Hospital Operations: Principles of High Efficiency Health Care, CourseSmart eTextbook

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 and metrics to substantially improve any hospital's operational, clinical, and financial performance. Replete with examples, Hospital Operations shows how to diagram and optimize hospital flows and trace interconnections, and offers 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 stakeholders' perspectives
• Improving bed availability, optimizing nurse schedules, and creating seamless patient handoffs
• Reducing lab turnaround time, improving imaging responsiveness, and decreasing lab errors

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

Index    595