Contents NEW TITLES Transforming Healthcare ..................................................3 Leading the Lean Healthcare Journey ..............................4 Essentials for the Improvement of Healthcare Using Lean & Six Sigma ..................................................5 Leveraging Lean in Healthcare ........................................6 Page 5
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Safer Hospital Care ..........................................................7 Dynamic Capacity Management for Hospitals ................8 Applying Lean in Healthcare ............................................9 Medical Error and Harm ................................................10 Healthcare Payment Systems ........................................11 The Medicare Recovery Audit Contractor Program ......11 Successful Collaboration in Healthcare ..........................12 Comprehensive Healthcare for the U.S. ........................12
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PROCESS IMPROVEMENT Lean Hospitals ................................................................13 The Pittsburgh Way to Efficient Healthcare....................13 Value Stream Mapping for Healthcare Made Easy ........14 A3 Problem Solving for Healthcare ................................14 5S for Healthcare............................................................15 Optimizing Emergency Department Throughput..........15 Page 20
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Paradox and Imperatives in Health Care........................16 Transformative Quality ..................................................16
FINANCIAL MANAGEMENT & LEADERSHIP Health Care Will Not Reform Itself ................................17 Workplace Clinics and Employer Managed Healthcare..17 Governance for Health Care Providers ..........................18 Healthcare Transformation ............................................18 Healthcare Delivery in the U.S.A. ..................................19 Statistical Analysis for Decision Makers in Healthcare, Second Edition ..............................................................19 The Managed Care Contracting Handbook, Second Edition ..............................................................20 Consumer Directed Health Care ....................................20 Healthcare Payment Systems ........................................21 Compliance for Coding, Billing & Reimbursement, Second Edition ..............................................................21 Discharge Planning Handbook for Healthcare ..............22 Pursuing Excellence in Healthcare..................................22
New Titles Transforming Health Care Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience Charles Kenney Virginia Mason Medical Center, Seattle, Washington, USA
A Must Read for Health Care Leaders “Virginia Mason Medical Center has been on a ten year journey to demonstrate just what is possible and the results have been profound. What is equally amazing, and must reading for health care leaders, is the story of their journey. It is possible to improve quality and safety while simultaneously reducing cost!” —John Kitzhaber, MD, Governor of Oregon 1995-2003
“An inspiring tale of leadership, discipline, and persistence… Must reading for all health care leaders who are serious about quality.” —Lucian L. Leape, MD, Harvard School of Public Health
“If you work in the health and medical care field and you believe you and your institution are as good as it is possible to be, you should read this book. It will reset your standards and show you how to produce more value for your patients at a lower cost. ... It is a story about real people dedicated to the pursuit of habitual excellence.” —Paul O’Neill, 72nd Secretary of the U.S. Treasury, former Chairman and CEO of Alcoa
“If you want to understand what health care can become, you need to know about Virginia Mason Medical Center. This book gives you the complete story. It is essential reading.” —David Cutler, former Senior Health Care Advisor, Obama Presidential Campaign
“… chronicles an arduous journey to achieve an exceptional patient-centered culture using a management system only now recognized as relevant to health care. This is a story of how Virginia Mason became the benchmark against which other health care systems must judge themselves, and a beacon in a field that has resisted change for far too long. — David M. Lawrence, MD, MPH, Chairman and CEO (retired), Kaiser Foundation Health Plan and Hospitals, Inc.
Just a decade ago, Virginia Mason Medical Center of Seattle was a prime example of so many of the things that are wrong with health care today. Then they discovered where actual health care reform needs to occur: not in any legislature but in the very corridors of the Center and in the attitudes of its stakeholders. Now after a decade of arduous dedicated work, VMMC stands as both example and inspiration to all of us who believe that it is possible to deliver health services that practice wellness, operate in the black, and do no harm. Contents: Preface: A Surprising Visit. A New Idea. Journey to Japan. The Blue Yarn. Safety Crusade. Ambulatory Care Breakthrough. Transforming Procedural Care. Transforming Inpatient Care. Better, Faster, More Affordable. Management Method. The Journey Continues. Source Notes. Catalog no. PP7375, November 2010, 240 pp. ISBN: 978-1-56327-375-9, $39.95 / £25.99
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New Titles Leading the Lean Healthcare Journey Driving Culture Change to Increase Value Edited by
Joan Wellman Wellman & Associates, Seattle, Washington, USA
Pat Hagan and Howard Jeffries Seattle Children's Hospital, Washington, USA
“… a compelling story of change at an enormously prestigious institution … a story about leadership taking the long view and systematically improving. It is a story of humility and the courage to go outside of healthcare to learn. … The reader gets to enjoy the 10 year story of transformation from the perspective of the staff and clinician leaders. —J. Michael Rona, Principal, Rona Consulting Group, Former president of Virginia Mason Medical Center, where he introduced the Toyota Management System in 2000
“Joan Wellman and her colleagues provide examples of dramatic performance improvements. Using their practical examples you can be on your way to becoming a leader who transforms your organization, empowers your team, adds value, and saves lives.” —Ken Graham, CEO of El Camino Hospital in Mountain View, CA
While every healthcare organization can learn from Seattle Children’s Lean improvement process, this book is not an operator’s manual. Instead, it is about challenging deeply held assumptions about healthcare. Contrary to traditional thinking, quality, cost, patient access, and safety outcomes are not a set of trade-offs but characteristics that can be improved concurrently. Written by those involved at the front lines of real and effective change, this book discusses ways to: • Transform doctors into change agents and engage all staff in a patient-focused culture • Eliminate waste and increase direct care by standardizing processes and streamlining bureaucracy • Control such variables as infection rates and improve patient outcomes through more efficient and mindful practices Providing both example and inspiration, Seattle Children’s stands today as proof positive that real healthcare reform is feasible. What it requires is real leaders; men and women who have the curiosity and tenacity to look critically at their work and find better, less wasteful ways to deliver safe, high-quality care. Contents Abridged: The Continuous Performance Improvement Journey. Creating High-Powered Healthcare Improvement Engines. Leadership and Culture. Transforming Doctors into Change Agents. Clinician Engagement. Ending the Paper Chase in the Operating Room. 5S and Demand Flow. Developing and Implementing Pull Systems in the ICU. Delivering Compassionate Care through Clinical Standard Work on Rounds. Developing Standardized Inpatient Care for Patients with Asthma. Making the Total Parenteral Nutrition Process Safer. Eliminating Mistakes and Central Line Associated Bloodstream Infections. Balancing the Line in Outpatient Pharmacy. The Everett Clinic Registration to Cash Value Stream. … Catalog no. K11406, December 2010, 290 pp., Soft Cover ISBN: 978-1-4398-2865-6, $59.95 / £38.99
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New Titles Essentials for the Improvement of Healthcare Using Lean & Six Sigma D.H. Stamatis Contemporary Consultants, Ypsilanti, Michigan, USA
Whatever means we use to measure and rank healthcare delivery in the United States, we can all agree that without significant reform, the prognosis is grim. Recently, we were subjected to much discussion about reform, but that discussion was more about government’s role, than improving medical outcomes. Essentials for the Improvement of Healthcare Using Lean & Six Sigma is all about real and immediate quality improvement. Written by a renowned expert in organizational development and quality, the book addresses concerns that can be ameliorated with minimum government intervention. Detailing immediate paths for improvement fundamental to primary care, hospitals, and managed care, Dr. Stamatis — • Introduces needed mechanics of change, especially the transition of hierarchical groups to interactive inclusionary teams responsible for initiating, refining, and implementing quality improvements • Focuses on customer satisfaction as a key indicator of quality • Explains how Lean and Six Sigma tools can be readily applied to healthcare • Spotlights primary care, including how to define and redesign its process and develop better metrics • Presents IT applications that will improve billing, documentation, and patient care • Examines Malcolm Baldrige National Quality Award criteria as it applies to healthcare • Illustrates quality improvements and best practices through real world case studies • Encourages actionable steps with a companion CD that includes Six Sigma forms and formulas, Lean improvement tools, and other quality tools and worksheets Whether we think that advances in technology and medicine, coupled with freedom of choice, makes the U.S. system the best in the world, or whether we believe growing costs, regulatory morass, and our tort-obsessed culture drops it to the bottom; it is painfully evident that the processes currently employed and the subsequent defensive medicine philosophy will not be able to meet the future demands of an aging society. Through Six Sigma and Lean, this text moves the focus from reactive controls to the proactive efficiency required to implement the sort of real and sustainable quality improvements that will allow us to forge a system that is all about wellness. Contents: The Four Critical Issues in Healthcare. Directions of Improvement in Healthcare. The Mechanics of Change. The Transition of Groups to Teams. Logistical Issues of Teams. The Effects of Change in Healthcare. Customer Satisfaction. Understanding the Process. Using Six Sigma Methodology for Improvement. Using Lean Methodology for Improvement. Understanding Measurement. Primary Care. Immediate Applications for Information Technology in Healthcare. Project Selection. Understanding and Utilizing ISO 9000 Standards. Understanding and Utilizing the Malcolm Baldrige National Quality Program. Epilogue. Catalog no. K12058, December 2010, 444 pp. ISBN: 978-1-4398-4601-8, $79.95 / £49.99
