization. 团队合作与解决方案方面除了关键领域的特别项目和量化的结果，这个过程有一个重要的副产品，那就是团队的专业，团结和交流更进了一步。员工在日常工作中面临到挑战的时候，开始采用同一个解决问题的工具，而且这个方法在组织内反响很好。Employees who went through Green Belt training said they felt as if they had received a "master's" level education. They appreciated the investment leadership had made in promoting the initiative, providing the training and recognizing their achievements. 参加过绿带培训的员工说他们仿佛受到了一次“硕士”教育。对于投资领导主动提出，提供的培训以及对他们成就的认可，他们表示感激。All project teams, especially within perioperative services, received additional support as they went through each phase of their projects. Team members from various departments provided input and participated in Work-Out sessions. They contributed suggestions in areas that might be considered outside their usual scope of work.所有项目工作组在项目的每个阶段都得到了额外的支持，尤其是手术全期护理小组。来自不同部门的成员贡献了他们的努力并参与了问题解决会议，在超出本职日常工作范围的领域方面提出了建议。Work-Out sessions, with their clear structure and focus on grassroots problem-solving, have changed the employee reactions to meetings at Doctors Hospital. A common employee complaint had been the seemingly endless meetings that did not create consensus or resolve the issues under discussion. People are beginning to use Work-Out tools in other meetings to make the meetings more focused and productive. In one session, a team was able to scope the vision, develop a toolkit and create a who-what-when plan with specific assignments - all accomplished within one hour. As more employees go through the training and gain experience applying the tools, this approach is becoming ingrained as a common framework for problem-solving. People now feel they are better equipped to solve problems and manage change.问题解决会议架构清晰，把重点放在了解决基层问题上，这改变了医生医院的员工对会议的看法。以前，一个最常见的员工抱怨就是，会议无休无止，却无法就讨论的问题达成任何共识或解决方案。现在，他们开始在其他会议上使用这个解决问题的工具，以使会议变得更有针对性，更有效率。在某次会议上，一个小组在一个小时之内便定义了会议讨论范围，开发了一套工具，创建一个人物—事件—时间并涵盖具体任务分工的计划。作为一个通用的问题解决的框架，这个方法逐渐深入人心。现在，在解决问题和管理变比时，人们觉得他们比以前更有能力了。Making the program work also depends on determining the right level of involvement for clinicians, and making the exchange of information as efficient as possible. One of the physicians participating in the process commented that this was the first time he had been really excited about an improvement project because he could actually see data-driven progress. Six Sigma is an objective and scientific process with a natural appeal for physicians.项目计划是否奏效还取决于临床医生的参与量合适与否，信息交流有效与否。一位参加该过程的医生说，这是他第一次真正为一个项目计划而兴奋，因为他切实看到了一个数据驱动的过程。对于医生们来说，六西格玛方法具有天然的吸引力，它是一个客观的，科学的过程。Tangible and Intangible ResultsImproving processes and operating as efficiently as possible in every facet of patient care is crucial for ensuring quality, managing the bottom line and raising patient and staff satisfaction. The data-driven approach also is helping the hospital to meet its compliance obligations.
