Category Archives: Lean Processes

23 March 2017

The Role of Professional Development in Physician Engagement

Sheridan’s Chief Quality Officer Gerald Maccioli, MD, MBA, FCCM sees physician engagement as essential for all stakeholders. He spoke with Becker’s ASC Review recently about the value of investing in comprehensive professional development opportunities for physicians to keep them engaged. 

“We all want the quadruple aim—which includes a satisfied population of physicians,” he said in the Q & A. “If engagement isn't developed, you are never going to get to that. It will always be a push and pull rather than a rolling together phenomenon.”

Dr. Maccioli explained that physicians are highly educated problem solvers for whom development and...

21 March 2017

Three Breakthrough Technologies That Will Change Medicine

The Massachusetts Institute of Technology (MIT) publishes an annual list of 10 Breakthrough Technologies. Three innovations from this year’s list promise to have a dramatic impact on the future of medicine.

Brain Implants that Reverse the Effects of Paralysis

In recent years, brain implants have enabled lab animals and even a few people to use thoughts to control computer cursors or robotic arms. According to the 2017 MIT report,  researchers are “taking a significant next step toward reversing paralysis once and for all” using what French neuroscientist Grégoire Courtine calls a “neural bypass.” Wireless implants transmit electrical impulses from brain to spinal cord, bypassing...

19 December 2016

Identify Pain Points First to Effectively Implement Radiology Process Improvements

Radiology departments are under tremendous pressure to increase efficiency without sacrificing quality, as nearly every department in the hospital depends on them to produce and read images in a timely manner. Hospital workflows are complex, and investments in new software, equipment or people that are not informed by a thorough understanding of the underlying causes of inefficiencies are unlikely to deliver the desired improvements.

An article in Radiology Today earlier this year advised department heads to do a full assessment of workflow processes to identify the “pain points” that result in inefficiencies. Pain points can be areas that may need improvement, like patient throughput, or areas where...

15 December 2016

U.S. Surgeon General Calls for Action on the Opioid Crisis

Opioid abuse remains a devastating public health concern, and the health care community has grappled with its role in the crisis and medical professionals’ responsibility to patients struggling with substance use. U.S. Surgeon General Vivek Murthy has responded with a report released last month analyzing the current opioid crisis and providing several recommendations for treating and preventing substance use disorders. These recommendations include:

1. Eliminate stigma

Misconceptions and negative judgments about people with substance use disorder abound, and the report stresses that even medical professionals are not immune to seeing addiction as a “moral failing or character...

13 December 2016

Five Key Strategies for Driving Change in the OR

Now more than ever, hospitals and ambulatory surgery centers are seeking anesthesia partners capable of driving positive change in their operating rooms. However, for many anesthesia providers, there are hurdles that must be overcome before such change can be realized.

Anesthesia groups of any size, regardless of their financial strength, can employ proven strategies to ensure the success of facility-wide patient care improvement initiatives. Here are five such strategies that Dr. Adam Blomberg, Sheridan’s national education director, has found to be effective.

Collaborate with nursing and surgeons on incremental steps toward larger improvements

Securing the buy-in of nursing and surgical staff is...

22 November 2016

Getting Creative with Emergency Room Care Starts with the Human Element

There is a new authority ruling emergency rooms across San Diego County, created to combat the influx of patients overwhelming the health care system in recent years. Known as “bed czars” and “zoomer nurses,” as featured in the San Diego Union-Tribune, medical personnel at Sharp Grossmont Hospital and Tri-City Medical Center monitor the ED and help make decisions to “fast track” patient care. They determine the patients with minor medical problems and allow them to remain for treatment and discharge, while patients with more severe conditions requiring at minimum an overnight stay are quickly transferred to the appropriate department.

The creation of these new positions...

28 October 2016

Preadmission Testing Kaizen at Memorial West: Part I

For an outsider looking in, a clinical Kaizen event may appear chaotic. Consisting of individuals well-versed in the sequence and flow of clinical processes, clinical Kaizen teams are charged with the task of deconstructing, analyzing and reconstructing critical workflows to maximize the creation of value for the patient. With its roots in the Toyota Production System, Kaizen provides cross-functional teams with a structured approach to process decomposition and waste reduction by allowing the team to systematically analyze process performance in an objective and comprehensive fashion. In practice, this typically involves engaging in activities, such as value-stream mapping, “trystorming,” simulation and direct...

27 July 2016

The Challenges of Staffing a Rural Hospital Successfully

Population health management is a challenging proposition in any location, but especially so in rural areas, which comprise nearly 20 percent of the U.S. population and more than 95 percent of the country’s land. Health care resources are more limited and the population is more spread out than in urban settings. The patient base at rural and nonurban hospitals also tends to be smaller, older, poorer, and less healthy than that of urban hospitals, which means there is little opportunity to mitigate financial risk. The inability to take advantage of the economies of scale enjoyed by urban healthcare systems affords little opportunity for cost reduction. Add in shrinking Medicare reimbursements, and it becomes...

11 July 2016

Engaging Physicians Collaboratively to Innovate Emergency Medicine

In today’s value-based care environment, healthcare providers are feeling the urgency of finding better ways to improve their processes and communications.   The problems caused by inefficient processes and poor communication are magnified exponentially in emergency departments (EDs) because of the high patient volume and high proportion of patients needing urgent care.  Sheridan physicians have already implemented innovative ED process and communication improvements that have improved patient care, cleared ED bottlenecks, dramatically lowered “left before being seen” rates and increased patient satisfaction. In 2015, the organization launched an annual Innovate Emergency Medicine (iEM) conference to...

6 July 2016

Physician Spotlight: Jody Crane, MD, MBA

Dr. Jody Crane is the chief clinical operations officer for Sheridan’s Emergency Medicine Division. A respected expert in emergency department (ED) operations, Dr. Crane wears many hats. In addition to his responsibilities at Sheridan, he’s the co-author of “The Definitive Guide to Emergency Department Operational Improvement: Employing Lean Principles with Current ED Best Practices to Create the ‘No Wait’ Department.” He’s also a very active educator who is helping to drive healthcare process and clinical improvements around the world.

Dr. Crane’s work in these varied roles focuses on ED and hospital-wide operations, the application of lean principles within the healthcare...