Principles Of Healthcare Reimbursement Ebook

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A new edition of the comprehensive and practical introduction to managerial epidemiology and population health

Managerial Epidemiology for Health Care Organizations has introduced the science of epidemiology and population health to students and practitioners in health management and health services for over sixteen years. The book covers epidemiology basics, introducing principles and traditional uses, and then expertly showing its contemporary uses in planning, evaluating, and managing health care for populations and the practical application in health care management. The book’s practical and applied approach, with real-world examples sprinkled throughout, has made it the go-to book for managerial epidemiology and population health courses.

Since the second edition was published in 2005, the health care landscape has undergone significant changes. Passage of the Patient Protection and Affordable Care Act and the incorporation of ICD-10 have impacted the entire health care system. This newly updated third edition will address these two significant changes, as well as several others that have taken place. It also features new chapters on reimbursement approaches and managing infection outbreaks, as well as updates to the four case study chapters that anchor the book.

If you’re a student or professional in any area of health services, including health administration, nursing, and allied health, then Managerial Epidemiology for Health Care Organizations is the perfect book for you. It successfully demonstrates how health care executives can incorporate the practice of epidemiology into their various management functions and is rich with current examples, concepts, and case studies that reinforce the essential theories, methods, and applications of managerial epidemiology.

Publication Details

Format

• OverDrive Read 5.7 MB
• Adobe PDF eBook 5.1 MB
• Adobe EPUB eBook 5.7 MB

Peter J. Fos (Author)

PETER J. FOS is professor of Health Policy and Systems Management at Louisiana State University Health Sciences Center, School of Public Health. DAVID J. FINE is former president and CEO of Catholic Health Initiatives (CHI) Institute for Research ..

Applying lean principles in healthcare is a goal for many health systems looking to become more efficient and effective when delivering care to patients. Manufacturing organizations like automaker, from whom a lean approach called “” originated, have developed amazing sophistication by allowing frontline employees to participate in building and honing processes. Lean has become a proven, practical approach to process improvement in industries such as manufacturing and industrial engineering. Applying it to healthcare, however, can be much more difficult.Many healthcare executives and staff have tried lean, failed to gain any sustainable benefit from it, and have come away from the process feeling frustrated.Based on our experience in working with scores of healthcare organizations to and eliminate waste, we’ll outline what worked best and share some of the most successful applications of lean tools and principles. A Basic Lean Principle: Intelligence on the FrontlinesDistilled down to its essence, lean is a way to counteract the common, top-down, command-and-control approach to management. Instead of relying on directives from management, lean seeks to take advantage of the intelligence an organization has on the frontlines; the employees who are engaging in the organization’s processes every day.

In a lean organization, management empowers employees to define and then continuously refine processes.It’s important to point out, however, that process improvement doesn’t become a free-for-all on the frontlines. Instead, lean organizations develop highly specified and exact processes that become standardized across the organization.

The employees own it and are encouraged to review and continuously improve the process.It’s a powerful, simple concept that can be quite difficult to apply, especially in healthcare. The State of Lean in HealthcareHealthcare is transitioning to so organizations have a pressing need to fine-tune processes and work waste out of the system. Lean, touted for its ability to remove waste from processes, has obviously caught the interest of these organizations. Some health systems adopt bits and pieces of lean (value-stream maps, one-piece flow, and any number of other cool tools and techniques).

Other organizations invite a lean expert to train their staff. Both approaches either temporarily translate to results or yield no results at all; hence, the skepticism about lean’s effectiveness in healthcare.Why do so many lean implementations fail?

Is it because the organizations only apply bits and pieces of lean?The truth is, lean isn’t a magic sauce. Process improvements only take hold across an enterprise when there is a cultural paradigm shift. In other words, lean works in healthcare when it is part of a larger initiative driving real cultural change.

Incorporating Lean Principles in Cultural ChangeBelow are examples for how to apply lean principles as part of a greater cultural change initiative.To be clear, healthcare organizations shouldn’t try to be lean organizations. In fact, they are well advised to avoid becoming lean purists. Instead, health systems should approach lean in a practical way, taking the pieces that work well and applying those pieces in a systematic way to help drive cultural change throughout the enterprise. Process Improvement Goes Beyond Workflow EfficiencyLean’s focus on workflow efficiency applies very well to some aspects of healthcare improvement, but not to others. The diagram below succinctly categorizes all of the work performed in a healthcare system. (Senior Vice President, future product strategy at Health Catalyst), in partnership with Dr. Brent James at, pioneered this healthcare-improvement process.Dr.

Burton divides healthcare into vertical processes (the ordering of care) and horizontal processes (the delivery of care). The vertical categories encompass the full spectrum of care that clinicians order for patients. The horizontal categories represent the work required to deliver the care ordered by the clinicians. Together they represent the fulfillment of care across the order-set spectrum. The mission of these horizontal support services is to deliver care in an efficient, consistent, and safe manner from patient to patient. These horizontal processes lend themselves very well to lean workflow improvement.In contrast, improving the vertical processes requires clinicians to order the proper care for patients.

Improvement initiatives in these areas don’t always lend themselves as readily to the lean approach as lean may not offer the level of precision needed to identify and develop superior treatment guidelines and protocols. Lean is more commonly used to improve the means by which diagnostic tests are performed and treatments implemented, not to improve the content of the diagnoses and treatments themselves, which is usually left to clinical researchers using rigorous statistical methods.

That is just one reason why lean may not be the end-all, be-all solution for healthcare improvement. Lean in Healthcare: Two ToolsTo be successful within this healthcare context, lean is applied to improve the horizontal services. Lean is pared down to bare minimum concepts so people within the organization completely understand what to do and what goals can be expected. This approach borrows extensively from, the founder of, who has helped pioneer the pragmatic simplification of lean in healthcare.The simplified application of lean involves at least two key tools:. Value-stream maps.

A lean expert from the manufacturing industry might not recognize the value-stream maps often used in healthcare. Healthcare organizations usually employ a simplified version of those seen in manufacturing. These process maps (for example surgery workflow) are reviewed at a high level to identify the best opportunities for workflow improvement. There is some focus on the transitions between departments because this is where most delays tend to occur. Key stakeholders involved in the workflow process assist in building the value-stream map and provide insight into improvement opportunities.

The value-stream map is best created while observing the actual process firsthand or immediately after observing it.(Value Stream Map. Tom clancy`s ghost recon predator psp iso. Click graphic to enlarge.). A3 diagrams. Once an improvement opportunity is identified, the team creates an A3 diagram. A3 diagrams (named for the paper size used by Toyota to create them) are a simple problem-solving tool designed for all to use—experts in process improvement and non-experts.