With the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey process, healthcare providers have to be able to demonstrate that they are actually improving their performance and helping the patient. This type of rigorous, evidence-based approach is giving the organization the confidence to know it is doing the right things.有形和无形的成果
为了保障质量，保证利润并提升患者和员工满意度，过程的改进以及在患者护理各方面得到最有效的实施是至关重要的。数据驱动的过程方法也有助于医院完成其履约义务。按照国际医疗卫生机构认证联合委员会的鉴定程序，医疗卫生单位必须能够提供他们的工作的确在改进，并且对患者有所帮助的证据。有了这种严格的证据导向的过程方法，组织相信他们的所作所为是正确的。All projects from the first wave are now in the Control phase. The leadership team is continuing to fine-tune processes and monitor progress, but its efforts have already paid off and delivered measurable benefits to the organization.现在，第一轮的项目都已经进入受控阶段。虽然领导团队仍在调整过程并监视其进展，但其努力已见成效，并给组织带来了很大利益。Potential Increase in Departmental Earnings by Project Project Process Improvement Potential Increasein Dept. Earnings Operating Room: Reducing Turnaround Time Capacity increased by 80 cases/month by reducing TAT from 39 minutes to 25 minutes. 8%项目计划使部门收入增长项目过程增加了改进的潜力部门的收入手术室：缩短周转时间。TAT的时间从39分钟缩短到25分钟，每月接诊能力增加了80例。占8%。MRI:Reducing Time from Patient to Patient Capacity increased by 22 cases/month by reducing time from 52 minutes to 45 minutes. No show reduction from 17% to 10%. 3%Reducing Unscanned Supplies Increase in number of items scanned; improved charge capture, and decreased losses for materials used. .5%MRI核磁共振成像：缩短患者等待的时间。患者等候时间从每月52分钟减少到45分钟，每月门诊接诊能力增加了22例。成像失败的几率从17%降低到了10%，占3%。不成像的记录减少了，成像的记录便增加了。费用管理得到了加强，资源利用损失率减少了5%。Reducing Cycle Time Capacity increased by 100 cases/month by reducing cycle time from 59 minutes to 38 minutes. 8%OP CT断层扫描检测：缩短周期。周期由59分钟减少到了38分钟，提升了周期能力，每月增加了100例。ER:Reducing Cycle Time Capacity increased by 254 cases/month by reducing cycle time from 135 minutes to 120 minutes. Increase in downstream ICU and med/surg patients for increase in number of ED patients (6 cases/month in ICU and 16 cases/month med/surg). 10%急诊室：缩短周期。周期由135分钟减少到120分钟，提升了周期能力，每个月增加了254例门诊。通过增加一些ED病人的办法（加护病房每个月6例，药剂和手术病房每个月16例）使下游的加护病房和药剂/外科门诊病人得到了增长。Unbilled:Reducing Time from Patient to Coding Reduced time to code records from 13 days to 5 days. Total out-patient unbilled amount is lowest since 2003. 记录缺失：缩短患者登记的时间。编写记录的时间由13天缩短到5天。门诊患者记录缺失数量达到了自2003年来的最低点。Wound Center:Reducing Cycle Time Finishing implementation of improvements and remeasuring. Yet to Be Determined。In the wound center, the hospital was able to reduce turnaround time for patient visit to coding of the medical record from 13 days to just five. The improvements in cycle time for outpatient CT scans provided the capacity for an additional 100 scans each month. A Black Belt team working in MRI reduced cycle time from 52 to 45 minutes, freeing capacity for 22 additional patients per month. With reduced cycle time in the emergency department, capacity was increased by approximately 250 more patients per month. Although the project team met its goal in this area, the hospital would like to see the numbers improve even more. 伤员中心缩短周期。改进实施的完成及复测。待定。在伤员中心，患者的医疗记录时间从13天缩短到了5天，从而缩短了患者复诊的时间。CT扫描门诊的周期也缩短了，每月扫描能力增加了100例。MRI部门的黑带团队将周期时间从52分钟缩短到了45分钟，使每月接诊能力增加了22例。而随着急诊室周期时间的缩短，每月增加的患者数超过大概250例。尽管项目团队在这些地方已经达到了目标，医院却希望能够看到数据进一步增加。A problem in the hospital's operating room that had lingered for a long time was room turnaround time. By applying the right tools and getting the right people into a one-day Work-Out session, the team was able to create consensus and develop a viable solution. Room turnaround time was reduced from 39 to 25 minutes, adding capacity to perform 80 additional surgeries each month.在医院的手术室，有一个长期存在的问题，就是病房周转时间。通过使用合理的工具，召集相关人员参加了一个为期一天的问题解决会议，团队达成了一致并提出了可行的解决方法。病房周转时间从39分钟缩短到25分钟，每个月的外科手术能力增加了80台。Keeping the Momentum GrowingWith the results that have been achieved so far, momentum has begun to build. Ideas for new projects are constantly rolling in. Four of the initial Green Belt liaisons are coordinating all projects during the second phase of the initiative. The hospital has integrated the entire process into the performance improvement committee. All projects - including Work-Out sessions and larger Green Belt projects - now report to this committee. The group's members comprise a major portion of the organization's JCAHO survey process. The level of information the hospital is tracking and the results it is able to demonstrate assist in reporting progress to the board of trustees and medical committees.