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New Titles Leveraging Lean in Healthcare Transforming Your Enterprise into a High Quality Patient Care Delivery System Charlie Protzman, George Mayzell, and Joyce Kerpchar What the experts are saying: “… This instructive book is well-timed and highly informative for those committed to creating deep levels of sustainable change in healthcare.” — Peter B. Angood, MD, FACS, FCCM, Senior Advisor – Patient Safety, National Quality Forum
“ … the most practical and healthcare applicable book I have ever read on Lean thinking and concepts. A must read for CEOs, managers and supervisors … it has all the tools needed to get the results we must achieve.” — Gary Shorb, CEO, Methodist Le Bonheur Healthcare
“I can recommend this well written book as an essential reference in the library of all healthcare leaders interested in performance improvement.” — Lee M. Adler, DO, VP, Quality and Safety Innovation & Research, Florida Hospital, Orlando; Associate Professor, University of Central Florida College of Medicine
“… a must read for all Leadership involved in healthcare. … I can see reading this book over and over.” — Brigit Zamora, BSN, RN, CPAN, CAPA, Administrative Nurse Manager, Florida Hospital, Orlando
A practical guide for healthcare executives, managers, and frontline workers, this book provides you with the means to transform your enterprise into a High-Quality Patient Care Business Delivery System. Designed for continuous reference, its self contained chapters are divided into three primary sections: • Part 1 defines Lean and includes some interesting history about Lean not found elsewhere • Part 2 describes and explains the application of each Lean tool and concept organized in their typical order of use • Part 3 looks specifically at how to implement Lean in various healthcare processes. Here, the authors provide examples, case studies, and lessons garnered from their own extensive experience This book is designed to take you out of your comfort zone and provide you with new ways to extend value to your customers. It drives home the importance of the Lean Six Sigma journey. The pursuit of continuous improvement is a journey with no end. Consequently, the opportunities are endless as to what you and your organization can accomplish. Forty percent of the authors’ profits from this book will be donated to help the homeless through two Baltimore charities. Contents: General Principles and Overview. General Approach to Implementing—50% People / 50% Tools. Tools. Lean Implementation by Service Line. Sustaining. Lean Design. Case Studies. Glossary. Catalog no. K10715, November 2010, 422 pp., Soft Cover ISBN: 978-1-4398-1385-0, $74.95 / £47.99
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New Titles Safer Hospital Care Strategies for Continuous Innovation Dev Raheja An examination of the effectiveness of present hospital care methods, this book illustrates how to find simple, comprehensive solutions that produce high return on investment. It emphasizes innovative techniques, proven safety methods, models for risk managers, heuristics for leading change, reliability methods that deliver right care over time, dangers in medical devices for critical care, and techniques for giving care with speed and efficiency without compromising safety. Experts from the aviation industry, world-class organizations such as Toyota and General Electric, and innovative hospitals such as Johns Hopkins offer their insight. • Presents world-class practices adjusted for hospitals • Transfers aerospace techniques for eliminating unsafe practices to hospitals • Provides solutions that produce a high return on investment Contents: What is Unsafe Healthcare and Why Do We Have So Much? Mishaps Never Happen from a Single Cause Any Work Done in a Shoddy Manner is Likely to be Unsafe Heuristics for Leading the Change. Try Continuous Innovation instead of Continuous Improvement Delivering Reliability in Healthcare: Quest for Failure-free Performance Prepare for "What if' Scenarios with Healthcare FMEA Current Root Cause Analysis is Inadequate for Adverse Events: Use Fault Tree Analysis A Good Risk Manager is Like a Maestro in a Symphony Orchestra Use Aviation Techniques: Current Techniques are Outdated What Every Critical Care Physician Should Know About the Dangers of Medical Devices? Implement Efficiency and Speed Without Compromising Safety Look for Management Oversights and Omissions A Checklist for Self Audit to Assure High Integrity at Lower Cost The Paradigm Pioneers About the Author: Dev Raheja, MS, CSP, has been an international risk management and quality assurance consultant for the healthcare, medical device, and aerospace industry for more than 25 years. He applies evidencebased safety techniques from a variety of industries to healthcare. He is a trainer and author, and shows clients how to come up with elegant solutions using creativity and innovation. Being a true international consultant, he has conducted training in several countries, including Sweden, Australia, Japan, Germany, the United Kingdom, Singapore, Taiwan, South Africa, and Brazil. He helped a major Midwest company avoid going out of business and become a world leader by eliminating safety mishaps. Prior to becoming a consultant in 1982, he worked at GE Healthcare as supervisor of quality assurance and manager of manufacturing, and at Booz-Allen & Hamilton as risk management consultant in the nuclear and mass transportation industry. Catalog no. K11114, December 2010, 200 pp., Soft Cover ISBN: 978-1-4398-2102-2, $59.95 / £38.99
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New Titles Dynamic Capacity Management for Healthcare Advanced Methods and Tools for Optimization Pierce Story Senior Consulting Manager, GE Healthcare, Wells, Maine, USA
“This book is a must-read for anyone engaged in healthcare improvement, whether you work in a clinic, hospital, or healthcare system.” — Keith Messner, MD, MBA, BSN, Emergency Physician, Healthcare Transformation Medical Director, Cape Fear Valley Health System, Fayetteville, North Carolina
“Healthcare is facing a huge challenge in reforming delivery predicated on changes and incentives in payment. Without revamping dynamic delivery systems to reduce and to reallocate current costs, chaos and disruption will likely occur. We need the analytical tools and creative mindset outlined in this book to help guide us on the path to reform.” — Mike Sack, CEO, Hallmark Health
“Pierce Story has added an important chapter to the growing body of literature on healthcare performance improvement. His theme of managing effectively to actual demand is compelling, and the contention that healthcare leaders should not be dogmatic about the methods or tools of continuous improvement is right on target.” — Pat Hagan, President and COO, Seattle Children’s Hospital
While hospitals can learn from other industries, they cannot be improved or run like factories. With work that is more individualized than standardized, and limited control over volume and arrivals, even the leanest-minded hospital must recognize that healthcare systems are more dynamic than nearly any work environment. Written with the creativity needed to navigate the rapidly changing landscape of healthcare, Dynamic Capacity Management for Healthcare: Advanced Methods and Tools for Optimization presents the unique new tools, methodologies, and thinking required of healthcare systems that want to survive and thrive in a reduced reimbursement, higher-cost world. Demonstrating his approaches and recommendations through case studies specific to the complex issues of healthcare delivery, Pierce Story, a longtime and passionate healthcare operations expert, shows how hospitals and health systems can make leaps in performance in an environment in which both financial and human resources are shrinking as expectations for clinical perfection continue to rise. Through its unique approach to the dynamic management of complex care systems, this volume raises the bar for what is possible. This text presents an excellent opportunity for healthcare’s “change agents” to meet the challenges and responsibilities of our day. Contents: Variability: Killer of Capacity. Interdependencies. DCAMM Introduction. Predictive Analytics. Demand Components: The Emergency Department. Surgical Services and DCAMM Analytics. Up–Down–Up: Creating a Systems View from a Component Perspective. Capacity Patterns and Analytics for DCAMM. Dynamic Resource Allocations, Dynamic Standardization, and Workload Analytics. A Word on Mandated Nurse–Patient Ratios. Outlier Management and System Balance Catalog no. K11039, November 2010, 235 pp. ISBN: 978-1-4398-1975-3, $59.95 / £38.99
