2010-2011 healthcare management - november 2010

http://www.crcpress.com/product/isbn/9781563273759




Contents

NEW TITLES

Transforming Healthcare ..................................................3

Leading the Lean Healthcare Journey ..............................4

Essentials for the Improvement of Healthcare Using Lean & Six Sigma ..................................................5

Leveraging Lean in Healthcare ........................................6

Safer Hospital Care ..........................................................7

Dynamic Capacity Management for Hospitals ................8

Applying Lean in Healthcare ............................................9

Medical Error and Harm ................................................10

Healthcare Payment Systems ........................................11

The Medicare Recovery Audit Contractor Program ......11

Successful Collaboration in Healthcare ..........................12

Comprehensive Healthcare for the U.S. ........................12

PROCESS IMPROVEMENT

Lean Hospitals ................................................................13

The Pittsburgh Way to Efficient Healthcare....................13

Value Stream Mapping for Healthcare Made Easy ........14

A3 Problem Solving for Healthcare ................................14

5S for Healthcare............................................................15

Optimizing Emergency Department Throughput..........15

Paradox and Imperatives in Health Care........................16

Transformative Quality ..................................................16

FINANCIAL MANAGEMENT &LEADERSHIP

Health Care Will Not Reform Itself ................................17

Workplace Clinics and Employer Managed Healthcare..17

Governance for Health Care Providers ..........................18

Healthcare Transformation ............................................18

Healthcare Delivery in the U.S.A. ..................................19

Statistical Analysis for Decision Makers in Healthcare, Second Edition ..............................................................19

The Managed Care Contracting Handbook, Second Edition ..............................................................20

Consumer Directed Health Care ....................................20

Healthcare Payment Systems ........................................21

Compliance for Coding, Billing & Reimbursement, Second Edition ..............................................................21

Discharge Planning Handbook for Healthcare ..............22

Pursuing Excellence in Healthcare..................................22

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3Phone 1.888.319.5852 Fax 1.800.394.6286 Online ProductivityPress.com

Transforming Health CareVirginia Mason Medical Center’s Pursuit of the Perfect Patient ExperienceCharles KenneyVirginia Mason Medical Center, Seattle, Washington, USA

A Must Read for Health Care Leaders

“Virginia Mason Medical Center has been on a ten year journey todemonstrate just what is possible and the results have been pro-found. What is equally amazing, and must reading for health careleaders, is the story of their journey. It is possible to improve qualityand safety while simultaneously reducing cost!”

—John Kitzhaber, MD, Governor of Oregon 1995-2003

“An inspiring tale of leadership, discipline, and persistence… Must reading for all health care leaders whoare serious about quality.”

—Lucian L. Leape, MD, Harvard School of Public Health

“If you work in the health and medical care field and you believe you and your institution are as good asit is possible to be, you should read this book. It will reset your standards and show you how to producemore value for your patients at a lower cost. ... It is a story about real people dedicated to the pursuit ofhabitual excellence.”

—Paul O’Neill, 72nd Secretary of the U.S. Treasury, former Chairman and CEO of Alcoa

“If you want to understand what health care can become, you need to know about Virginia MasonMedical Center. This book gives you the complete story. It is essential reading.”

—David Cutler, former Senior Health Care Advisor, Obama Presidential Campaign

“… chronicles an arduous journey to achieve an exceptional patient-centered culture using a manage-ment system only now recognized as relevant to health care. This is a story of how Virginia Mason becamethe benchmark against which other health care systems must judge themselves, and a beacon in a fieldthat has resisted change for far too long. — David M. Lawrence, MD, MPH, Chairman and CEO (retired), Kaiser Foundation Health Plan and Hospitals, Inc.

Just a decade ago, Virginia Mason Medical Center of Seattle was a prime example of so many of thethings that are wrong with health care today. Then they discovered where actual health care reformneeds to occur: not in any legislature but in the very corridors of the Center and in the attitudes of itsstakeholders. Now after a decade of arduous dedicated work, VMMC stands as both example and inspi-ration to all of us who believe that it is possible to deliver health services that practice wellness, operatein the black, and do no harm.

Contents:

Preface: A Surprising Visit. A New Idea. Journey to Japan. The Blue Yarn. Safety Crusade. AmbulatoryCare Breakthrough. Transforming Procedural Care. Transforming Inpatient Care. Better, Faster, MoreAffordable. Management Method. The Journey Continues. Source Notes.

Catalog no. PP7375, November 2010, 240 pp.ISBN: 978-1-56327-375-9, $39.95 / £25.99

New Titles


4 Phone 1.888.319.5852 Fax 1.800.394.6286 Online ProductivityPress.com

Leading the Lean Healthcare JourneyDriving Culture Change to Increase ValueEdited by

Joan WellmanWellman & Associates, Seattle, Washington, USA

Pat Hagan and Howard JeffriesSeattle Children's Hospital, Washington, USA

“… a compelling story of change at an enormously prestigious insti-tution … a story about leadership taking the long view and system-atically improving. It is a story of humility and the courage to go out-side of healthcare to learn. … The reader gets to enjoy the 10 yearstory of transformation from the perspective of the staff and clinicianleaders. —J. Michael Rona, Principal, Rona Consulting Group, Former president of

Virginia Mason Medical Center, where he introduced the ToyotaManagement System in 2000

“Joan Wellman and her colleagues provide examples of dramatic performance improvements. Using theirpractical examples you can be on your way to becoming a leader who transforms your organization,empowers your team, adds value, and saves lives.”

—Ken Graham, CEO of El Camino Hospital in Mountain View, CA

While every healthcare organization can learn from Seattle Children’s Lean improvement process, thisbook is not an operator’s manual. Instead, it is about challenging deeply held assumptions about health-care. Contrary to traditional thinking, quality, cost, patient access, and safety outcomes are not a set oftrade-offs but characteristics that can be improved concurrently. Written by those involved at the frontlines of real and effective change, this book discusses ways to:

• Transform doctors into change agents and engage all staff in a patient-focused culture

• Eliminate waste and increase direct care by standardizing processes and streamlining bureaucracy

• Control such variables as infection rates and improve patient outcomes through more efficient andmindful practices

Providing both example and inspiration, Seattle Children’s stands today as proof positive that real health-care reform is feasible. What it requires is real leaders; men and women who have the curiosity andtenacity to look critically at their work and find better, less wasteful ways to deliver safe, high-quality care.

Contents Abridged:

The Continuous Performance Improvement Journey. Creating High-Powered HealthcareImprovement Engines. Leadership and Culture. Transforming Doctors into Change Agents. ClinicianEngagement. Ending the Paper Chase in the Operating Room. 5S and Demand Flow. Developingand Implementing Pull Systems in the ICU. Delivering Compassionate Care through Clinical StandardWork on Rounds. Developing Standardized Inpatient Care for Patients with Asthma. Making the TotalParenteral Nutrition Process Safer. Eliminating Mistakes and Central Line Associated BloodstreamInfections. Balancing the Line in Outpatient Pharmacy. The Everett Clinic Registration to Cash ValueStream. …

Catalog no. K11406, December 2010, 290 pp., Soft CoverISBN: 978-1-4398-2865-6, $59.95 / £38.99

New Titles



Essentials for the Improvement ofHealthcare Using Lean & Six SigmaD.H. StamatisContemporary Consultants, Ypsilanti, Michigan, USA

Whatever means we use to measure and rank healthcaredelivery in the United States, we can all agree that with-out significant reform, the prognosis is grim. Recently, wewere subjected to much discussion about reform, but thatdiscussion was more about government’s role, than improvingmedical outcomes.