保持增长的势头按照目前达成的成果来看，增长势头开始显现。新项目的需求纷至沓来。在新方案进展到第二阶段时，四个最初的绿带联络员开始协调全部的项目。医院整合了整个过程，成立了绩效改进委员会。从现在开始，所有的项目，包括问题解决会议和大型绿带项目都要向这个委员会报告。这个团队的成员包含了大部分由ACHO调查过程组织的成员。.医院对信息的追踪以及结果有助于向董事会以及医学委员会的报告过程As requests increase, the improvement committee will continually prioritize projects, with a particular focus on increasing patient safety, clinical quality and patient satisfaction. The leadership team is putting a process in place to streamline how people make improvement suggestions.随着需求的增加，改进委员会将尤其关注加强患者安全，临床治疗质量和患者满意度，并据此逐步使项目优化。领导团队对简化员工提出改善建议的方法开始建立一个合理的过程。To familiarize new employees with the purpose and basics of Six Sigma, a short elevator speech on the methodology has been created. "During orientation, new employees learn that Six Sigma is a highly structured process that we began using in 2004 to evaluate and improve the way we work," said John Doriot, a Green Belt who also teaches customer service training at the hospital. "An important part of our service excellence culture is to make decisions based on data rather than opinions. We need help from all employees to identify changes that need to be made, and to support and sustain change," Being able to clearly explain the purpose of the process helps to build acceptance and encourage participation.
为了使新员工全面了解六西格玛的宗旨和基本知识，医院创建了一个简短的阶梯式演讲方法。“在新员工培训中，他们了解到，六西格玛一种高度结构化的过程，我们从2004年开始用它来评估和改善我们的工作方式，”负责医院客服培训的绿带约翰·奥特说，“我们的决策基于数据，而不是个人主观看法。这是我们优秀的服务文化的一个重要组成部分。我们需要借助全体员工的努力来识别出必要的改变，支持并维护这些改变。”对过程主旨的明确解释有助于人们接受并积极参与。For 2005, Doctor's Hospital focused on maintaining the momentum and using the training to impact other key areas in the organization. With a large influx of new physicians, the hospital is streamlining existing processes to accommodate extra procedures and volume. It also is continuing to use Six Sigma as a way to create greater efficiencies in perioperative services.2005年，医生医院将集中精力保持增长势头，并通过培训来扩大在组织中的其他关键部门的影响。随着新医生大量引进，为了适应增加的程序和容量，医院将精简现有过程。而在外科手术全服务上将继续推行六西格玛，以此来创造更高的效率。Hard work and dedication from the entire team, along with ongoing leadership commitment, have been key factors in making this initiative a success. Beyond specific process improvements, one of the most important benefits of this initiative has been the ability to furnish people with proven new tools and techniques to solve everyday problems.
