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By one estimate, the U.S. wastes $480 billion annually on healthcare expenditures that don’t improve care. Worse, because of faulty systems – not personnel – up to 98,000 people die every year due to preventable medical errors – and that doesn’t count non-terminal events such as hospital-acquired infections. In Hospital Operations, two leading operations management experts and four senior physicians demonstrate how to apply new OM advances to substantially improve any hospital’s operational, clinical, and financial performance. Replete with examples, this bookshows how to diagram hospital flows, trace interconnections, and optimize flows for better performance. Readers will find specific guidance on improving emergency departments, operating rooms, hospital floors, and diagnostic units; and successfully applying metrics. Coverage includes: reducing ER overcrowding and enhancing patient safety…improving OR scheduling, enhancing organizational learning, and responding to surgeons and other stakeholders… improving bed availability, optimizing nurse schedules, and creating more seamless patient handoffs… reducing lab turnaround time, improving imaging responsiveness, and decreasing lab errors…successfully applying the right metrics for every facet of hospital performance. The authors conclude by previewing the "Hospital of the Future," addressing issues ranging from prevention and self-care to the evolution of technology and evidence-based medicine.
1 INTRODUCTION TO HOSPITAL OPERATIONS 1
1.1 Stakeholders’ Perspectives 1
1.2 A Metaphor for Hospital Operations 3
1.3 Health Care in Crisis 4
1.4 A Focus on Practice 7
1.5 The Time Is Now; The Tools Are Known 9
1.6 Principles-Driven Management: Marrying Theory and Practice 13
1.7 The Structure of This Book 15
1.8 References 19
2 EMERGENCY DEPARTMENT 21
2.1 Stakeholders’ Perspectives 21
2.2 Introduction to the ED 29
2.3 Managing the ED 42
2.4 Key Management Issues in the ED 48
2.5 Conclusions 112
2.6 Stakeholders’ Perspectives 113
2.7 References 117
3 NURSING UNITS 127
3.1 Stakeholders’ Perspectives 127
3.2 Introduction to Nursing Units 137
3.3 Managing a Nursing Unit 153
3.4 Key Management Issues in a Nursing Unit 160
3.5 Conclusions 235
3.6 Stakeholders’ Perspectives 236
3.7 References 240
4 OPERATING ROOMS 243
4.1 Stakeholders’ Perspectives 243
4.2 Introduction to the OR 248
4.3 Managing the OR Suite 263
4.4 Key Management Issues in the OR 271
4.5 Conclusions 332
4.6 Stakeholders’ Perspectives 333
4.7 References 336
5 DIAGNOSTIC SERVICES 339
5.1 Stakeholders’ Perspectives 339
5.2 Introduction to the Diagnostic Units 344
5.3 Managing a Diagnostic Unit 370
5.4 Key Management Issues in the Diagnostic Units 376
5.5 Conclusions 449
5.6 Stakeholders’ Perspectives 450
5.7 References 457
6 HOSPITAL OF THE FUTURE 463
6.1 Stakeholders’ Perspectives 463
6.2 Product and Process Integration 466
6.3 Looking to the Future 476
6.4 Management Challenges 481
6.5 Final Message 495
6.6 References 496
Appendix A MANAGEMENT PRINCIPLES 497
Appendix B HISTORICAL JUSTIFICATION FOR AND DEVELOPMENT OF STANDARD BED/POPULATION RATIOS 589
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