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New Titles Applying Lean in Healthcare A Collection of International Case Studies Edited by
Joe Aherne and John Whelton Leading Edge Group Charter House, Cobh, Ireland
“… these case studies provide wonderful examples and an opportunity to take a glimpse into the many possibilities of Lean. These case studies move beyond the theory of Lean and illustrate how Lean translates into simple actions that are capable of effecting positive change.” —Colleen Kennedy MLIS, MHA, Leader Physician Engagement, British Columbia, Canada
“The case studies provided in this book provide relevant examples that are useful and informative for organizations like ours that are implementing Lean principles and methodology. … provides examples of actual implementation strategies and solutions to change management issues in applying Lean.” —Bonnie Urquhart CGA, CHE, Director - Strategic Initiatives and Project Support, Northern Health Authority, British Columbia
“Many healthcare professionals are frustrated by the disappointing quality and the waste in our healthcare systems. … This book binds together the philosophy that revolutionized the safety and quality of the motor industry with practical examples from the pioneers in healthcare. Through examples big and small, they share their learning of the problem-solving techniques and, more importantly, the fundamental change in their beliefs and behaviors that brought about change for the benefit of colleagues and patients.” —Dr Kate Silvester BSc, MBA, FRCOphth, Programme Lead for enquiry into patient flow, cost and quality
“ … a must buy for any healthcare professional interested in delivering improvement opportunities. It highlights relevant and insightful examples from other healthcare organizations that have benefited from Lean thinking. The book will help you and your colleagues to better understand Lean in healthcare and benefit from the experiences of those who provide patient care in an international healthcare context.” —Eamon Counihan, Quality Coordinator, Bon Secours Health System, Ireland
Covering healthcare from clinical to nutritional services, this book provides a collection of international case studies that demonstrate how Lean thinking can be applied in the healthcare industry. Offering an international perspective, the text introduces key concepts of Lean healthcare and presents real-life examples to illustrate the practical benefits—which include m0ore efficient processes, increased patient satisfaction, and cost savings—that result from a Lean philosophy. The book features a number of expert contributors who offer practical tips. It also includes a foreword from eminent psychiatry professor Jeffrey Clotheir, MD. Contents: Introduction to Lean Healthcare. Making It Lean, Hilary Grey. Providing Rapid Access to a Vascular Surgery Outpatient Clinic, Simon Dodds. Reorganizing and Standardizing Supply Rooms across a Health System, Franciscan Health System. A Quick-Start Lean Method to Cut the Clutter and Get Your Hospital Back into Shape, Kelley Williamson. Applying Lean Thinking to the Outpatient Registration Process, Deborah Miller. Establishing a Standardized and Efficient Client Laboratory Supplies Process, Christian Buchsteiner. Improving Accommodation and Organizational Arrangements at an Outpatient Antenatal Clinic, Brendan Murphy. Improving Wait Times at a Medical Oncology Unit, Carlos F. Pinto. Minimizing the Time from "Cooking Pot to Patient", Judy-Ann Wybenga. A Journey in Lean—Bringing about Change, Improving Quality for the Patient, and Developing the Culture of a Healthcare Organization, John Coleman and Tim Franklin. Process Improvements to Reduce Operating Room Cancellations, Mimi Kokoska, Samuel B. Welch, and Teresa Stevens. The Future for Lean Healthcare, Timothy D. Hill. Glossary Catalog no. K11351, April 2010, 247 pp. ISBN: 978-1-4398-2739-0, $49.95 / £31.99
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New Titles Medical Error and Harm Understanding, Prevention, and Control Milos Jenicek McMaster University, Hamilton, Ontario, Canada
Recent debate over healthcare and its spiraling costs has brought medical error into the spotlight as an indicator of everything that is ineffective, inhumane, and wasteful about modern medicine. But while the tendency is to blame it all on human error, it is a much more complex problem that involves overburdened systems, constantly changing technology, increasing specialization, and a cycle of continual funding shortfalls made even more acute by resourcewasting inefficiencies. Medical Error and Harm: Understanding, Prevention and Control presents the work of long time physician and teacher Milos Jenicek, a pioneering expert on epidemiology, evidence-based medicine, and critical thinking and decision making in the health sciences. Providing a comprehensive overview of the subject that is thorough and free of rhetoric, Dr. Jenicek: • Presents a short history of error in general across various domains of human activity and endeavor, including concepts, methodologies of study, and management applications • Provides semantic and taxonomic classifications of challenges in medical error and harm, two distinct domains • Explores approaches used to investigate and ameliorate challenges in medicine and other health sciences • Explains why, when, and how studies and decisions regarding errors should be carried out, such as whether risk assessment should be undertaken in the diagnosis, treatment, or prognosis stage • Covers essential strategies for mitigating errors in the broader framework of medical care, specifically in community medicine and public health • Considers the ever-growing role of physicians in tort law and litigation The book discusses whether dealing with errors is a learned skill and looks at how much of the problem with medical error is caused by the medical community’s failure to teach, learn, and understand everything there is to know about medical error, including the often neglected critical thinking skills. Understanding and correcting this shortfall is a primary responsibility of every health professional, one they can begin to realize with the study of these pages. Contents: Putting Medical Error and Harm in Context. Reducing Errors and Harm in Medicine; Beyond the ‘Oops!’ Factor. The Valued Legacy. Error and Harm across General Human Experience in the NonMedical Domains. Welcome to Lathology. Error and Harm in the Health Sciences. Defining and Classifying Human Error and its Consequences in Clinical and Community Settings. Describing Medical Error and Harm. Their Occurrence and Nature in Clinical and Community Settings. Analyzing Medical Error and Harm. Search for their Causes and Consequences. Flaws in Operator’s Reasoning and Decision Making before Action. Prevention, Intervention and Control of Medical Error and Harm. Clinical Epidemiological Considerations of Actions and their Evaluation. Taking Medical Error and Harm to Court. Contributions of Physicians and Expectations of Physicians in Tort Litigation and Legal Decision-Making. Conclusions. A Brief and Harmonized Glossary. Catalog no. K11671, July 2010, 384 pp. ISBN: 978-1-4398-3694-1, $79.95 / £49.99
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New Titles Healthcare Payment Systems Fee Schedule Payment System Duane C. Abbey Abbey & Abbey Consultants, Inc., Ames, Iowa, USA
Healthcare Payment Systems: Fee Schedule Payment System, the second volume in a series by expert consultant and workshop facilitator Duane Abbey, is dedicated to fee schedule payment systems. Dr. Abbey illustrates the diverse challenges involved with these systems through the discussion of reimbursement claims for several individuals in a fictitious community served by a hospital, a nursing facility, and a hospice among other healthcare providers. Including more than 60 very real scenarios that illustrate best practices for various fee payment challenges, this comprehensive volume — • Explores the general concept of usual, customary, and reasonable (UCR) that is often applied by private third-party payers • Provides web links to a number of essential resources including various government acts and manuals • Discusses in-depth what is arguably the most complex fee schedule system: the Medicare Physician Fee Schedule
The Medicare Recovery Audit Contractor Program A Survival Guide for Healthcare Providers Duane C. Abbey Abbey & Abbey Consultants, Inc., Ames, Iowa, USA
Written by medical billing guru and Lean accounting expert, Duane Abbey, The Medicare Recovery Audit Contractor Program: A Survival Guide for Healthcare Providers explains all that is required to prepare and successfully defend against inappropriate RAC audit recoveries. Using the same succinct style that always makes his writing so accessible, Dr. Abbey illustrates his lessons with simple case studies placed in the context of a fictitious community whose population is served by a hospital, clinics, a nursing facility, and other providers all seeking to maintain compliance and profitability. In discussing RAC guidelines, this resource — • Shows how to identify overpayment areas and associated compliance issues • Details a systematic problem-solving process relative to RAC processes • Addresses resource requirements including new personnel, such as RAC specialists
• Defines a comprehensive list of acronyms used in the medical payment industry
• Includes planning models for developing compliance departments
Conceptually, fee schedule payment systems are one of the simpler approaches; however, even straightforward healthcare payment systems can, and indeed do, become quite complex. No payment system exists in a vacuum. In fact, when services are provided, the reimbursement from multiple payment systems may be required. This guide shows you how all these systems work, as well as how they interface with one another in everyday practical use. Understanding the differences among systems and learning how to navigate them can make a huge difference in whether a claim is accepted or not and how much payment is allowed.
