Want to Make Tremendous Gains at Your Healthcare Site? Use Process Mapping! | healthcare

I want to tell you some ways to eliminate waste at your medical site. Am I talking
about physical waste, like soiled bandages or used needles? No, I mean any action
that results in a poor or unintended outcome. I mean taking too long to accomplish
some outcome, like taking too long to get an operating room ready for the next
surgery. The National Institute of Health in “Crossing the Quality Chasm” stated
that any waiting time for a patient is a waste. A patient waiting past the time of his/
her scheduled appointment is an example. A patient having to wait too long to be
admitted to a hospital after being seen in the emergency room is an example of
poor processes–a waste. A patient who develops an infection after being treated or
going through surgery is a good example of waste from unintended outcomes.
These are just a few examples. I am sure that you are aware of many more.Japanese manufacturers are leaders in eliminating waste. One trick they use is to
send a new employee to the manufacturing floor and have him/her watch someone
performing a task; the new employee is told to watch until he/she sees a better way
to do the job. These manufacturers know that the time spent doing this will save
more time and money in due time. Hospitals and healthcare sites are not
manufacturing plants, though. Yet many of the same principals can be applied. The
effort will more than pay for itself. In fact, savings of 3 to 100 times the investment
is not unusual. The movement going on in the healthcare field adapted from the
Japanese manufacturers is commonly called “lean healthcare.” Perhaps you have
heard of some of the terms associated with it, like Kaisen events or poka-yoke. You
don’t have to be a master of these tools and terms to make good use of them,
though. Many are just applying logic with common sense.The tools are best applied in efficient working teams or groups where some
problems with processes or outcomes are already agreed upon. If the working
group is larger than 3 or 4 people I suggest that one tool you use are string and 3
by 5 cards. You are going to use these to map out a process from beginning to end
and see if the group can find waste and suggest ways to eliminate it. Use the cards
to describe what physically happens during a process and use the string to connect
the activities that flow from one to another. For example, you might want to track a
patient in a doctor’s office coming in for a physical. The first card would represent
the patient’s encounter with the first staff person who records the patient’s
presence. From there, strings would indicate communicating with other pertinent
personnel of the patient’s presence and the ensuing events as well a string and card
that would indicate the patient waiting in the waiting room. In all of these mappings
you should be thinking of what you would like to use as variables to measure. You
certainly should be measuring time by all involved parties. You might also want to
count the number of successes/failures in communications. Many unintended
consequences occur at transition points and handoff points due to poor
communication. You might count if a supply was missing and someone had to
scurry to find another one. You will want to later find the mean and standard
deviations of these measures. The goal is achieve a target mean with as small as
possible standard deviation. For example, you should have 0 as a target for the
number of times a supply was missing.After reaching a mapping that all agree represents as best as possible the present
flow of events, the group should brain storm ways to improve the flow. The goal is
to find a significantly better path. If a consensus is reached, fine; implement it. If
not, then perhaps you will want to try the various ways and then decide which is
best, based upon agreed upon measures of outcomes.Once an optimized process is developed by the staff, you should write it down.
Make it a standard operating procedure and try to have all involved parties adopt it.
You might want to allow a little bit of wiggle room for individual differences in
performing a task; the goal of a common target with small standard deviation
should the goal of all, though.Another tool to use is open communication. Too often a staff person or nurse will
see some event unfolding that will lead to poor outcomes. If the work environment
is not conducive to positive communication–communication which does not result
in negative outcomes for the reporting individual–mistakes and waste will always
occur that could easily have been prevented. To reach a high level of positive
communication, the leaders at a site must work long and patiently to build trust. It
is not easy to do, but the payoffs are tremendous. Everyone wins!Most healthcare leaders think of quality improvement as applying to activities that
directly involve the patient. However, the best healthcare providers use these tools
and others to evaluate all the processes at a healthcare site. The admissions and
billings departments are ripe targets, for instance. The result will be happier, more
motivated employees who are working more efficiently. In fact, sites which were
experiencing a shortage of staff often finding themselves well staffed because of
quality improvement processes. I do suggest that you promise all employees
involved in these processes that you guarantee there will be no layoffs. Doing so
will produce better outcomes.If you want more examples of system wide applications of quality improvement in
healthcare facilities, I suggest that you go to the Baldrige Award site on the internet
and read the success stories of winners. Their results will amaze you, I promise.I hope that you seriously consider adopting these tools and research other methods.
Many are described at various healthcare sites. Two of my favorites are Institute for
Healthcare Improvement and the American Academy of Family Physicians.