Essentials for the Improvement of Healthcare Using Lean & SixSigma is all about real and immediate quality improvement. Writtenby a renowned expert in organizational development and quality,the book addresses concerns that can be ameliorated with mini-mum government intervention. Detailing immediate paths forimprovement fundamental to primary care, hospitals, and managedcare, Dr. Stamatis —

• Introduces needed mechanics of change, especially the transition of hierarchical groups to interac-tive inclusionary teams responsible for initiating, refining, and implementing quality improvements

• Focuses on customer satisfaction as a key indicator of quality

• Explains how Lean and Six Sigma tools can be readily applied to healthcare

• Spotlights primary care, including how to define and redesign its process and develop better metrics

• Presents IT applications that will improve billing, documentation, and patient care

• Examines Malcolm Baldrige National Quality Award criteria as it applies to healthcare

• Illustrates quality improvements and best practices through real world case studies

• Encourages actionable steps with a companion CD that includes Six Sigma forms and formulas,Lean improvement tools, and other quality tools and worksheets

Whether we think that advances in technology and medicine, coupled with freedom of choice, makesthe U.S. system the best in the world, or whether we believe growing costs, regulatory morass, and ourtort-obsessed culture drops it to the bottom; it is painfully evident that the processes currently employedand the subsequent defensive medicine philosophy will not be able to meet the future demands of anaging society. Through Six Sigma and Lean, this text moves the focus from reactive controls to the proac-tive efficiency required to implement the sort of real and sustainable quality improvements that will allowus to forge a system that is all about wellness.

Contents:

The Four Critical Issues in Healthcare. Directions of Improvement in Healthcare. The Mechanics ofChange. The Transition of Groups to Teams. Logistical Issues of Teams. The Effects of Change inHealthcare. Customer Satisfaction. Understanding the Process. Using Six Sigma Methodology forImprovement. Using Lean Methodology for Improvement. Understanding Measurement. PrimaryCare. Immediate Applications for Information Technology in Healthcare. Project Selection.Understanding and Utilizing ISO 9000 Standards. Understanding and Utilizing the Malcolm BaldrigeNational Quality Program. Epilogue.

Catalog no. K12058, December 2010, 444 pp.ISBN: 978-1-4398-4601-8, $79.95 / £49.99

New Titles



Leveraging Lean in HealthcareTransforming Your Enterprise into a High Quality Patient Care Delivery SystemCharlie Protzman, George Mayzell, and Joyce Kerpchar

What the experts are saying:

“… This instructive book is well-timed and highly informative forthose committed to creating deep levels of sustainable change inhealthcare.”

— Peter B. Angood, MD, FACS, FCCM, Senior Advisor – Patient Safety,National Quality Forum

“ … the most practical and healthcare applicable book I have ever read on Lean thinking and concepts.A must read for CEOs, managers and supervisors … it has all the tools needed to get the results we mustachieve.”

— Gary Shorb, CEO, Methodist Le Bonheur Healthcare

“I can recommend this well written book as an essential reference in the library of all healthcare leadersinterested in performance improvement.”— Lee M. Adler, DO, VP, Quality and Safety Innovation & Research, Florida Hospital, Orlando; Associate Professor,

University of Central Florida College of Medicine

“… a must read for all Leadership involved in healthcare. … I can see reading this book over and over.”— Brigit Zamora, BSN, RN, CPAN, CAPA, Administrative Nurse Manager, Florida Hospital, Orlando

A practical guide for healthcare executives, managers, and frontline workers, this book provides you withthe means to transform your enterprise into a High-Quality Patient Care Business Delivery System.Designed for continuous reference, its self contained chapters are divided into three primary sections:

• Part 1 defines Lean and includes some interesting history about Lean not found elsewhere

• Part 2 describes and explains the application of each Lean tool and concept organized in their typical order of use

• Part 3 looks specifically at how to implement Lean in various healthcare processes. Here, the authorsprovide examples, case studies, and lessons garnered from their own extensive experience

This book is designed to take you out of your comfort zone and provide you with new ways to extendvalue to your customers. It drives home the importance of the Lean Six Sigma journey. The pursuit ofcontinuous improvement is a journey with no end. Consequently, the opportunities are endless as towhat you and your organization can accomplish.

Forty percent of the authors’ profits from this book will be donated to help the homeless through twoBaltimore charities.

Contents:

General Principles and Overview. General Approach to Implementing—50% People / 50% Tools.Tools. Lean Implementation by Service Line. Sustaining. Lean Design. Case Studies. Glossary.

Catalog no. K10715, November 2010, 422 pp., Soft CoverISBN: 978-1-4398-1385-0, $74.95 / £47.99

New Titles



Safer Hospital CareStrategies for Continuous InnovationDev Raheja

An examination of the effectiveness of present hospital care meth-ods, this book illustrates how to find simple, comprehensive solu-tions that produce high return on investment. It emphasizes inno-vative techniques, proven safety methods, models for risk managers,heuristics for leading change, reliability methods that deliver rightcare over time, dangers in medical devices for critical care, and tech-niques for giving care with speed and efficiency without compro-mising safety. Experts from the aviation industry, world-class organ-izations such as Toyota and General Electric, and innovative hospitalssuch as Johns Hopkins offer their insight.

• Presents world-class practices adjusted for hospitals

• Transfers aerospace techniques for eliminating unsafe practices to hospitals

• Provides solutions that produce a high return on investment

Contents:

What is Unsafe Healthcare and Why Do We Have So Much?Mishaps Never Happen from a Single CauseAny Work Done in a Shoddy Manner is Likely to be UnsafeHeuristics for Leading the Change. Try Continuous Innovation instead of Continuous ImprovementDelivering Reliability in Healthcare: Quest for Failure-free PerformancePrepare for "What if' Scenarios with Healthcare FMEACurrent Root Cause Analysis is Inadequate for Adverse Events: Use Fault Tree AnalysisA Good Risk Manager is Like a Maestro in a Symphony OrchestraUse Aviation Techniques: Current Techniques are OutdatedWhat Every Critical Care Physician Should Know About the Dangers of Medical Devices?Implement Efficiency and Speed Without Compromising SafetyLook for Management Oversights and OmissionsA Checklist for Self Audit to Assure High Integrity at Lower CostThe Paradigm Pioneers

About the Author:

Dev Raheja, MS, CSP, has been an international risk management and quality assurance consultant forthe healthcare, medical device, and aerospace industry for more than 25 years. He applies evidence-based safety techniques from a variety of industries to healthcare. He is a trainer and author, and showsclients how to come up with elegant solutions using creativity and innovation. Being a true internation-al consultant, he has conducted training in several countries, including Sweden, Australia, Japan,Germany, the United Kingdom, Singapore, Taiwan, South Africa, and Brazil. He helped a major Midwestcompany avoid going out of business and become a world leader by eliminating safety mishaps.