• Provides an extensive glossary to make sense of medical billing’s alphabet soup of acronyms While the book works well as a stand-alone reference for those seeking advice on RAC audits, readers will also discover that this volume extends the lesson of Abbey’s classic Compliance for Coding, Billing & Reimbursement, Second Edition, making this book a natural companion for those wanting to fully explore the role of compliance and Lean accounting in medical billing. Catalog no. K11113, February 2010, 124 pp. Soft Cover, ISBN: 978-1-4398-2100-8 $59.95 / £38.99
Catalog no. K11862, October 2010, 152 pp. Soft Cover, ISBN: 978-1-4398-4023-8 $59.95 / £38.99
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New Titles Successful Collaboration in Healthcare
Comprehensive Healthcare for the U.S.
A Guide for Physicians, Nurses and Clinical Documentation Specialists
An Idealized Model William F. Roth DeSales University, Center Valley, Pennsylvania, USA
Colleen M. Stukenberg FHN Memorial Hospital, Freeport, IL, USA
“Colleen Stukenberg writes from the perspective of one who has been there and done that. … a skilled teacher who shares lessons she has learned in the trenches.” —Beth Gale, RN, BSN
“Colleen has successfully navigated the clinical and front-end-revenue cycle job market over the last 20 years. … Her vast knowledge and know-how has actualized one of the more successful documentation programs in the industry with the financial gains in a rural hospital rivaling major urban medical centers. Colleen is definitely an authority on Clinical Documentation programs and has much to share with her peers.” — Tamar Gorenyuk, MBA, RHIA, Director, HIM & Resource Management, Freeport Health Network
“Anyone interested in implementing a successful Clinical Documentation Improvement Program should read this book before starting the process. Never before has this valuable information been presented in one, all-encompassing reference.” —Lynne Spryszak, RN, CCDS, CPC-A, Manager, Precyse Solutions, LLC
A guide to forging alliances that will improve patient care, this book describes ways in which nurses and physicians can collaborate to enhance safety, quality, and treatment efficacy. Explaining how this collaboration can result in positive financial effects, it demonstrates how cooperation can meet the changing requirements of governing bodies and government regulations. The text addresses the roles of direct patient caregiver, charge or team leader nurse, case manager, and clinical documentation specialist. It also covers regulatory and financial topics, including Recovery Audit Contractors (RAC) and Pay for Performance.
“ … although the idealized model is not likely to be fully implemented, it provides a standard by which to measure and shape health care reform in the US. The work is somewhat distinctive in the recent flood of books dealing with health care reform in that the author is not a health care specialist but a systems analyst.” —C.L. Kammer, The College of Wooster, CHOICE, Vol. 47, No. 11, Aug. 2010
Award-winning author Roth solicits the contributions of health workers from around the globe to examine the mire of technical quality and inefficient delivery that has become the U.S. healthcare system. He looks at various challenges, discussing how these are dealt with by 12 nations, all of which, according to the WHO, rank higher than the U.S. in terms of services provided. Roth draws from the best to design an idealized model for healthcare that would fit this country's unique requirements. Researched and referenced to satisfy policy professionals and administrators, the book is written to engage all stakeholders with a fresh understanding of what is valuable and viable. • Provides the information in an easy-to-read format that doesn't bury readers in statistical data • Offers a comprehensive model for U.S. healthcare rather than just one or several pieces of such a model • Addresses the major problems of the current U.S. healthcare system including cost, competition, lack of access, variances in quality of care, lack of adequate communication and access to information, and lack of a preventative focus • Explores the major problems associated with universal healthcare systems Catalog no. K11453, January 2010, 174 pp. ISBN: 978-1-4398-2955-4, $49.95 / £31.99
Catalog no. K10656, January 2010, 136 pp. ISBN: 978-1-4398-1292-1, $59.95 / £38.99
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Process Improvement Lean Hospitals Improving Quality, Patient Safety, and Employee Satisfaction Mark Graban Senior Fellow at the Lean Enterprise Institute
“The concepts outlined in this book are the most powerful tools that I have ever encountered to foster innovation, ownership, and accountability at the frontline staff level. … a must-read for any leader in today’s increasingly complex healthcare industry.” —Brett Lee, PhD, FACHE, Vice President, Children’s Medical Center Dallas
“… lays out the nuts and bolts of the Lean methodology … I wish I could have read this book six years ago, as it might have prevented some of the mistakes we made in our Lean transformation journey.” —John S. Toussaint, MD, President/CEO ThedaCare Center for Healthcare Value
“Finally! The healthcare industry has needed this book for many years. Informative, understandable, and timely…” —Jim Adams, Senior Director, Laboratory Operations, Children’s Medical Center, Dallas
“… should definitely be on the reading list for those who want to bring the benefits of Lean thinking to healthcare.” —David Mann, manager, Lean Management + O.D, Steelcase, Inc., author of Creating a Lean Culture
“…a welcome translation of the Toyota Production System into language any healthcare professional can understand.” —Jeffrey K. Liker, author of The Toyota Way
The Pittsburgh Way to Efficient Healthcare Improving Patient Care Using Toyota Based Methods Naida Grunden Naida Grunden, L.L.C. - Medical Communications, Bellingham, Washington, USA
"Every person who cares about modernizing health in America should read this book." —Newt Gingrich, Former House Speaker & Founder of the Center for Health Transformation
"This book reports how managers—without more money or federal action—can use Toyota management principles to create an environment where it is difficult to make a mistake and people can take joy in work and deliver better and better patient care." —Clare Crawford-Mason, co-author, The Nun and the Bureaucrat and Thinking About Quality
“… chock full of pearls, useful tools, and inspiring stories of people and organizations who made quality improvement concepts and principles spring to life.” —Robert M. Wachter, MD, Department of Medicine, University of California, San Francisco, USA
“I love this book! Like the Toyota Production System on which these case study improvements were founded, it is clear, concise and visual…” —Cindy Jimmerson, President, Lean Healthcare West
“What exactly is ‘workflow re-design’? Can it really make the health care experience safer and more effective, efficient, and rewarding for patients and providers? Ms. Grunden answers these questions through dozens of fascinating examples which really happened in Pittsburgh’s hospitals …”
Winner of a 2009 Shingo Research and Professional Publication Prize, this book has received universal acclaim from industry insiders as well as reform advocates. Drawing on his years of working with hospitals, Graban explains how Lean can help to improve safety, quality, and efficiency in a healthcare setting. He explains how Lean manufacturing staples such as value stream mapping and process observation can help hospital personnel identify and eliminate waste in their processes. The book includes access to an accompanying website with additional information.