关于这次方案，成功的关键在于，整个团队的辛勤工作和奉献精神，以及领导团队持续的承诺。除了特殊过程的改进之外，这个举措的一个重要的收益是，在解决日常问题时，员工掌握了经过事实检验的新的问题解决工具和技术。The approach is creating a common foundation for leading change within the organization. Instead of simply making assumptions about underlying issues, teams are gathering, analyzing and verifying data to make an educated decision. Then they put in place solutions that can be sustained.在组织内，这个方法为引领变化建立了一个共同的基石。现在，对于潜在发生的问题，团队不再只是简单的假想，而是凝聚在一起，分析并验证数据，得出一个基于数据和讨论的决定。然后，得出合理的可持续的解决方案About the Author: Sondra Smith is assistant vice president of service line development and sales for Doctors Hospital in Augusta. She oversees product line development of musculoskeletal services, neuroscience, oncology and cardiology. Prior to this role, she was director of physical medicine services at the hospital. Ms. Smith is a Six Sigma Green Belt, and her current projects include outpatient CT turnaround time and day surgery preoperative process cycle time. She can be reached at mailto:Sondra.Smith@HCAHealthcare.com This e-mail address is being protected from spambots. You need JavaScript enabled to view it .作者简介：桑德拉·史密斯，奥古斯特医生医院中负责服务线开发和销售的助理副总裁。她负责监督肌肉骨骼服务项目，神经科学，肿瘤学和心脏病学的生产线开发。在此之前，她担任医院物理治疗学的服务总监。史密斯女士是六西格玛绿带，她目前的项目包括门诊部的拍CT周转时间和日间手术术前过程周期。她的E - mai地址为Sondra.Smith @ HCAHealthcare.com，这个地址已经被防止恶意灌水程式保护。您需要启动Javascript才能观看它。附：美国医院公司：美国医疗医院公司(Hospital Corporation of America)是以营利为目的的连锁医院的先锋，是世界上最大的营利医院公司，它拥有219家分院，另外还代理经营165家医院，员工总数7.5万人。
大家好，我是小编H。组员们对第四篇文章翻译有什么意见或者建议，请跟帖回复讨论，以便对文章翻译进行最后的确认。
Addressing the Issues at Doctors Hospital of Augusta
奥古斯特医生医院的问题解决之道 Implementing Six Sigma has allowed Doctors Hospital of Augusta to begin winning the battles with the familiar healthcare issues related to quality, resource constraints and ensuring optimal, accessible services for the community. By Sondra Smith众所周知，医疗界在医疗质量，资源，便捷优化的社区医疗保障的提供方面面临诸多问题，而奥古斯特医生医院却在这场战斗中旗开得胜，这其中的原因要归功于六西格玛的实施。桑德拉·史密斯Like most healthcare providers, Doctors Hospital in Augusta, Georgia, USA, has struggled with familiar issues related to quality, resource constraints and ensuring optimal, accessible services for the community. Implementing Six Sigma has allowed the hospital to begin winning the battles with these issues.众所周知，医疗界在医疗质量，资源，便捷优化的社区医疗保障的提供方面面临诸多问题，而位于美国乔治亚州的奥古斯特的医生医院也和大多数医疗单位一样为此付出了巨大的努力。六西格玛的推行使得该医院在这场战斗中旗开得胜。In 2004, the hospital's leadership team decided to launch a new initiative aimed at improving performance throughout the organization. This effort included project-based education in Six Sigma and change management.2004年，该医院的领导班子决定实行一项新举措，旨在改进整个组织的绩效。而这其中就包括六西格玛项目培训和变革管理。
The first wave of Green Belt training began in May 2004, with 16 people selected from the hospital's staff. Initial projects targeted outpatient CT scan cycle time, wound center turnaround time, emergency department cycle time from the patient's experience, wound center accounts receivable billing, operating room turnaround time and MRI cycle time.2004年5月，院方选派了16名代表，开始进行第一批绿带培训。最初的项目包括：门诊CT扫描的时间周期，伤员中心的周转周期，基于病人经验的急诊室时间周期，伤员中心应收账款账单，手术室的周转时间以及做MRI（核磁共振）的时间周期。
To a certain degree, the improvement initiative at Doctors Hospital was a test case for Hospital Corporation of America, the hospital's parent organization. So far, the hospital's leadership team has been pleased with the progress and achievements.从某种程度上看，医生医院的改善举措也是美国医疗公司（院方的主办机构）的一个试验实例。截至目前，院方领导对取得的进展和业绩很满意。"Much of the excitement generated during our Six Sigma experience has actually come not only from the accomplishments of the teams, but also from the experience of getting together and attacking opportunities together," Shayne George, president and CEO at Doctors Hospital, said. "We have been able to gain a great deal of value during the journey, as well as the destination."