Prior to becoming a consultant in 1982, he worked at GE Healthcare as supervisor of quality assuranceand manager of manufacturing, and at Booz-Allen & Hamilton as risk management consultant in thenuclear and mass transportation industry.

Catalog no. K11114, December 2010, 200 pp., Soft CoverISBN: 978-1-4398-2102-2, $59.95 / £38.99

New Titles



Dynamic Capacity Management forHealthcareAdvanced Methods and Tools forOptimizationPierce StorySenior Consulting Manager, GE Healthcare, Wells, Maine, USA

“This book is a must-read for anyone engaged in healthcare improve-ment, whether you work in a clinic, hospital, or healthcare system.”

— Keith Messner, MD, MBA, BSN, Emergency Physician, HealthcareTransformation Medical Director, Cape Fear Valley Health System,

Fayetteville, North Carolina

“Healthcare is facing a huge challenge in reforming delivery predi-cated on changes and incentives in payment. Without revampingdynamic delivery systems to reduce and to reallocate current costs,chaos and disruption will likely occur. We need the analytical toolsand creative mindset outlined in this book to help guide us on the path to reform.”

— Mike Sack, CEO, Hallmark Health

“Pierce Story has added an important chapter to the growing body of literature on healthcare perform-ance improvement. His theme of managing effectively to actual demand is compelling, and the contentionthat healthcare leaders should not be dogmatic about the methods or tools of continuous improvementis right on target.”

— Pat Hagan, President and COO, Seattle Children’s Hospital

While hospitals can learn from other industries, they cannot be improved or run like factories. With workthat is more individualized than standardized, and limited control over volume and arrivals, even theleanest-minded hospital must recognize that healthcare systems are more dynamic than nearly any workenvironment.

Written with the creativity needed to navigate the rapidly changing landscape of healthcare, DynamicCapacity Management for Healthcare: Advanced Methods and Tools for Optimization presents theunique new tools, methodologies, and thinking required of healthcare systems that want to survive andthrive in a reduced reimbursement, higher-cost world. Demonstrating his approaches and recommen-dations through case studies specific to the complex issues of healthcare delivery, Pierce Story, a long-time and passionate healthcare operations expert, shows how hospitals and health systems can makeleaps in performance in an environment in which both financial and human resources are shrinking asexpectations for clinical perfection continue to rise.

Through its unique approach to the dynamic management of complex care systems, this volume raisesthe bar for what is possible. This text presents an excellent opportunity for healthcare’s “change agents”to meet the challenges and responsibilities of our day.

Contents:

Variability: Killer of Capacity. Interdependencies. DCAMM Introduction. Predictive Analytics. DemandComponents: The Emergency Department. Surgical Services and DCAMM Analytics. Up–Down–Up:Creating a Systems View from a Component Perspective. Capacity Patterns and Analytics forDCAMM. Dynamic Resource Allocations, Dynamic Standardization, and Workload Analytics. A Wordon Mandated Nurse–Patient Ratios. Outlier Management and System Balance

Catalog no. K11039, November 2010, 235 pp.ISBN: 978-1-4398-1975-3, $59.95 / £38.99

New Titles



Applying Lean in HealthcareA Collection of International Case StudiesEdited by

Joe Aherne and John WheltonLeading Edge Group Charter House, Cobh, Ireland

“… these case studies provide wonderful examples and an opportuni-ty to take a glimpse into the many possibilities of Lean. These case stud-ies move beyond the theory of Lean and illustrate how Lean translatesinto simple actions that are capable of effecting positive change.”

—Colleen Kennedy MLIS, MHA, Leader Physician Engagement, BritishColumbia, Canada

“The case studies provided in this book provide relevant examplesthat are useful and informative for organizations like ours that areimplementing Lean principles and methodology. … provides exam-ples of actual implementation strategies and solutions to changemanagement issues in applying Lean.”

—Bonnie Urquhart CGA, CHE, Director - Strategic Initiatives and Project Support, Northern Health Authority,British Columbia

“Many healthcare professionals are frustrated by the disappointing quality and the waste in our healthcaresystems. … This book binds together the philosophy that revolutionized the safety and quality of the motorindustry with practical examples from the pioneers in healthcare. Through examples big and small, theyshare their learning of the problem-solving techniques and, more importantly, the fundamental change intheir beliefs and behaviors that brought about change for the benefit of colleagues and patients.”

—Dr Kate Silvester BSc, MBA, FRCOphth, Programme Lead for enquiry into patient flow, cost and quality

“ … a must buy for any healthcare professional interested in delivering improvement opportunities. Ithighlights relevant and insightful examples from other healthcare organizations that have benefited fromLean thinking. The book will help you and your colleagues to better understand Lean in healthcare andbenefit from the experiences of those who provide patient care in an international healthcare context.”

—Eamon Counihan, Quality Coordinator, Bon Secours Health System, Ireland

Covering healthcare from clinical to nutritional services, this book provides a collection of international casestudies that demonstrate how Lean thinking can be applied in the healthcare industry. Offering an inter-national perspective, the text introduces key concepts of Lean healthcare and presents real-life examples toillustrate the practical benefits—which include m0ore efficient processes, increased patient satisfaction, andcost savings—that result from a Lean philosophy. The book features a number of expert contributors whooffer practical tips. It also includes a foreword from eminent psychiatry professor Jeffrey Clotheir, MD.

Contents:

Introduction to Lean Healthcare. Making It Lean, Hilary Grey. Providing Rapid Access to a VascularSurgery Outpatient Clinic, Simon Dodds. Reorganizing and Standardizing Supply Rooms across aHealth System, Franciscan Health System. A Quick-Start Lean Method to Cut the Clutter and Get YourHospital Back into Shape, Kelley Williamson. Applying Lean Thinking to the Outpatient RegistrationProcess, Deborah Miller. Establishing a Standardized and Efficient Client Laboratory Supplies Process,Christian Buchsteiner. Improving Accommodation and Organizational Arrangements at an OutpatientAntenatal Clinic, Brendan Murphy. Improving Wait Times at a Medical Oncology Unit, Carlos F. Pinto.Minimizing the Time from "Cooking Pot to Patient", Judy-Ann Wybenga. A Journey in Lean—Bringingabout Change, Improving Quality for the Patient, and Developing the Culture of a HealthcareOrganization, John Coleman and Tim Franklin. Process Improvements to Reduce Operating RoomCancellations, Mimi Kokoska, Samuel B. Welch, and Teresa Stevens. The Future for Lean Healthcare,Timothy D. Hill. Glossary

Catalog no. K11351, April 2010, 247 pp.ISBN: 978-1-4398-2739-0, $49.95 / £31.99

New Titles



Medical Error and HarmUnderstanding, Prevention, and ControlMilos JenicekMcMaster University, Hamilton, Ontario, Canada

Recent debate over healthcare and its spiraling costs has broughtmedical error into the spotlight as an indicator of everything that isineffective, inhumane, and wasteful about modern medicine. Butwhile the tendency is to blame it all on human error, it is a muchmore complex problem that involves overburdened systems, con-stantly changing technology, increasing specialization, and a cycle ofcontinual funding shortfalls made even more acute by resource-wasting inefficiencies.