This critically acclaimed book provides a look at how Toyota’s concept of Lean manufacturing can be applied to make healthcare safer, more effective, and less costly. It is a compilation of case studies from units in different hospitals around the Pittsburgh region that successfully applied industrial principles to the benefit of their patients and employees.
Catalog no. PP3805, 2009, 280 pp., Soft Cover ISBN: 978-1-4200-8380-4, $47.95 / £29.99
Catalog no. PP7367, 2008, 224 pp. ISBN: 978-1-56327-367-4, $41.95 / £26.99
—Christopher Guadagnino, Managing Editor, Physician’s News Digest
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Process Improvement Value Stream Mapping for Healthcare Made Easy Cindy Jimmerson Lean Healthcare West, Missoula, Montana, USA
“The selection of case studies reflects the range of common problems across the whole healthcare system. A must read for all." — Lesley Wright, Director of Diagnostics, NHS Improvement
"Jimmerson has demystified the value stream map and made it an actionable tool for all!" — Mimi Falbo, Mimi Falbo LLC
"I would highly recommend this book to anyone desiring to genuinely adopt the Toyota approach to the healthcare industry and to do so with confidence. This is the real deal."
A3 Problem Solving for Healthcare A Practical Method for Eliminating Waste Cindy Jimmerson Lean Healthcare West, Missoula, Montana, USA
"Having a source book to teach continuous change and illustrate waste reduction based on the Toyota Production System to busy healthcare practitioners has been sorely lacking until now. I have used the A3 in my hospital and it works! … The illustrations are superb and I loved all the practical examples. Great work Cindy!" —James Nesbitt, MD, MMM, Project Manager, Providence Alaska Medical Center
"I thoroughly recommend it."
— Ken Pilone, President, Sterling Methods Consulting Group, LLC
—Professor Peter Hines, Director, Lean Enterprise Research Centre, Cardiff University
"This is an outstanding book, the best one available on value stream mapping. Cindy Jimmerson is a remarkable teacher and a pioneer in Lean thinking. Her visual organization in this book (and her book on A3 problem solving) make VSM immediately accessible and useful."
"Doing more, better, faster, and with less is our new reality. Cindy, because of her curiosity, creativity and clinical acumen, demonstrates that solutions originating outside of our healthcare enterprise can realize (previously) unrealized results."
— Shaun Sullivan, MD, Partner, Bellingham Anesthesia Associates, and Anesthesia Medical Director, Skagit Valley Hospital
“Cindy is a remarkable teacher and this book captures the essence of her teaching on the effective use of value stream mapping in health care." — John Salyer RRT-NPS, MBA, FAARC, Author of Managing the Respiratory Care Department, Director Respiratory Therapy Services, Seattle Children's Hospital and Research Institute
Introducing readers to the simple but essential Value Stream Map (VSM), this book offers an accessible introduction to this proven high-level view tool that can be used in every aspect of healthcare. It illustrates the simplicity and completeness of the tool and describes its applications to staff communication, regulatory documentation, and activities of daily work. The book also highlights simple to use data collection and interpretation as part of the VSM process. Catalog no. PP7852, January 2010, 119 pp. Soft Cover, ISBN: 978-1-4200-7852-7 $54.95 / £34.99
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—Kathy Okland, RN, MPH, Clinical Applications Consultant, Herman Miller Healthcare
"The book gives a great view of how The Toyota Production System can be applied to Healthcare all over the world. … written by a clinician for clinicians … the book we have been waiting for." —Inge Holck, General Manager, Lean Healthcare Europe
Written by an expert in Lean principles, this book offers an easy-to-use problem-solving method that can be applied to improve processes in every aspect of healthcare. Illustrated with numerous A3s in various stages of development, this easy-touse workbook explains how to extend the VSM philosophy to a more focused perspective. The book explores the value of the A3 problem-solving tool in healthcare—demonstrating the simplicity and completeness of the tool in applications ranging from regulatory documentation to daily work activities. Catalog no. PP7358, 2007, 176 pp., Soft Cover ISBN: 978-1-56327-358-2, $57.95 / £36.99
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Process Improvement
5S for Healthcare J. Michael Rona Consulting Group LLC Bellevue, Washington, USA
While there are a growing number of books based on the Toyota Production System, or Lean, focused on healthcare, there are very few that detail the tools that make Lean more than just a way of thinking and put the methodology into practice. Based on Hiroyuki Hirano's classic 5 Pillars of the Visual Workplace and modeled after the Shingo Prize-winning Shopfloor Series for Lean Manufacturers, 5S for Healthcare adopts a proven reader-friendly format to impart all the information needed to understand and implement this essential lean methodology. It provides examples and cased studies based on the experiences of the principals involved with the Rona Consulting Group, who were responsible for the groundbreaking implementation of the Toyota Production System at the Virginia Mason Medical Center. • Encourages efficiency and patient care while promoting a safe working environment • Contains innovative features designed to improve understanding and assist implementation such as margin assists and key terms • Includes practical examples and how-to-steps proven to work in the healthcare industry Written to readily assist with hands-on implementation efforts, this volume offers innovative features designed to improve understanding and support application. This includes helpful how-tosteps and practical examples taken directly from the healthcare industry.
Optimizing Emergency Department Throughput Operations Management Solutions for Health Care Decision Makers John M. Shiver and David Eitel " … Shiver gives the healthcare manager the tools they need to enhance the function of the Emergency Department, the ‘front door’ of every community’s health care system. The text is clear, concise and understandable to those lacking a technical background but who still want to apply fairly sophisticated techniques to improving the patient experience and the productivity of ED staff." — J. Knox Singleton, President and CEO, Inova Health System
"… a breakthrough in creating a framework for ED transformation. … uses state-of-the-art improvement techniques to solve problems bedeviling America: crowding and delays in critical treatment. Shiver and Eitel offer clear, practical approaches that leaders can use to get results." — Bruce Siegel MD MPH, Director, Center for Health Care Quality, Department of Health Policy
"… provides a needed introduction to the science of reengineering your health care delivery system. The authors build on decades of experience together with proven models from the literature that will help you move your organization forward, while improving patient and staff satisfaction." — Christopher MB Fernandes, Professor of Emergency Medicine, University of Western Ontario
Getting Started. Introduction. The First Pillar: Sort. The Second Pillar: Set In Order. The Third Pillar: Shine. The Fourth Pillar: Standardize. The Fifth Pillar: Sustain. Reflections and Conclusions.
This landmark book explores the relationships of individual stakeholders and illustrates how information technology can play an important role in improving the performance of the ED. It explains how to improve financial performance, specialty services, and billing and collections functions. Because there are so many unpredictable elements related to the emergency room environment, this text explains how to predict patient volumes, flow, and space needs, using historical data to best plan for the unknowns.