“在推行六西格玛的过程中，有很多让人兴奋的地方，不仅来自于团队取得的成就，更来自于共同工作、共同争取机会的经历”,医院的总裁兼首席执行官沙恩•乔治说,“在这个过程和成就中，我们收获了很多宝贵的价值。”Linking Six Sigma with Strategic Plans六西格玛与全局战略计划Doctors Hospital creates a strategic plan every year, and for 2004, driving Six Sigma and achieving culture change were major themes within the plan. The hospital concentrated on establishing a clear communication plan to keep everyone informed, making sure people received training and instilling the process as the way they would work going forward. 每年，医院都会建立一个全局战略计划，而2004年计划的主题是，推进六西格玛并实现文化变革。医院集中精力建立了一个的沟通明确计划，确保信息在人与人之间的沟通，确保每个人得到培训，并逐步将这个过程贯穿到工作推进进程中。Six Sigma has been viewed as supporting the organization's strategic plan in several ways:六西格玛对全局战略计划起到了支持作用，表现在以下几个方面：
Human resources - The project-based training helped to drive a specific strategy listed under human resources retention and productivity.人力资源方面--基于项目的训练有助于推动人力资源保持力和生产力具体策略的建立。Efficiency and growth - At the division level, the hospital has an outpatient imaging and surgery taskforce focused on driving efficiency and strategic growth. One objective is to effectively compete against freestanding imaging centers by improving the customer's experience. Projects in CT and MRI specifically addressed cycle time, aimed at reducing lengthy waits, which are a major source of dissatisfaction for patients. Another objective was to increase capacity in the operating room by striving for turnaround times found in ambulatory surgery centers. 效率与增长方面—在医院的每个区域，都设有门诊监控录像和诊室特别工作小组，以集中提高效率，促进全局战略增长。这样做的一个目的是提升客户体验，以与独立成像中心展开有效竞争。而CT和MRI核磁共振项目则将重点放在了时间周期上，目标是缩短过长的等待时间，而这是客人不满意的主要原因。这样做的另一个目的是，通过缩短流动外科中心的周转时间来提高手术室的容纳能力。Emergency department performance - Another strategy targeted the improvement of emergency room performance metrics, including throughput time. 急诊室业绩方面—又一个旨在改善急诊室工作节奏增加单位时间内接待人数的全局性战略计划。Patient satisfaction - The hospital measures customer satisfaction each quarter using an independent survey company. In the outpatient test and treatment areas, one of the strongest drivers of satisfaction is wait time. The team knew that reducing cycle time with the CT, MRI and wound center projects would help improve satisfaction by shortening the wait time.
患者满意度方面— 每个季度，医院都会雇佣独立的咨询公司，对客户满意度进行评估。在门诊检查和治疗区，最强一个满意驱动力就是等待时间。团队了解到，缩短等待时间，减少CT、MRI和创伤中心项目的时间周期，将有助于改善满意度。Teamwork and SolutionsBeyond specific projects and measurable results in key areas, an important byproduct of this effort has been greater proficiency, collaboration and communication among the team. Challenges that face the staff on a daily basis are being addressed through a common set of tools, and the approach is resonating well within the organization. 团队合作与解决方案方面除了关键领域的特别项目和量化的结果，这个过程有一个重要的副产品，那就是团队的专业，团结和交流更进了一步。员工在日常工作中面临到挑战的时候，开始采用同一个解决问题的工具，而且这个方法在组织内反响很好。Employees who went through Green Belt training said they felt as if they had received a "master's" level education. They appreciated the investment leadership had made in promoting the initiative, providing the training and recognizing their achievements. 参加过绿带培训的员工说他们仿佛受到了一次“硕士”教育。对于投资领导主动提出，提供的培训以及对他们成就的认可，他们表示感激。All project teams, especially within perioperative services, received additional support as they went through each phase of their projects. Team members from various departments provided input and participated in Work-Out sessions. They contributed suggestions in areas that might be considered outside their usual scope of work.所有项目工作组在项目的每个阶段都得到了额外的支持，尤其是手术全期护理小组。来自不同部门的成员贡献了他们的努力并参与了问题解决会议，在超出本职日常工作范围的领域方面提出了建议。