The Hospital and Clinic Improvement Handbook Using Lean and the Theory of Constraints for Better Healthcare Delivery

The essential healthcare guide to doing more with existing resources

The healthcare industry faces foundational challenges to how it sustains itself. As the gap between cost and revenue continues to widen, and as cost-effectiveness remains an elusive imperative, the question persists: how can healthcare organizations do more with the same resources?

The Hospital and Clinic Improvement Handbook is a practical guide to how operations management -- in particular Lean and the Theory of Constraints (TOC) -- can rapidly advance value and performance in any healthcare organization. Utilizing a systems approach that will be relevant for healthcare managers and executives, it unpacks and demystifies concepts such as performance measures, operations, quality, cost accounting, pricing, and value enhancement, all as they relate to eliminating waste and non-value-adding activities.

Enriched with dozens of examples and building on the authors' experience teaching and refining these concepts for healthcare, this text is an essential guide for executives and managers across the industry.

Boaz Ronen, PhD, is Professor Emeritus of Healthcare Management and Value Creation at the Coller of School Management, Tel Aviv University.

Joseph S. Pliskin, PhD, is Professor Emeritus of Healthcare Management and Industrial Engineering and Management, Ben-Gurion University of the Negev, and Adjunct Professor of Health Policy and Management, Harvard T.H. Chan School of Public Health.

Shimeon Pass, MBA, MSc, is a management consultant whose work applies the philosophy and tools of the focused-management methodology, Lean, and TOC to the healthcare, technology, service, retail, and non-profit sectors.

Foreword
Donald M. Berwick, M.D.

Preface

1. The Modern Healthcare Environment

2. Principles of Management in the Dynamic Healthcare Environment

3. The Pareto Rule, the Focusing Table, and the Focusing Matrix

4. The Seven Focusing Steps of the Theory of Constraints (TOC)

5. Constraint Management in a Bottleneck Environment

6. Constraint Management under a Market Constraint

7. Focused Current Reality Tree (fCRT)

8. Resolving Managerial Conflicts

9. The "Efficiencies Syndrome"

10. The "Evils" of Long Response Times

11. Reducing Response Times

12. The Complete Kit Concept

13. Performance Measures

14. The Effects of Variability and Uncertainty

15. The Evils of Traditional Cost-Accounting

16. Global Decision Making (GDM)

17. Quality Management and Process Control

18. Creating Value for Healthcare Organizations

19. Implementation and the Process of Ongoing Improvement (POOGI)

20. Success Stories