Catalog no. K10196, January 2010, 120 pp. Soft Cover, ISBN: 978-1-4398-0350-9 $28.95 / £18.99
Catalog no. PP3775, January 2010, 260 pp. Soft Cover, ISBN: 978-1-4200-8377-4 $69.95 / £44.99
Contents:
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Process Improvement Paradox and Imperatives in Health Care How Efficiency, Effectiveness, and E-Transformation Can Conquer Waste and Optimize Quality Jeffrey C. Bauer, PhD Futures Practice, ACS Health Care Solutions, Chicago, Illinois, USA
Mark Hagland Chicago, Illinois, USA
“… a masterful job of discussing practical approaches to achieving material gains in health care provider effectiveness and efficiency through e-health technologies and disciplined process change. … a superb book.” —John Glaser, Vice President and Chief Information Officer, Partners HealthCare, Boston, Massachusetts
“… the right combination of empirical research, rigorous methods, and analytical thinking … real-world solutions to control costs and improve quality...” —Helen Darling, President, National Business Group on Health, Washington, DC
“... puts the health care industry’s biggest challenges into a fresh and useful perspective. ... Through numerous case studies, the authors show how successful health care organizations are using performance-improvement tools to produce topquality services as inexpensively as possible.” —QualityDigest, Vol. 28, Issue 2
In this critically acclaimed collaboration, awardwinning authors, Bauer and Hagland, explain why providers must draw upon internal resources to increase net revenue and provide the quality of care that payers and consumers demand. Through numerous case studies, the authors show how pioneering health care organizations are using performance improvement tools—including Lean management, Six Sigma, and the Toyota Production System—to produce excellent services as inexpensively as possible. This book challenges health care leaders to change their status quo mentality and to put their organizations on a positive path.
Transformative Quality The Emerging Revolution in Health Care Performance Mark Hagland Chicago, Illinois, USA
“… provides the how-to details for health care executives who are ready to lead meaningful supply-side responses to the growing demand for safe and error-free medical services. … shows how theory has been put into practice by some of the best delivery organizations in the world.” —Jeffrey C. Bauer, PhD, Partner, Futures Practice, Affiliated Computer Services Healthcare Solutions, Chicago, USA
Always interesting and informed, national awardwinning journalist Mark Hagland demonstrates how pioneering organizations are combining new tools with a new way of thinking to reinvent the way we deliver health care services in this country. Through exceptionally well-documented case studies, this insightful volume — • Puts the current journey towards industry-wide quality transformation into an understandable context • Explores how performance improvement methodologies borrowed from other industries, including Six Sigma, Lean management, and the Toyota Production System are transforming care delivery processes • Examines the strategic role that information technology will play in the transformation of clinical care quality and patient safety The case studies contained in this book document the surprising strides being made by pioneering hospitals and health systems, advances that have the potential to transform the delivery of health care in the United States. Offered in a context that frames the current state of health care quality in this country, they are indispensable reading for anyone working in the trenches to improve that quality. Catalog no. PP8492, 2009, 174 pp. ISBN: 978-1-4200-8492-4, $52.95 / £33.99
Catalog no. PP7379, 2008, 192 pp. ISBN: 978-1-56327-379-7, $41.95 / £26.99
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Financial Management & Leadership Health Care Will Not Reform Itself A User's Guide to Refocusing and Reforming American Health Care
Workplace Clinics and Employer Managed Healthcare
George C. Halvorson
A Catalyst for Cost Savings and Improved Productivity
President and CEO, Kaiser Permanente, Oakland, California, USA
A. Michael La Penna
"… takes complex problems and makes them understandable. Halvorson’s experience as leader of one of the world’s largest and most successful implementations of health information technology makes his insights into that subject particularly valuable."
"… outlines the many aspects of how to think about an on-site program and how to implement one … a valuable reference … ."
—Dr. Alain C. Enthoven, PhD Marriner S. Eccles Professor of Public and Private Management, Stanford University
"… offers a timely and compelling prescription to addressing the chronic ills of our health care system … ." —Tom Daschle, Former U.S. Senate Majority Leader
"George Halvorson, CEO of the nation’s largest health care delivery system, says reducing costs while expanding coverage not only should be done, but can be done, and tells us how … " —Dr. James Robinson, Professor of Health Economics, UC Berkeley
With detail that might shock you, George C. Halvorson shows why the nonsystem we now use is failing. Then, applying the same sensible leadership that makes Kaiser the most progressive health care organization in the world, he answers President Obama’s mandate for reform with a profound incentive-based, system-supported, goalfocused, care-improvement plan. Halvorson draws from respected studies and the examples of successful systems across the world to show that while good health care is expensive, it is nowhere near as costly as bad health care. While this book offers sage advice to policy makers, it’s also written to educate the 260 million stakeholders and invite their participation in the debate that is now shaping. What makes this plan so easy to understand is that it never strays from a profound truth: that the best health system is one that actually focuses on good health for everyone. *All royalties from the sale of this book go to Oakland Community Voices: Healthcare for the Underserved.
Catalog no. K10830, 2009, 184 pp. ISBN: 978-1-4398-1614-1, $29.95 / £19.99
The La Penna Group, Grand Rapids, Michigan, USA
—Ford Brewer, M.D., Medical Director, Toyota Motor Manufacturing of North America
The advent of organizations considering an on-site approach to the delivery of healthcare services increases in direct proportion to the rising of healthcare costs. This volume is a how-to manual on the design and implementation of an on-site program—presenting the challenges and benefits of such a system. Topics discussed include hospital and specialty contracting; employee choice concerns; cost-control; ancillary services; workers compensation issues; benefits consultants; and quality vs. value analysis. • Reviews the benefits and challenges of on-site healthcare • Includes a case study that follows the implementation of a program from inception to introduction • Helps readers determine if on-site healthcare is appropriate for their organization • Defines the terms and phases of employer healthcare purchasing and implementation Contents Abridged: Workplace On-Site Healthcare as a Catalyst for Cost Savings and Improved Productivity. Company Planning for Healthcare and Employees’ Participation. The Myth of the Company Doctor. Components and Complements to On-Site Healthcare. The On-Site Program: What and Who Are In and Out? Why? Cost Savings, Cost Avoidance, and Confidence Levels... Catalog no. PP2448, January 2010, 278 pp. Soft Cover, ISBN: 978-1-4200-9244-8 $54.95 / £34.99
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Financial Management & Leadership Governance for Health Care Providers
Healthcare Transformation
The Call to Leadership
A Guide for the Hospital Board Member
Edited by
Maulik S. Joshi
David B. Nash & Valerie P. Pracilio
Network for Regional Healthcare Improvement, Easton, Maryland, USA
Jefferson Medical College, Philadelphia, Pennsylvania, USA
Bernard J. Horak Health Systems Administration Programs, Georgetown University, Washington DC, USA
William J. Oetgen Georgetown University, Washington D.C., USA
"… will guide trustees down the road to more fully accept the responsibility for the mission of the corporations they lead." —Michael D. Connelly, MA, JD, FACHE, President and CEO, Catholic Healthcare Partners
"… the definitive guide for the physician board member as well as any leader who has made the leap to govern an organization … well-written and concise … essential reading for all physicians who are about to embark on the journey of governance. I for sure will recommend this book to the physicians on my hospital board." —ACMQ Focus
Written by leading health care advocates and authorities, this volume provides a readily accessible resource that defines the functions of board members—summarizing the problems they are likely to face. This accessible and well-organized resource includes coverage of finance, compliance, funding, strategic planning, legal duties, quality, conflicts of interest, corporate structure, and governance best practices.