Work-Out sessions, with their clear structure and focus on grassroots problem-solving, have changed the employee reactions to meetings at Doctors Hospital. A common employee complaint had been the seemingly endless meetings that did not create consensus or resolve the issues under discussion. People are beginning to use Work-Out tools in other meetings to make the meetings more focused and productive. In one session, a team was able to scope the vision, develop a toolkit and create a who-what-when plan with specific assignments - all accomplished within one hour. As more employees go through the training and gain experience applying the tools, this approach is becoming ingrained as a common framework for problem-solving. People now feel they are better equipped to solve problems and manage change.问题解决会议架构清晰，把重点放在了解决基层问题上，这改变了医生医院的员工对会议的看法。以前，一个最常见的员工抱怨就是，会议无休无止，却无法就讨论的问题达成任何共识或解决方案。现在，他们开始在其他会议上使用这个解决问题的工具，以使会议变得更有针对性，更有效率。在某次会议上，一个小组在一个小时之内便定义了会议讨论范围，开发了一套工具，创建一个人物—事件—时间并涵盖具体任务分工的计划。作为一个通用的问题解决的框架，这个方法逐渐深入人心。现在，在解决问题和管理变比时，人们觉得他们比以前更有能力了。Making the program work also depends on determining the right level of involvement for clinicians, and making the exchange of information as efficient as possible. One of the physicians participating in the process commented that this was the first time he had been really excited about an improvement project because he could actually see data-driven progress. Six Sigma is an objective and scientific process with a natural appeal for physicians.项目计划是否奏效还取决于临床医生的参与量合适与否，信息交流有效与否。一位参加该过程的医生说，这是他第一次真正为一个项目计划而兴奋，因为他切实看到了一个数据驱动的过程。对于医生们来说，六西格玛方法具有天然的吸引力，它是一个客观的，科学的过程。Tangible and Intangible ResultsImproving processes and operating as efficiently as possible in every facet of patient care is crucial for ensuring quality, managing the bottom line and raising patient and staff satisfaction. The data-driven approach also is helping the hospital to meet its compliance obligations.
With the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) survey process, healthcare providers have to be able to demonstrate that they are actually improving their performance and helping the patient. This type of rigorous, evidence-based approach is giving the organization the confidence to know it is doing the right things.有形和无形的成果
为了保障质量，保证利润并提升患者和员工满意度，过程的改进以及在患者护理各方面得到最有效的实施是至关重要的。数据驱动的过程方法也有助于医院完成其履约义务。按照国际医疗卫生机构认证联合委员会的鉴定程序，医疗卫生单位必须能够提供他们的工作的确在改进，并且对患者有所帮助的证据。有了这种严格的证据导向的过程方法，组织相信他们的所作所为是正确的。All projects from the first wave are now in the Control phase. The leadership team is continuing to fine-tune processes and monitor progress, but its efforts have already paid off and delivered measurable benefits to the organization.现在，第一轮的项目都已经进入受控阶段。虽然领导团队仍在调整过程并监视其进展，但其努力已见成效，并给组织带来了很大利益。Potential Increase in Departmental Earnings by Project Project Process Improvement Potential Increasein Dept. Earnings Operating Room: Reducing Turnaround Time Capacity increased by 80 cases/month by reducing TAT from 39 minutes to 25 minutes. 8%项目计划使部门收入增长项目过程增加了改进的潜力部门的收入手术室：缩短周转时间。TAT的时间从39分钟缩短到25分钟，每月接诊能力增加了80例。占8%。MRI:Reducing Time from Patient to Patient Capacity increased by 22 cases/month by reducing time from 52 minutes to 45 minutes. No show reduction from 17% to 10%. 3%Reducing Unscanned Supplies Increase in number of items scanned; improved charge capture, and decreased losses for materials used. .5%MRI核磁共振成像：缩短患者等待的时间。患者等候时间从每月52分钟减少到45分钟，每月门诊接诊能力增加了22例。成像失败的几率从17%降低到了10%，占3%。不成像的记录减少了，成像的记录便增加了。费用管理得到了加强，资源利用损失率减少了5%。Reducing Cycle Time Capacity increased by 100 cases/month by reducing cycle time from 59 minutes to 38 minutes. 8%OP CT断层扫描检测：缩短周期。周期由59分钟减少到了38分钟，提升了周期能力，每月增加了100例。ER:Reducing Cycle Time Capacity increased by 254 cases/month by reducing cycle time from 135 minutes to 120 minutes. Increase in downstream ICU and med/surg patients for increase in number of ED patients (6 cases/month in ICU and 16 cases/month med/surg). 10%急诊室：缩短周期。周期由135分钟减少到120分钟，提升了周期能力，每个月增加了254例门诊。