Medical Error and Harm: Understanding, Prevention andControl presents the work of long time physician and teacher MilosJenicek, a pioneering expert on epidemiology, evidence-based med-icine, and critical thinking and decision making in the health sciences.

Providing a comprehensive overview of the subject that is thorough and free of rhetoric, Dr. Jenicek:

• Presents a short history of error in general across various domains of human activity and endeavor,including concepts, methodologies of study, and management applications

• Provides semantic and taxonomic classifications of challenges in medical error and harm, two dis-tinct domains

• Explores approaches used to investigate and ameliorate challenges in medicine and other health sci-ences

• Explains why, when, and how studies and decisions regarding errors should be carried out, such aswhether risk assessment should be undertaken in the diagnosis, treatment, or prognosis stage

• Covers essential strategies for mitigating errors in the broader framework of medical care, specificallyin community medicine and public health

• Considers the ever-growing role of physicians in tort law and litigation

The book discusses whether dealing with errors is a learned skill and looks at how much of the problemwith medical error is caused by the medical community’s failure to teach, learn, and understand every-thing there is to know about medical error, including the often neglected critical thinking skills.Understanding and correcting this shortfall is a primary responsibility of every health professional, onethey can begin to realize with the study of these pages.

Contents:

Putting Medical Error and Harm in Context. Reducing Errors and Harm in Medicine; Beyond the‘Oops!’ Factor. The Valued Legacy. Error and Harm across General Human Experience in the Non-Medical Domains. Welcome to Lathology. Error and Harm in the Health Sciences. Defining andClassifying Human Error and its Consequences in Clinical and Community Settings. DescribingMedical Error and Harm. Their Occurrence and Nature in Clinical and Community Settings.Analyzing Medical Error and Harm. Search for their Causes and Consequences. Flaws in Operator’sReasoning and Decision Making before Action. Prevention, Intervention and Control of Medical Errorand Harm. Clinical Epidemiological Considerations of Actions and their Evaluation. Taking MedicalError and Harm to Court. Contributions of Physicians and Expectations of Physicians in Tort Litigationand Legal Decision-Making. Conclusions. A Brief and Harmonized Glossary.

Catalog no. K11671, July 2010, 384 pp.ISBN: 978-1-4398-3694-1, $79.95 / £49.99

New Titles



HealthcarePaymentSystemsFee SchedulePayment SystemDuane C. AbbeyAbbey & Abbey Consultants,Inc., Ames, Iowa, USA

Healthcare Payment Systems: Fee SchedulePayment System, the second volume in a seriesby expert consultant and workshop facilitatorDuane Abbey, is dedicated to fee schedule pay-ment systems. Dr. Abbey illustrates the diversechallenges involved with these systems throughthe discussion of reimbursement claims for severalindividuals in a fictitious community served by ahospital, a nursing facility, and a hospice amongother healthcare providers. Including more than60 very real scenarios that illustrate best practicesfor various fee payment challenges, this compre-hensive volume —

• Explores the general concept of usual, custom-ary, and reasonable (UCR) that is often appliedby private third-party payers

• Provides web links to a number of essentialresources including various government actsand manuals

• Discusses in-depth what is arguably the mostcomplex fee schedule system: the MedicarePhysician Fee Schedule

• Defines a comprehensive list of acronyms usedin the medical payment industry

Conceptually, fee schedule payment systems areone of the simpler approaches; however, evenstraightforward healthcare payment systems can,and indeed do, become quite complex. No pay-ment system exists in a vacuum. In fact, whenservices are provided, the reimbursement frommultiple payment systems may be required. Thisguide shows you how all these systems work, aswell as how they interface with one another ineveryday practical use. Understanding the differ-ences among systems and learning how to navi-gate them can make a huge difference in whethera claim is accepted or not and how much pay-ment is allowed.

Catalog no. K11862, October 2010, 152 pp.Soft Cover, ISBN: 978-1-4398-4023-8$59.95 / £38.99

The MedicareRecovery AuditContractorProgramA Survival Guidefor HealthcareProvidersDuane C. AbbeyAbbey & Abbey Consultants,Inc., Ames, Iowa, USA

Written by medical billing guru and Lean account-ing expert, Duane Abbey, The MedicareRecovery Audit Contractor Program: A SurvivalGuide for Healthcare Providers explains all thatis required to prepare and successfully defendagainst inappropriate RAC audit recoveries. Usingthe same succinct style that always makes his writ-ing so accessible, Dr. Abbey illustrates his lessonswith simple case studies placed in the context of afictitious community whose population is servedby a hospital, clinics, a nursing facility, and otherproviders all seeking to maintain compliance andprofitability.

In discussing RAC guidelines, this resource —

• Shows how to identify overpayment areas andassociated compliance issues

• Details a systematic problem-solving processrelative to RAC processes

• Addresses resource requirements including newpersonnel, such as RAC specialists

• Includes planning models for developing com-pliance departments

• Provides an extensive glossary to make sense ofmedical billing’s alphabet soup of acronyms

While the book works well as a stand-alone refer-ence for those seeking advice on RAC audits, read-ers will also discover that this volume extends thelesson of Abbey’s classic Compliance for Coding,Billing & Reimbursement, Second Edition, makingthis book a natural companion for those wantingto fully explore the role of compliance and Leanaccounting in medical billing.

Catalog no. K11113, February 2010, 124 pp.Soft Cover, ISBN: 978-1-4398-2100-8$59.95 / £38.99

New Titles




New Titles

SuccessfulCollaborationin HealthcareA Guide forPhysicians,Nurses andClinicalDocumentationSpecialistsColleen M. StukenbergFHN Memorial Hospital, Freeport, IL, USA

“Colleen Stukenberg writes from the perspective ofone who has been there and done that. … a skilledteacher who shares lessons she has learned in thetrenches.”

—Beth Gale, RN, BSN

“Colleen has successfully navigated the clinical andfront-end-revenue cycle job market over the last 20years. … Her vast knowledge and know-how hasactualized one of the more successful documenta-tion programs in the industry with the financialgains in a rural hospital rivaling major urban med-ical centers. Colleen is definitely an authority onClinical Documentation programs and has muchto share with her peers.”

— Tamar Gorenyuk, MBA, RHIA, Director, HIM &Resource Management, Freeport Health Network

“Anyone interested in implementing a successfulClinical Documentation Improvement Programshould read this book before starting the process.Never before has this valuable information beenpresented in one, all-encompassing reference.”

—Lynne Spryszak, RN, CCDS, CPC-A, Manager,Precyse Solutions, LLC

A guide to forging alliances that will improvepatient care, this book describes ways in whichnurses and physicians can collaborate to enhancesafety, quality, and treatment efficacy. Explaininghow this collaboration can result in positive finan-cial effects, it demonstrates how cooperation canmeet the changing requirements of governingbodies and government regulations. The textaddresses the roles of direct patient caregiver,charge or team leader nurse, case manager, andclinical documentation specialist. It also coversregulatory and financial topics, including RecoveryAudit Contractors (RAC) and Pay for Performance.