“… presents the ten major transformers for healthcare in the first part of the twenty-first century and how boards can understand and use them to transform their own organizations. … this book makes an important and invaluable contribution to elevating board performance in quality and safety.” —John R. Combes, MD, President and Chief Operating Officer, Center for Healthcare Governance
"The safety and quality of the care delivered in a hospital is the number one responsibility of each and every Board member … . This important book provides hospital leaders and Boards key information for that dialogue." — Diane C. Pinakiewicz, MBA, President, National Patient Safety Foundation
"This book is a ‘must-read’ resource for Hospital Management Teams and Board members. The content is supported by extensive knowledge and practical current experience of the authors." — Alexander (Rusty) Sloan, MD, MACP, Lt. General, USAF, Retired
Non-profit Organizations. Duties and Responsibilities of Directors. Quality of Care. Professionals Affairs. Finance. Auditing, Compliance, and Reporting. Legal Issues. Executive Compensation. Philanthropy. Strategic Planning. Governance. Future of Health Care Boards.
This concise manual provides hospital board members and executives with practical guidance on how to become actively engaged in the transformation of their organization. Ideal for orienting new board members and for providing more experienced members with insight on key issues, it supplies a list of questions to ask stakeholders that will facilitate engagement. Each chapter is organized around action steps referred to as Top Healthcare Transformers—designed to disseminate best practices, build organizational quality, establish transparency, and develop the culture and leadership needed to facilitate intelligent and progressive change. The final chapter provides an overall governance engagement checklist that details the things to do to ensure board members and senior colleagues are prepared to lead the transformation.
Catalog no. PP7853, 2009, 344 pp. ISBN: 978-1-4200-7853-4, $83.95 / £52.99
Catalog no. K10283, 2009, 128 pp., Soft Cover ISBN: 978-1-4398-0506-0, $39.95 / £24.99
• Provides essential information on the most important issues confronting nonprofit boards • Fills a major gap in the education of health care professionals • Considers the future role of health care boards Contents:
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Financial Management & Leadership Healthcare Delivery in the U.S.A. An Introduction Margaret F. Schulte, DBA Grand Valley State University, Grand Rapids, Michigan, USA
“This brief but remarkable book is balanced in its consideration of the history and scope of health care in the U.S. ...” —D.R. Shanklin, University of Chicago, CHOICE, Vol. 47, No. 09, May 2010
“… helpful for those early in their careers or transitioning in from other industries to help improve quality … . I certainly wish I had this guide when I was starting in healthcare. —Mark Graban, Senior Lean Consultant, ValuMetrix Services, Ortho Clinical Diagnostics, Inc., Author of Lean Hospitals
“… the resource that outsiders need to join the conversation … . The more non-health professionals who read this book, the sooner we’ll see efficiency and effectiveness in medical care.” —Jeff Bauer, Ph.D., Management Consulting Partner and Director of the Futures Practice, Affiliated Computer Services Healthcare Solutions
“In easy-to-understand terms, Dr. Schulte lays out the components of the healthcare system so those of us who enter can be oriented to the terms and to the various entities we will be encountering.” —Dean Bliss, Lean Improvement Specialist, Iowa Health System
“Dr. Schulte’s book is ‘Healthcare 101’ for any sales professional striving to understand the healthcare industry.” —Linda Ewing, Regional Sales Director, Amcom Software
An ideal guide for those new to healthcare, this popular reference provides the understanding required to navigate the business of medicine. For those working in hospitals or as vendors and manufacturers, it supplies an orientation to the broader healthcare work environment. The author, editor of the American College of Health Executive’s Frontiers in Health Services Management, confronts challenges facing the industry as a whole, including finance, legal, regulatory, and workforce issues. Catalog no. PP8493, January 2010, 144 pp. Soft Cover, ISBN: 978-1-4200-8493-1 $49.95 / £25.99
Statistical Analysis for Decision Makers in Healthcare Second Edition, Understanding and Evaluating Critical Information in Changing Times Jeffrey C. Bauer Futures Practice, ACS Health Care Solutions, Chicago, Illinois, USA
All segments of healthcare rely on data provided by insurance companies, consultants, research firms, and the federal government to help make a host of decisions regarding the delivery of medical services. Statistical Analysis for Decision Makers in Healthcare, Second Edition explains the fundamental concepts of statistics, along with common uses and misuses. Without jargon or mathematical formulas, renowned healthcare expert, Jeff Bauer, presents a clear explanation of what statistics really do. He provides a practical discussion of scientific methods and data to show why statistics should never be allowed to compensate for bad science or bad data. Relying on real-world examples, Dr. Bauer stresses a conceptual understanding that empowers readers to apply a scientifically rigorous approach to the evaluation of data. With the tools he supplies, you will learn how to dismantle statistical evidence that goes against common sense. Easy to understand and practical, this is the book you wish you had when you took statistics in college — and the one you’ll be glad to have to defend yourself against the abundance of misinformation that could corrupt your decisions. Contents: The Scientific Foundations of Statistical Analysis. Scientific Method: The language of statistical studies. Experimental design: the foundation of statistical conclusions. The Fundamental Importance of Data. Numbers Good and Bad: How to judge the quality of data. Samples and Surveys: How numbers should be collected. The Different Types of Statistics. Descriptive Statistics: The foundation of comparisons. Inferential Statistics: Studies of differences. Relational Statistics: Studies of relationships. Explanatory Statistics: Studies of causality. Postscript: Statistics in Perspective. Catalog no. K10061, 2009, 160 pp., Soft Cover ISBN: 978-1-4398-0076-8, $49.95 / £30.99
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Financial Management & Leadership The Managed Care Contracting Handbook
Consumer Directed Health Care
Second Edition, Planning and Negotiating the Managed Care Relationship
A 360 Degree View
Maria K. Todd
“… a great job of explaining and analyzing complex health insurance issues … successfully challenges the widespread belief – dear to many employers, insurers and consultants – that the best way to fix the system is to have consumers pay a bigger share of the costs …. Everyone who wants to participate in the debate about health care reform should read his prescriptions for the future.”