The Key To Starting And Running Your Business | business services

In Brian Sher’s book, What the Rich Know & Desperately Want to Keep Secret, he said “As far as I know, there are only five ways to make money:1. Steal it or cheat others out of theirs-which is risky and undermines your values.2. Inherit it.3. Put what you have in financial investments, which is perfect so long as you have perfect skills- or the right advice- and lots of patience.4. Work for it, which is both honest and noble-but won’t make you rich without leverage.5. Go into business-the most effective way if you do your homework and pick the right business.A well- run business can generate staggering profits and will outperform any other means of gaining wealth.”Running a Business is the Pathway to WealthAccording Sher (business expert), running your own business is the pathway to a world of wealth and riches. It suffices then to say that every wealth seeker must give the idea of running a business a second thought. In J. Paul Getty’s book, How to Be Rich, his first rule is that you must be in business for yourself…. “and to do your own business, and to work with your own hands, as we commanded you.” 1Th 4:11Friend, if you want to be rich, your effort and energy should be going into starting and running your own business. Prosperous people have always known this basic rule of wealth creation. Starting, owning, and running a successful and profitable small business is one of the most exciting things, which give great joy in life.Deciding to go into business for yourself is one of the most important decisions you will make in your life.Andy Warhol once said, “Making money is art and working
is art, and good business is the best art of all,” (The Philosophy of
Andy Warhol, Harcourt, 1975).According to Brian Sher, the foundational key to running a successful business is the ability to pick the right business.Whenever you see a successful and prosperous business, know that someone once made a courageous and right decision.Basically, there are two types of businesses:
1.Product-based businesses- Product or goods. They deal in tangibles.
2. Service-based businesses -Service-based businesses sell time and expertise. They deal in intangibles. Therefore tend to be less expensive to start as there is no inventory to buy.Operate Around Your PassionDeciding on an area that you love is the first step when choosing a business to start. A friend of mine who is the editor of a national news paper here in Nigeria went seeking God’s face concerning what to do with his life. And God simply asked him what he loved doing, to which he said writing. Today he’s become a successful and prosperous person. What is it you love doing? What is your hobby? There is something about your passion that pushes you into success and prosperity.The road to happiness lies in two simple principles: Find
what it is that interests you and that you can do well, and
when you find it, put your whole soul into it-every bit of
energy and ambition and natural ability you have.
-John D. Rockefeller IIIDoing what you love is indeed the first prerequisite when you are choosing the right business. There is a saying that goes, Do what you love, the money will follow. We tend to succeed when we are engaged in something that we really enjoy.Barbara Winter, in her great book, Making a Living Without a Job (Bantam) 1993, says that “passion leads to purpose, that once you get in touch with those things you are most passionate about, you can begin to create a business of purpose around them.”Offer What the People WantDeciding on an area that you love is only the first step when choosing a business to start. The second step is to do a market research to find out if there is a market for the product or service you intend offering.If there are no people willing to pay you for your expertise, people willing to buy the product or service you want to sell, you do not have a business. So be realistic-there must be a market willing to buy what you plan to offer.”We don’t want to push our ideas onto customers; we simply want to make what they want.”-Laura AshleyThe bottom line is to find a business that combines your interests with the ability to make a good living selling your product or service. While hunches and intuition are great, you need some objective criteria before making the leap into the land of entrepreneurshipToo many new entrepreneurs fall in love with their idea and become convinced that it is the greatest thing that has ever happened to humanity. You must strive to be as objective as possible. Be a businessperson.”There is a way which seemeth right unto a man, but the end thereof are the ways of death.” Pro 14:12Whatever business you want to start then, whatever product or service you decide to sell, you have to be able to sell it at a price high enough to make a profit, but low enough that people will buy it.To Your Prosperity

Gardening Information – Choosing Your Perfect Garden | gardening

What is the perfect garden for you?Now that you’ve been thinking of a garden for yourself perhaps your considering what type of garden to create. The choices are unlimited and the kinds of gardens are as varied as the number of gardeners. Yet you will want to think about some basic issues related to making the perfect garden for who you are and your lifestyle.A flower garden will add color and look nice in several areas of your yard. You can choose perennial flowers which will be there next year and the years to come, or you can choose annuals which will need to be replaced every spring with new plants. The benefit of perennials is you only plant once the benefit of annuals is no commitment. Say this is kind of like dating and marriage isn’t it? With annuals you never get stuck with wort’s, start again next spring. Perennials you adjust to habits you may not be happy with, though thankfully you never have to worry about the toilet seat. Ha!You must decide for yourself how much time you want to spend on gardening, if you haven’t gardened before perhaps just do a little as time permits till you get a small garden underway. If you find yourself with more time, energy and desire later start another garden. Next season you will have an idea of how much time and thus how large a garden you can comfortably commit to.As a seasoned gardener you know what kind of gardener you are and what your time commitment is thus you need only decide on how to change this years gardening from what you have done in the past. Perhaps you want to grow a certain kind of plant to blue ribbon status. Tomatoes and Squash in the vegetable garden of certain flowers, roses to see how well you can do concentrating on one or two varieties.Many folks are turning to vegetable gardens to offset the cost of food. It’s appalling to realize that nowadays the “good” food is nearly beyond the financial reach of many people with oranges running as high as $1.69 yesterday where I shopped. If you have the climate you may want to plant a few fruit trees. I have had years of enjoyment from my two, Bing Cherry, cherry trees my favorite summer fruit.Tip: with the demise of the honey bee in our nation, I had to order mason bees and install their nest under the eves of my house closest to the cherries in order to get the blossoms pollinated. You can order them online no problem. Also with trees you need to be able to prune and harvest, I also sprayed my trees for insects such as aphids every year, some considerations for you to think about.A benefit if the vegetable garden is the pay off of course, fresh veggies and oh my, I can just taste that fresh corn on the cob and new potatoes, oh yeah. Though perhaps more time consuming the vegetable garden is so rewarding to work in, talk about a stress reliever. Also it is place for quite conversations with family members something for everyone to do together and I have yet to meet a child or grandchild who is not interested in the garden.I enjoy all aspects of gardening, even the weeding as I think most gardeners do. Not only to deal dirt and fertilizer, choosing a pesticide thinning out excess plants or branches, its all out doors fulfilling because you get to enjoy the results of your labor. Indoor or outdoor a garden can provide comfort and soothing release from stress, a place and time of reflection, a family project.Whatever your reason for gardening you’ve only to decide what you want to plant, how and where to plant it and then, dig in (literally).