通过增加一些ED病人的办法（加护病房每个月6例，药剂和手术病房每个月16例）使下游的加护病房和药剂/外科门诊病人得到了增长。Unbilled:Reducing Time from Patient to Coding Reduced time to code records from 13 days to 5 days. Total out-patient unbilled amount is lowest since 2003. 记录缺失：缩短患者登记的时间。编写记录的时间由13天缩短到5天。门诊患者记录缺失数量达到了自2003年来的最低点。Wound Center:Reducing Cycle Time Finishing implementation of improvements and remeasuring. Yet to Be Determined。In the wound center, the hospital was able to reduce turnaround time for patient visit to coding of the medical record from 13 days to just five. The improvements in cycle time for outpatient CT scans provided the capacity for an additional 100 scans each month. A Black Belt team working in MRI reduced cycle time from 52 to 45 minutes, freeing capacity for 22 additional patients per month. With reduced cycle time in the emergency department, capacity was increased by approximately 250 more patients per month. Although the project team met its goal in this area, the hospital would like to see the numbers improve even more. 伤员中心缩短周期。改进实施的完成及复测。待定。在伤员中心，患者的医疗记录时间从13天缩短到了5天，从而缩短了患者复诊的时间。CT扫描门诊的周期也缩短了，每月扫描能力增加了100例。MRI部门的黑带团队将周期时间从52分钟缩短到了45分钟，使每月接诊能力增加了22例。而随着急诊室周期时间的缩短，每月增加的患者数超过大概250例。尽管项目团队在这些地方已经达到了目标，医院却希望能够看到数据进一步增加。A problem in the hospital's operating room that had lingered for a long time was room turnaround time. By applying the right tools and getting the right people into a one-day Work-Out session, the team was able to create consensus and develop a viable solution. Room turnaround time was reduced from 39 to 25 minutes, adding capacity to perform 80 additional surgeries each month.在医院的手术室，有一个长期存在的问题，就是病房周转时间。通过使用合理的工具，召集相关人员参加了一个为期一天的问题解决会议，团队达成了一致并提出了可行的解决方法。病房周转时间从39分钟缩短到25分钟，每个月的外科手术能力增加了80台。Keeping the Momentum GrowingWith the results that have been achieved so far, momentum has begun to build. Ideas for new projects are constantly rolling in. Four of the initial Green Belt liaisons are coordinating all projects during the second phase of the initiative. The hospital has integrated the entire process into the performance improvement committee. All projects - including Work-Out sessions and larger Green Belt projects - now report to this committee. The group's members comprise a major portion of the organization's JCAHO survey process. The level of information the hospital is tracking and the results it is able to demonstrate assist in reporting progress to the board of trustees and medical committees.
保持增长的势头按照目前达成的成果来看，增长势头开始显现。新项目的需求纷至沓来。在新方案进展到第二阶段时，四个最初的绿带联络员开始协调全部的项目。医院整合了整个过程，成立了绩效改进委员会。从现在开始，所有的项目，包括问题解决会议和大型绿带项目都要向这个委员会报告。这个团队的成员包含了大部分由ACHO调查过程组织的成员。.医院对信息的追踪以及结果有助于向董事会以及医学委员会的报告过程As requests increase, the improvement committee will continually prioritize projects, with a particular focus on increasing patient safety, clinical quality and patient satisfaction. The leadership team is putting a process in place to streamline how people make improvement suggestions.随着需求的增加，改进委员会将尤其关注加强患者安全，临床治疗质量和患者满意度，并据此逐步使项目优化。领导团队对简化员工提出改善建议的方法开始建立一个合理的过程。To familiarize new employees with the purpose and basics of Six Sigma, a short elevator speech on the methodology has been created. "During orientation, new employees learn that Six Sigma is a highly structured process that we began using in 2004 to evaluate and improve the way we work," said John Doriot, a Green Belt who also teaches customer service training at the hospital. "An important part of our service excellence culture is to make decisions based on data rather than opinions. We need help from all employees to identify changes that need to be made, and to support and sustain change," Being able to clearly explain the purpose of the process helps to build acceptance and encourage participation.