HealthPro Consulting, Inc., The Healthcare Reimbursement Institute
"... a must have book for the non-attorney health care professional negotiating managed care contracts for providers. Dr. Todd combines a thorough discussion of managed care contracting basics with helpful hints and practical tools for contracting with all types of payor organizations ..." —Ellen E. Stewart, MSHA, JD, FHFMA, Berenbaum, Weinshienk & Eason P.C., Denver, Colorado
"Many organizations struggle to optimize their managed care strategies to achieve operational and financial success. Maria Todd's new book could be the missing keystone to achieve that success. … a must-read for every hospital executive involved in the managed care process - clinical and financial leaders alike. … should be used as a key part of any healthcare provider's managed care strategy." —David Hammer, MBA, MHS, FHFMA, CHFP, Vice President, Revenue Cycle Solutions McKESSON Provider Technologies
Demystifying the contracting process, the second edition of this unique work is an essential resource for venders involved with the delivery of managed care services. This edition provides an updated look at this rapidly evolving area. It offers an indepth look at managed care and its organizations as a foundation for contracting strategies and covers key issues such as consumer driven health plans, pay for performance initiatives, and contract negotiations. Written by seasoned professional in managed care contracting, it offers a comprehensive layman’s evaluation of a typical managed care agreement, as well as sample contracts and important checklists. Catalog no. PP7369, 2009, 300 pp. ISBN: 978-1-56327-369-8, $79.95 / £48.99
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Kim D. Slocum KDS Consulting LLC, West Chester, Pennsylvania, USA
—Humphrey Taylor, Chairman, The Harris Poll
“… gets to the heart of consumer-directed healthcare, takes a biopsy, and makes a quick and accurate diagnosis. I wish everyone inside the Beltway would read Slocum’s new book!” —David B. Nash, MD, MBA, Department Chair of Health Policy, Jefferson Medical College, Philadelphia, Pennsylvania, USA
“… a top-notch synthesis of credible research on health care in the United States. … a call to action for persons in policy and leadership positions in and out of health care …” —Margaret F. Schulte, DBA, FACHE, Editor, Frontiers of Health Services Management
With three decades of experience in a variety of healthcare, pharmaceutical, and biotechnology firms, respected healthcare consultant, Kim Slocum provides a broad perspective of the U.S. healthcare crisis. He discusses how the system has evolved and debunks various myths. Exploring potential solutions, the book balances many diverse and conflicting factors, including the movement to make healthcare more patient-centered and the growing trend to transfer significant portions of financial risk to patients via highdeductibles. The final section of the text explains what a successful consumer-directed system looks like and the steps needed to make it happen. Catalog no. PP7391, 2009, 160 pp., Soft Cover ISBN: 978-1-56327-391-9, $57.95 / £36.99
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Financial Management & Leadership Healthcare Payment Systems An Introduction Edited by
Duane C. Abbey Abbey & Abbey Consultants, Inc., Ames, Iowa, USA
The numerous payment systems that medical practitioners must access, with their varied procedures and multitude of medical codes, can make these systems difficult to manage. However, with the right knowledge and the right approach, you can turn a system that controls you into one that you control. Healthcare Payment Systems: An Introduction provides a complete introduction to healthcare payment systems. Written by Dr. Duane Abbey, one of the nation’s leading experts and most sought out consultants in payment systems, this volume makes the monumental task of medical reimbursement approachable and manageable. Covering the fundamentals and terminology needed to understand this discipline, he supplies the insight and strategies needed to master it. • Highlights the differences between healthcare payment systems • Shows you the best ways to categorize specific third-party payer requirements • Explains what you need to know about Medicare’s use of different payment systems • Provides the understanding needed to negotiate better contracts This self-contained guide provides an overview and discussion of topics that one must understand to optimize usage of various systems. Ultimately, it will help you begin to develop the solid core of skills and knowledge needed to confidently manage these systems for improved revenue cycles and higher levels of profitability. Contents: Healthcare Providers. Types of Healthcare Payment Systems. Healthcare Provider Organizational Structuring. Revenue Cycle versus Reimbursement Cycle. Claims Generation and Adjudication. HIPAA Administrative Simplification. Compliance. Research, Problem Solving, and Knowledge Base Development. Case Study Listing. Acronym Listing.
Compliance for Coding, Billing & Reimbursement Second Edition, A Systematic Approach to Developing a Comprehensive Program Duane C. Abbey Abbey & Abbey Consultants, Inc., Ames, Iowa, USA
Includes a CD Packed with Regulations and Information Compliance for Coding, Billing & Reimbursement, Second Edition provides an organized way to deal with the complex coding, billing, and reimbursement (CBR) processes. Revised to account for recent changes and evolving terminology, this accessible resource covers statutorily based programs and contract-based relationships, as well as ways to efficiently handle those situations that do not involve formal relationships. Based on 25 years of direct client consultation and drawing on teaching techniques developed in successful workshops, Dr. Duane Abbey offers a logical approach to CBR compliance. Designed to facilitate efficient reimbursements that don’t run afoul of laws and regulations, this resource – • Addresses the seven key elements promulgated by the OIG for any compliance program • Discusses numerous types of compliance issues for all type of healthcare providers • Offers access to online resources that provide continually updated information • Cuts through the morass of terminology and acronyms with a comprehensive glossary In addition to offering salient information illustrated by case studies, Dr. Abbey provides healthcare providers and administrators, as well as consultants and attorneys, with the mindset and attitude required to meet this very real challenge with savvy, humor, and perseverance. Catalog no. PP7368, 2008, 232 pp., Soft Cover ISBN: 978-1-56327-368-1, $78.95 / £49.99
Catalog no. PP9277, 2009, 172 pp., Soft Cover ISBN: 978-1-4200-9277-6, $44.95 / £27.99
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Financial Management & Leadership Discharge Planning Handbook for Healthcare
Pursuing Excellence in Healthcare
Top 10 Secrets to Unlocking a New Revenue Pipeline
Preserving America's Academic Medical Centers
Ali Birjandi
Arthur M. Feldman
Operational Performance Improvement, ProMedica Health System, Toledo, Ohio, USA
Jefferson Medical College, Philadelphia, PA, USA
Lisa M. Bragg Waterville, Ohio, USA
Hidden opportunities to improve profits in the healthcare industry abound in the area of discharge planning. The Discharge Planning Handbook for Healthcare: Top Ten Secrets to Unlocking a New Revenue Pipeline provides innovative new solutions that will show hospital administrators how to turn one of the most antiquated aspects of healthcare into one of the most productive. The performance-improvement concepts and approaches discussed in this volume balance all aspects of existing business models and provide a new approach to managing the discharge planning process. Management engineer and Six Sigma Black Belt Ali Birjandi and registered nurse and administrative director Lisa M. Bragg employ innovative solutions to help readers: • Redefine the concept of discharge planning • Assign the proper metrics • Implement the COS-Q snapshot • Employ Lean concepts in redesign • Apply a practical approach to improvement • Create a culture that produces results An extended case study invites managers and administrators to take an interactive approach to the learning and application of these concepts. A spreadsheet tool is included to help readers stay on task in their quest to improve efficiency and quality of care. The approach and methods taught in this book have led to dramatic results in a number of institutions. When adopted by your organization, they can help you improve performance and boost revenue. Catalog no. PP7392, 2009, 208 pp., Soft Cover ISBN: 978-1-56327-392-6, $62.95 / £40.99
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"… a terrific resource for anyone interested in understanding the indispensable role of the academic health center. ... A book all health care leaders should read and then read again." —Michael M.E. Johns, MD, Chancellor, Emory University
“Scientist, scholar, educator, entrepreneur, and, especially, clinician, Dr. Feldman has given us a provocative and passionate insider’s view. It arrives just in time to stimulate our thinking at this moment of great opportunity." —Andrew L. Epstein, MD, Managing Director, Navigant Consulting, Inc.
"… I recommend it for anyone who wants to know about the elements that have shaped and continue to influence the structure and functioning of academic medical centers in the United States." —Paul K. Whelton, MB, MD. M.Sc., President and CEO, Loyola University Health System, Loyola University Medical Center
"… a landmark work, documenting the plight of the U.S. academic medical center (AMC), highlighting its importance, and charting a course for securing its successful future." —Marvin A. Konstam, MD, Chief Physician Executive, The CardioVascular Center, Tufts Medical Center
For over 100 years, academic medical centers (AMCs) have been the bastion of medicine. Delineating the issues that have lead to the current crisis in AMCs, this book provides a radically different model for achieving success. The model presents four intersecting spheres of action, each of which is necessary but none of which can stand alone. The book presents an in depth analysis of the issues and challenges facing AMCs and offers recommendations for delivering outstanding patient care. Catalog no. K10852, January 2010, 336 pp. ISBN: 978-1-4398-1657-8, $49.95 / £31.99
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For those who are tired of just talking about health care reform Adopting the principles and practices of the Toyota Production System, Virginia Mason has moved from the red into the black while improving on all measures of patient care.
e3 pag See At the newly improved Virginia Mason Medical Center:
• Nurses now spend 90 percent of their time in direct patient care • Liability insurance costs have dropped by over a third • Rates of central line infections, injurious falls, and surgical site infections are now some of the lowest anywhere • Profits are strong enough that all staff receive bonuses While the journey is not an easy one, it is possible for any medical facility to transition itself to one that delivers superb medical care while at the same time controlling costs. And more and more are coming to Virginia Mason to find out how…
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