Catalog no. K10656, January 2010, 136 pp.ISBN: 978-1-4398-1292-1, $59.95 / £38.99

ComprehensiveHealthcare forthe U.S.An IdealizedModelWilliam F. RothDeSales University, CenterValley, Pennsylvania, USA

“ … although the idealized model is not likely to befully implemented, it provides a standard by whichto measure and shape health care reform in the US.The work is somewhat distinctive in the recentflood of books dealing with health care reform inthat the author is not a health care specialist but asystems analyst.”—C.L. Kammer, The College of Wooster, CHOICE, Vol.

47, No. 11, Aug. 2010

Award-winning author Roth solicits the contribu-tions of health workers from around the globe toexamine the mire of technical quality and ineffi-cient delivery that has become the U.S. healthcaresystem. He looks at various challenges, discussinghow these are dealt with by 12 nations, all ofwhich, according to the WHO, rank higher thanthe U.S. in terms of services provided. Roth drawsfrom the best to design an idealized model forhealthcare that would fit this country's uniquerequirements. Researched and referenced to satis-fy policy professionals and administrators, thebook is written to engage all stakeholders with afresh understanding of what is valuable and viable.

• Provides the information in an easy-to-read for-mat that doesn't bury readers in statistical data

• Offers a comprehensive model for U.S. health-care rather than just one or several pieces ofsuch a model

• Addresses the major problems of the currentU.S. healthcare system including cost, competi-tion, lack of access, variances in quality of care,lack of adequate communication and access toinformation, and lack of a preventative focus

• Explores the major problems associated withuniversal healthcare systems





Process Improvement

Lean HospitalsImprovingQuality, PatientSafety, andEmployeeSatisfactionMark GrabanSenior Fellow at the LeanEnterprise Institute

“The concepts outlined in this book are the mostpowerful tools that I have ever encountered to fosterinnovation, ownership, and accountability at thefrontline staff level. … a must-read for any leader intoday’s increasingly complex healthcare industry.”

—Brett Lee, PhD, FACHE, Vice President, Children’sMedical Center Dallas

“… lays out the nuts and bolts of the Lean method-ology … I wish I could have read this book six yearsago, as it might have prevented some of the mis-takes we made in our Lean transformation journey.”

—John S. Toussaint, MD, President/CEO ThedaCareCenter for Healthcare Value

“Finally! The healthcare industry has needed thisbook for many years. Informative, understandable,and timely…” —Jim Adams, Senior Director, Laboratory Operations,

Children’s Medical Center, Dallas

“… should definitely be on the reading list forthose who want to bring the benefits of Lean think-ing to healthcare.” —David Mann, manager, Lean Management + O.D,

Steelcase, Inc., author of Creating a Lean Culture

“…a welcome translation of the Toyota ProductionSystem into language any healthcare professionalcan understand.”

—Jeffrey K. Liker, author of The Toyota Way

Winner of a 2009 Shingo Research and ProfessionalPublication Prize, this book has received universalacclaim from industry insiders as well as reformadvocates. Drawing on his years of working withhospitals, Graban explains how Lean can help toimprove safety, quality, and efficiency in a health-care setting. He explains how Lean manufacturingstaples such as value stream mapping and processobservation can help hospital personnel identifyand eliminate waste in their processes. The bookincludes access to an accompanying website withadditional information.

Catalog no. PP3805, 2009, 280 pp., Soft CoverISBN: 978-1-4200-8380-4, $47.95 / £29.99

The PittsburghWay toEfficientHealthcareImprovingPatient CareUsing ToyotaBased MethodsNaida GrundenNaida Grunden, L.L.C. - Medical Communications,Bellingham, Washington, USA

"Every person who cares about modernizing healthin America should read this book." —Newt Gingrich, Former House Speaker & Founder of

the Center for Health Transformation

"This book reports how managers—without moremoney or federal action—can use Toyota manage-ment principles to create an environment where it isdifficult to make a mistake and people can take joyin work and deliver better and better patient care." —Clare Crawford-Mason, co-author, The Nun and the

Bureaucrat and Thinking About Quality

“… chock full of pearls, useful tools, and inspiringstories of people and organizations who madequality improvement concepts and principlesspring to life.” —Robert M. Wachter, MD, Department of Medicine,

University of California, San Francisco, USA

“I love this book! Like the Toyota ProductionSystem on which these case study improvementswere founded, it is clear, concise and visual…” —Cindy Jimmerson, President, Lean Healthcare West

“What exactly is ‘workflow re-design’? Can it real-ly make the health care experience safer and moreeffective, efficient, and rewarding for patients andproviders? Ms. Grunden answers these questionsthrough dozens of fascinating examples whichreally happened in Pittsburgh’s hospitals …”

—Christopher Guadagnino, Managing Editor,Physician’s News Digest

This critically acclaimed book provides a look at howToyota’s concept of Lean manufacturing can beapplied to make healthcare safer, more effective, andless costly. It is a compilation of case studies fromunits in different hospitals around the Pittsburghregion that successfully applied industrial principlesto the benefit of their patients and employees.

Catalog no. PP7367, 2008, 224 pp.ISBN: 978-1-56327-367-4, $41.95 / £26.99




Process Improvement

Value StreamMapping forHealthcareMade EasyCindy JimmersonLean Healthcare West,Missoula, Montana, USA

“The selection of case stud-ies reflects the range ofcommon problems acrossthe whole healthcare system. A must read for all."

— Lesley Wright, Director of Diagnostics, NHSImprovement

"Jimmerson has demystified the value stream mapand made it an actionable tool for all!"

— Mimi Falbo, Mimi Falbo LLC

"I would highly recommend this book to anyonedesiring to genuinely adopt the Toyota approachto the healthcare industry and to do so with confi-dence. This is the real deal."— Ken Pilone, President, Sterling Methods Consulting

Group, LLC

"This is an outstanding book, the best one avail-able on value stream mapping. Cindy Jimmerson isa remarkable teacher and a pioneer in Lean think-ing. Her visual organization in this book (and herbook on A3 problem solving) make VSM immedi-ately accessible and useful."— Shaun Sullivan, MD, Partner, Bellingham Anesthesia

Associates, and Anesthesia Medical Director, SkagitValley Hospital

“Cindy is a remarkable teacher and this book cap-tures the essence of her teaching on the effectiveuse of value stream mapping in health care."

— John Salyer RRT-NPS, MBA, FAARC, Author ofManaging the Respiratory Care Department, Director

Respiratory Therapy Services, Seattle Children'sHospital and Research Institute

Introducing readers to the simple but essentialValue Stream Map (VSM), this book offers anaccessible introduction to this proven high-levelview tool that can be used in every aspect ofhealthcare. It illustrates the simplicity and com-pleteness of the tool and describes its applicationsto staff communication, regulatory documenta-tion, and activities of daily work. The book alsohighlights simple to use data collection and inter-pretation as part of the VSM process.