为了使新员工全面了解六西格玛的宗旨和基本知识，医院创建了一个简短的阶梯式演讲方法。“在新员工培训中，他们了解到，六西格玛一种高度结构化的过程，我们从2004年开始用它来评估和改善我们的工作方式，”负责医院客服培训的绿带约翰·奥特说，“我们的决策基于数据，而不是个人主观看法。这是我们优秀的服务文化的一个重要组成部分。我们需要借助全体员工的努力来识别出必要的改变，支持并维护这些改变。”对过程主旨的明确解释有助于人们接受并积极参与。For 2005, Doctor's Hospital focused on maintaining the momentum and using the training to impact other key areas in the organization. With a large influx of new physicians, the hospital is streamlining existing processes to accommodate extra procedures and volume. It also is continuing to use Six Sigma as a way to create greater efficiencies in perioperative services.2005年，医生医院将集中精力保持增长势头，并通过培训来扩大在组织中的其他关键部门的影响。随着新医生大量引进，为了适应增加的程序和容量，医院将精简现有过程。而在外科手术全服务上将继续推行六西格玛，以此来创造更高的效率。Hard work and dedication from the entire team, along with ongoing leadership commitment, have been key factors in making this initiative a success. Beyond specific process improvements, one of the most important benefits of this initiative has been the ability to furnish people with proven new tools and techniques to solve everyday problems.
关于这次方案，成功的关键在于，整个团队的辛勤工作和奉献精神，以及领导团队持续的承诺。除了特殊过程的改进之外，这个举措的一个重要的收益是，在解决日常问题时，员工掌握了经过事实检验的新的问题解决工具和技术。The approach is creating a common foundation for leading change within the organization. Instead of simply making assumptions about underlying issues, teams are gathering, analyzing and verifying data to make an educated decision. Then they put in place solutions that can be sustained.在组织内，这个方法为引领变化建立了一个共同的基石。现在，对于潜在发生的问题，团队不再只是简单的假想，而是凝聚在一起，分析并验证数据，得出一个基于数据和讨论的决定。然后，得出合理的可持续的解决方案About the Author: Sondra Smith is assistant vice president of service line development and sales for Doctors Hospital in Augusta. She oversees product line development of musculoskeletal services, neuroscience, oncology and cardiology. Prior to this role, she was director of physical medicine services at the hospital. Ms. Smith is a Six Sigma Green Belt, and her current projects include outpatient CT turnaround time and day surgery preoperative process cycle time. She can be reached at mailto:Sondra.Smith@HCAHealthcare.com This e-mail address is being protected from spambots. You need JavaScript enabled to view it .作者简介：桑德拉·史密斯，奥古斯特医生医院中负责服务线开发和销售的助理副总裁。她负责监督肌肉骨骼服务项目，神经科学，肿瘤学和心脏病学的生产线开发。在此之前，她担任医院物理治疗学的服务总监。史密斯女士是六西格玛绿带，她目前的项目包括门诊部的拍CT周转时间和日间手术术前过程周期。她的E - mai地址为Sondra.Smith @ HCAHealthcare.com，这个地址已经被防止恶意灌水程式保护。您需要启动Javascript才能观看它。附：美国医院公司：美国医疗医院公司(Hospital Corporation of America)是以营利为目的的连锁医院的先锋，是世界上最大的营利医院公司，它拥有219家分院，另外还代理经营165家医院，员工总数7.5万人。
没有找到相关结果
已邀请:
RSS Feed
0 个回复