Why This Book? x
About the Authors xi
List of Stories, Examples, Exercises, and Case Studies xiii
About the Companion Website xv
Part I The Basics 1
Chapter 1 The Problem with Healthcare 3
Chapter 2 We Need to Improve the Way We Improve 11
Part II The First “R”: The Right Project 21
Chapter 3 The Project Selection Process 23
Chapter 4 Frame Your Challenge: The Problem Statement and Charter 36
Part III The Second “R”: The Right People 45
Chapter 5 Don’t Go at It Alone: Find a Primary Sponsor 47
Chapter 6 Organize Your QI Team and Select the Team Leader 51
Part IV The Third “R”: The Right Problem 61
Chapter 7 What is the Scope of the Project? The SIPOC Diagram 63
Chapter 8 Who Are the “Customers,” and What Do They Need? 68
Chapter 9 Who Are the “Stakeholders,” and What Challenges Do They Have? 81
Part V The Fourth “R”: The Right Cause 87
Chapter 10 To Understand a Process, You Need to “Go See” and Create a Map 89
Chapter 11 Get a Quick Win: Identify and Eliminate “Waste” 109
Chapter 12 Measure What Matters: Choose the Right Project Metrics 124
Chapter 13 Practicalities for Planning and Collecting Baseline Data 137
Chapter 14 Define Baseline Performance: Is the Process “Stable”? 147
Chapter 15 Tools to Characterize the Type of Variation: The Run Chart 176
Chapter 16 Tools to Characterize the Type of Variation: The Control Chart 186
Chapter 17 Define Baseline Performance: Is the Process Capable? 207
Chapter 18 How to Identify and Prioritize the Most Likely Cause of the Problem 222
Chapter 19 Before Proceeding, Confirm the Cause-and-Effect Relationship 242
Part VI The Fifth “R”: The Right Solution 253
Chapter 20 Develop and Prioritize Your Improvement Ideas 255
Chapter 21 Test the Effectiveness of Your Ideas with a Pilot 280
Chapter 22 Improve “Flow” and Work Conditions 288
Chapter 23 Now Roll-Out Your Improvement Ideas and Make Them “Stick” 310
Part VII Additional Things You May Need to Know 331
Chapter 24 How to Prepare and Conduct a Tollgate Review 333
Chapter 25 How to Communicate Effectively to Engage the Frontline 339
Chapter 26 How to Lead an Effective Team Meeting 354
Chapter 27 How to Help Your QI Team Become a High-Performing Team 369
Chapter 28 Steps and Strategies to Effective Decision-Making 393
Chapter 29 What Neurosciences Can Teach Us to Motivate People to Change 403
Chapter 30 How Does it All Fit Together? The MRI Suite at St. Mary’s Hospital 421
Appendix 449
Appendix I Common Improvement Tools and Techniques 451
Appendix II Glossary of Improvement Terms 457
Appendix III Additional Resources 460
Index 463