Catalog no. PP7852, January 2010, 119 pp.Soft Cover, ISBN: 978-1-4200-7852-7$54.95 / £34.99

A3 ProblemSolving forHealthcareA PracticalMethod forEliminatingWasteCindy JimmersonLean Healthcare West,Missoula, Montana, USA

"Having a source book to teach continuous changeand illustrate waste reduction based on the ToyotaProduction System to busy healthcare practitionershas been sorely lacking until now. I have used theA3 in my hospital and it works! … The illustrationsare superb and I loved all the practical examples.Great work Cindy!"

—James Nesbitt, MD, MMM, Project Manager,Providence Alaska Medical Center

"I thoroughly recommend it." —Professor Peter Hines, Director, Lean Enterprise

Research Centre, Cardiff University

"Doing more, better, faster, and with less is our newreality. Cindy, because of her curiosity, creativityand clinical acumen, demonstrates that solutionsoriginating outside of our healthcare enterprisecan realize (previously) unrealized results."

—Kathy Okland, RN, MPH, Clinical ApplicationsConsultant, Herman Miller Healthcare

"The book gives a great view of how The ToyotaProduction System can be applied to Healthcare allover the world. … written by a clinician for clini-cians … the book we have been waiting for."

—Inge Holck, General Manager, Lean HealthcareEurope

Written by an expert in Lean principles, this bookoffers an easy-to-use problem-solving method thatcan be applied to improve processes in everyaspect of healthcare. Illustrated with numerousA3s in various stages of development, this easy-to-use workbook explains how to extend the VSMphilosophy to a more focused perspective. Thebook explores the value of the A3 problem-solvingtool in healthcare—demonstrating the simplicityand completeness of the tool in applications rang-ing from regulatory documentation to daily workactivities.





Process Improvement

5S forHealthcareJ. Michael RonaConsulting GroupLLCBellevue, Washington, USA

While there are a growing number of books basedon the Toyota Production System, or Lean, focusedon healthcare, there are very few that detail thetools that make Lean more than just a way of think-ing and put the methodology into practice.

Based on Hiroyuki Hirano's classic 5 Pillars of theVisual Workplace and modeled after the ShingoPrize-winning Shopfloor Series for LeanManufacturers, 5S for Healthcare adopts a provenreader-friendly format to impart all the informa-tion needed to understand and implement thisessential lean methodology. It provides examplesand cased studies based on the experiences of theprincipals involved with the Rona ConsultingGroup, who were responsible for the ground-breaking implementation of the ToyotaProduction System at the Virginia Mason MedicalCenter.

• Encourages efficiency and patient care whilepromoting a safe working environment

• Contains innovative features designed toimprove understanding and assist implementa-tion such as margin assists and key terms

• Includes practical examples and how-to-stepsproven to work in the healthcare industry

Written to readily assist with hands-on implemen-tation efforts, this volume offers innovative fea-tures designed to improve understanding andsupport application. This includes helpful how-to-steps and practical examples taken directly fromthe healthcare industry.

Contents:

Getting Started. Introduction. The First Pillar:Sort. The Second Pillar: Set In Order. The ThirdPillar: Shine. The Fourth Pillar: Standardize. TheFifth Pillar: Sustain. Reflections and Conclusions.

Catalog no. K10196, January 2010, 120 pp.Soft Cover, ISBN: 978-1-4398-0350-9$28.95 / £18.99

OptimizingEmergencyDepartmentThroughputOperationsManagementSolutions forHealth CareDecision MakersJohn M. Shiver and David Eitel

" … Shiver gives the healthcare manager the toolsthey need to enhance the function of the EmergencyDepartment, the ‘front door’ of every community’shealth care system. The text is clear, concise andunderstandable to those lacking a technical back-ground but who still want to apply fairly sophisti-cated techniques to improving the patient experi-ence and the productivity of ED staff."— J. Knox Singleton, President and CEO, Inova Health

System

"… a breakthrough in creating a framework for EDtransformation. … uses state-of-the-art improve-ment techniques to solve problems bedevilingAmerica: crowding and delays in critical treatment.Shiver and Eitel offer clear, practical approachesthat leaders can use to get results."— Bruce Siegel MD MPH, Director, Center for Health

Care Quality, Department of Health Policy

"… provides a needed introduction to the science ofreengineering your health care delivery system. Theauthors build on decades of experience togetherwith proven models from the literature that willhelp you move your organization forward, whileimproving patient and staff satisfaction."— Christopher MB Fernandes, Professor of Emergency

Medicine, University of Western Ontario

This landmark book explores the relationships ofindividual stakeholders and illustrates how infor-mation technology can play an important role inimproving the performance of the ED. It explainshow to improve financial performance, specialtyservices, and billing and collections functions.Because there are so many unpredictable ele-ments related to the emergency room environ-ment, this text explains how to predict patient vol-umes, flow, and space needs, using historical datato best plan for the unknowns.





Process Improvement

Paradox andImperatives inHealth CareHow Efficiency,Effectiveness, andE-TransformationCan ConquerWaste andOptimize QualityJeffrey C. Bauer, PhDFutures Practice, ACS Health Care Solutions, Chicago,Illinois, USA

Mark HaglandChicago, Illinois, USA

“… a masterful job of discussing practicalapproaches to achieving material gains in healthcare provider effectiveness and efficiency throughe-health technologies and disciplined processchange. … a superb book.”

—John Glaser, Vice President and Chief InformationOfficer, Partners HealthCare, Boston, Massachusetts

“… the right combination of empirical research,rigorous methods, and analytical thinking … real-world solutions to control costs and improvequality...” —Helen Darling, President, National Business Group

on Health, Washington, DC

“... puts the health care industry’s biggest chal-lenges into a fresh and useful perspective. ...Through numerous case studies, the authors showhow successful health care organizations are usingperformance-improvement tools to produce top-quality services as inexpensively as possible.”

—QualityDigest, Vol. 28, Issue 2

In this critically acclaimed collaboration, award-winning authors, Bauer and Hagland, explain whyproviders must draw upon internal resources toincrease net revenue and provide the quality ofcare that payers and consumers demand. Throughnumerous case studies, the authors show how pioneering health care organizations are usingperformance improvement tools—including Lean management, Six Sigma, and the ToyotaProduction System—to produce excellent servicesas inexpensively as possible. This book challengeshealth care leaders to change their status quomentality and to put their organizations on a pos-itive path.


TransformativeQualityThe EmergingRevolution inHealth CarePerformanceMark HaglandChicago, Illinois, USA

“… provides the how-to details for health careexecutives who are ready to lead meaningful sup-ply-side responses to the growing demand for safeand error-free medical services. … shows how the-ory has been put into practice by some of the bestdelivery organizations in the world.”

—Jeffrey C. Bauer, PhD, Partner, Futures Practice,Affiliated Computer Services Healthcare Solutions,

Chicago, USA

Always interesting and informed, national award-winning journalist Mark Hagland demonstrateshow pioneering organizations are combining newtools with a new way of thinking to reinvent theway we deliver health care services in this country.Through exceptionally well-documented casestudies, this insightful volume —

• Puts the current journey towards industry-widequality transformation into an understandablecontext

• Explores how performance improvementmethodologies borrowed from other indus-tries, including Six Sigma, Lean management,and the Toyota Production System are trans-forming care delivery processes

• Examines the strategic role that informationtechnology will play in the transformation ofclinical care quality and patient safety

The case studies contained in this book documentthe surprising strides being made by pioneeringhospitals and health systems, advances that havethe potential to transform the delivery of healthcare in the United States. Offered in a context thatframes the current state of health care quality inthis country, they are indispensable reading foranyone working in the trenches to improve thatquality.





Financial Management & Leadership

Health CareWill NotReform ItselfA User's Guide to Refocusingand ReformingAmerican Health CareGeorge C. HalvorsonPresident and CEO, Kaiser Permanente, Oakland, California, USA

"… takes complex problems and makes them under-standable. Halvorson’s experience as leader of oneof the world’s largest and most successful imple-mentations of health information technology makeshis insights into that subject particularly valuable."—Dr. Alain C. Enthoven, PhD Marriner S. Eccles Professorof Public and Private Management, Stanford University

"… offers a timely and compelling prescription toaddressing the chronic ills of our health care system … ."

—Tom Daschle, Former U.S. Senate Majority Leader

"George Halvorson, CEO of the nation’s largesthealth care delivery system, says reducing costswhile expanding coverage not only should bedone, but can be done, and tells us how … "—Dr. James Robinson, Professor of Health Economics,

UC Berkeley

With detail that might shock you, George C.Halvorson shows why the nonsystem we now useis failing. Then, applying the same sensible leader-ship that makes Kaiser the most progressive healthcare organization in the world, he answersPresident Obama’s mandate for reform with a pro-found incentive-based, system-supported, goal-focused, care-improvement plan. Halvorson drawsfrom respected studies and the examples of suc-cessful systems across the world to show thatwhile good health care is expensive, it is nowherenear as costly as bad health care.

While this book offers sage advice to policy mak-ers, it’s also written to educate the 260 millionstakeholders and invite their participation in thedebate that is now shaping. What makes this planso easy to understand is that it never strays from aprofound truth: that the best health system is onethat actually focuses on good health for everyone.*All royalties from the sale of this book go to OaklandCommunity Voices: Healthcare for the Underserved.

Catalog no. K10830, 2009, 184 pp.ISBN: 978-1-4398-1614-1, $29.95 / £19.99

WorkplaceClinics andEmployerManagedHealthcareA Catalyst forCost Savings andImprovedProductivityA. Michael La PennaThe La Penna Group, Grand Rapids, Michigan, USA

"… outlines the many aspects of how to thinkabout an on-site program and how to implementone … a valuable reference … ."—Ford Brewer, M.D., Medical Director, Toyota Motor

Manufacturing of North America

The advent of organizations considering an on-siteapproach to the delivery of healthcare servicesincreases in direct proportion to the rising ofhealthcare costs. This volume is a how-to manualon the design and implementation of an on-siteprogram—presenting the challenges and benefitsof such a system. Topics discussed include hospitaland specialty contracting; employee choice con-cerns; cost-control; ancillary services; workers com-pensation issues; benefits consultants; and qualityvs. value analysis.

• Reviews the benefits and challenges of on-sitehealthcare

• Includes a case study that follows the imple-mentation of a program from inception tointroduction

• Helps readers determine if on-site healthcare isappropriate for their organization

• Defines the terms and phases of employerhealthcare purchasing and implementation

Contents Abridged:

Workplace On-Site Healthcare as a Catalyst forCost Savings and Improved Productivity.Company Planning for Healthcare and Employees’Participation. The Myth of the Company Doctor.Components and Complements to On-SiteHealthcare. The On-Site Program: What and WhoAre In and Out? Why? Cost Savings, CostAvoidance, and Confidence Levels...






Governance forHealth CareProvidersThe Call toLeadershipEdited by

David B. Nash &Valerie P. PracilioJefferson Medical College,Philadelphia, Pennsylvania,USA

William J. OetgenGeorgetown University, Washington D.C., USA

"… will guide trustees down the road to more fullyaccept the responsibility for the mission of the cor-porations they lead."—Michael D. Connelly, MA, JD, FACHE, President and

CEO, Catholic Healthcare Partners

"… the definitive guide for the physician boardmember as well as any leader who has made theleap to govern an organization … well-writtenand concise … essential reading for all physicianswho are about to embark on the journey of gover-nance. I for sure will recommend this book to thephysicians on my hospital board."

—ACMQ Focus

Written by leading health care advocates andauthorities, this volume provides a readily accessi-ble resource that defines the functions of boardmembers—summarizing the problems they arelikely to face. This accessible and well-organizedresource includes coverage of finance, compli-ance, funding, strategic planning, legal duties,quality, conflicts of interest, corporate structure,and governance best practices.

• Provides essential information on the mostimportant issues confronting nonprofit boards

• Fills a major gap in the education of healthcare professionals

• Considers the future role of health care boards

Contents:

Non-profit Organizations. Duties andResponsibilities of Directors. Quality of Care.Professionals Affairs. Finance. Auditing, Compliance,and Reporting. Legal Issues. ExecutiveCompensation. Philanthropy. Strategic Planning.Governance. Future of Health Care Boards.


HealthcareTransformationA Guide for theHospital BoardMemberMaulik S. JoshiNetwork for RegionalHealthcare Improvement,Easton, Maryland, USA

Bernard J. HorakHealth Systems Administration Programs, GeorgetownUniversity, Washington DC, USA

“… presents the ten major transformers for health-care in the first part of the twenty-first century andhow boards can understand and use them to trans-form their own organizations. … this book makesan important and invaluable contribution to ele-vating board performance in quality and safety.”—John R. Combes, MD, President and Chief Operating

Officer, Center for Healthcare Governance

"The safety and quality of the care delivered in ahospital is the number one responsibility of eachand every Board member … . This important bookprovides hospital leaders and Boards key informa-tion for that dialogue."

— Diane C. Pinakiewicz, MBA, President, NationalPatient Safety Foundation

"This book is a ‘must-read’ resource for HospitalManagement Teams and Board members. Thecontent is supported by extensive knowledge andpractical current experience of the authors."

— Alexander (Rusty) Sloan, MD, MACP, Lt. General,USAF, Retired

This concise manual provides hospital boardmembers and executives with practical guidanceon how to become actively engaged in the trans-formation of their organization. Ideal for orientingnew board members and for providing moreexperienced members with insight on key issues,it supplies a list of questions to ask stakeholdersthat will facilitate engagement. Each chapter isorganized around action steps referred to as TopHealthcare Transformers—designed to disseminatebest practices, build organizational quality, estab-lish transparency, and develop the culture andleadership needed to facilitate intelligent and pro-gressive change. The final chapter provides anoverall governance engagement checklist thatdetails the things to do to ensure board membersand senior colleagues are prepared to lead thetransformation.

Catalog no. K10283, 2009, 128 pp., Soft CoverISBN: 978-1-4398-0506-0, $39.95 / £24.99





HealthcareDelivery in theU.S.A.An IntroductionMargaret F. Schulte,DBAGrand Valley State University,Grand Rapids, Michigan, USA

“This brief but remarkablebook is balanced in its consideration of the historyand scope of health care in the U.S. ...”—D.R. Shanklin, University of Chicago, CHOICE, Vol.

47, No. 09, May 2010

“… helpful for those early in their careers or tran-sitioning in from other industries to help improvequality … . I certainly wish I had this guide when Iwas starting in healthcare.

—Mark Graban, Senior Lean Consultant, ValuMetrixServices, Ortho Clinical Diagnostics, Inc., Author of

Lean Hospitals

“… the resource that outsiders need to join theconversation … . The more non-health profession-als who read this book, the sooner we’ll see effi-ciency and effectiveness in medical care.”—Jeff Bauer, Ph.D., Management Consulting Partner

and Director of the Futures Practice, AffiliatedComputer Services Healthcare Solutions

“In easy-to-understand terms, Dr. Schulte lays outthe components of the healthcare system so thoseof us who enter can be oriented to the terms andto the various entities we will be encountering.”

—Dean Bliss, Lean Improvement Specialist, IowaHealth System

“Dr. Schulte’s book is ‘Healthcare 101’ for any salesprofessional striving to understand the healthcareindustry.”—Linda Ewing, Regional Sales Director, Amcom Software

An ideal guide for those new to healthcare, thispopular reference provides the understandingrequired to navigate the business of medicine. Forthose working in hospitals or as vendors and man-ufacturers, it supplies an orientation to the broaderhealthcare work environment. The author, editorof the American College of Health Executive’sFrontiers in Health Services Management, confrontschallenges facing the industry as a whole, includ-ing finance, legal, regulatory, and workforce issues.


StatisticalAnalysis forDecisionMakers inHealthcareSecond Edition,Understandingand EvaluatingCriticalInformation in Changing TimesJeffrey C. BauerFutures Practice, ACS Health Care Solutions, Chicago,Illinois, USA

All segments of healthcare rely on data providedby insurance companies, consultants, researchfirms, and the federal government to help make ahost of decisions regarding the delivery of medicalservices. Statistical Analysis for Decision Makersin Healthcare, Second Edition explains the fun-damental concepts of statistics, along with com-mon uses and misuses. Without jargon or mathe-matical formulas, renowned healthcare expert, JeffBauer, presents a clear explanation of what statis-tics really do. He provides a practical discussion ofscientific methods and data to show why statisticsshould never be allowed to compensate for badscience or bad data.

Relying on real-world examples, Dr. Bauer stressesa conceptual understanding that empowers read-ers to apply a scientifically rigorous approach tothe evaluation of data. With the tools he supplies,you will learn how to dismantle statistical evidencethat goes against common sense. Easy to under-stand and practical, this is the book you wish youhad when you took statistics in college — and theone you’ll be glad to have to defend yourselfagainst the abundance of misinformation thatcould corrupt your decisions.

Contents:

The Scientific Foundations of Statistical Analysis.Scientific Method: The language of statistical stud-ies. Experimental design: the foundation of statis-tical conclusions. The Fundamental Importance ofData. Numbers Good and Bad: How to judge thequality of data. Samples and Surveys: How num-bers should be collected. The Different Types ofStatistics. Descriptive Statistics: The foundation ofcomparisons. Inferential Statistics: Studies of differ-ences. Relational Statistics: Studies of relationships.Explanatory Statistics: Studies of causality.Postscript: Statistics in Perspective.

Catalog no. K10061, 2009, 160 pp., Soft CoverISBN: 978-1-4398-0076-8, $49.95 / £30.99





The ManagedCareContractingHandbookSecond Edition,Planning andNegotiating theManaged CareRelationshipMaria K. ToddHealthPro Consulting, Inc., The HealthcareReimbursement Institute

"... a must have book for the non-attorney healthcare professional negotiating managed care con-tracts for providers. Dr. Todd combines a thoroughdiscussion of managed care contracting basicswith helpful hints and practical tools for contract-ing with all types of payor organizations ..."

—Ellen E. Stewart, MSHA, JD, FHFMA, Berenbaum,Weinshienk & Eason P.C., Denver, Colorado

"Many organizations struggle to optimize theirmanaged care strategies to achieve operationaland financial success. Maria Todd's new bookcould be the missing keystone to achieve that suc-cess. … a must-read for every hospital executiveinvolved in the managed care process - clinical andfinancial leaders alike. … should be used as a keypart of any healthcare provider's managed carestrategy."

—David Hammer, MBA, MHS, FHFMA, CHFP, VicePresident, Revenue Cycle Solutions McKESSON

Provider Technologies

Demystifying the contracting process, the secondedition of this unique work is an essential resourcefor venders involved with the delivery of managedcare services. This edition provides an updatedlook at this rapidly evolving area. It offers an in-depth look at managed care and its organizationsas a foundation for contracting strategies and cov-ers key issues such as consumer driven healthplans, pay for performance initiatives, and con-tract negotiations. Written by seasoned profes-sional in managed care contracting, it offers acomprehensive layman’s evaluation of a typicalmanaged care agreement, as well as sample con-tracts and important checklists.


ConsumerDirectedHealth CareA 360 DegreeViewKim D. SlocumKDS Consulting LLC, WestChester, Pennsylvania, USA

“… a great job of explaining and analyzing com-plex health insurance issues … successfully chal-lenges the widespread belief – dear to manyemployers, insurers and consultants – that the bestway to fix the system is to have consumers pay abigger share of the costs …. Everyone who wantsto participate in the debate about health carereform should read his prescriptions for the future.”

—Humphrey Taylor, Chairman, The Harris Poll

“… gets to the heart of consumer-directed health-care, takes a biopsy, and makes a quick and accu-rate diagnosis. I wish everyone inside the Beltwaywould read Slocum’s new book!”

—David B. Nash, MD, MBA, Department Chair ofHealth Policy, Jefferson Medical College, Philadelphia,

Pennsylvania, USA

“… a top-notch synthesis of credible research onhealth care in the United States. … a call to actionfor persons in policy and leadership positions inand out of health care …” —Margaret F. Schulte, DBA, FACHE, Editor, Frontiers of

Health Services Management

With three decades of experience in a variety ofhealthcare, pharmaceutical, and biotechnologyfirms, respected healthcare consultant, KimSlocum provides a broad perspective of the U.S.healthcare crisis. He discusses how the system hasevolved and debunks various myths. Exploringpotential solutions, the book balances manydiverse and conflicting factors, including themovement to make healthcare more patient-cen-tered and the growing trend to transfer significantportions of financial risk to patients via high-deductibles. The final section of the text explainswhat a successful consumer-directed system lookslike and the steps needed to make it happen.






HealthcarePaymentSystemsAn IntroductionEdited by

Duane C. AbbeyAbbey & Abbey Consultants,Inc., Ames, Iowa, USA

The numerous payment systems that medical prac-titioners must access, with their varied proceduresand multitude of medical codes, can make these sys-tems difficult to manage. However, with the rightknowledge and the right approach, you can turn asystem that controls you into one that you control.

Healthcare Payment Systems: An Introductionprovides a complete introduction to healthcarepayment systems. Written by Dr. Duane Abbey,one of the nation’s leading experts and mostsought out consultants in payment systems, thisvolume makes the monumental task of medicalreimbursement approachable and manageable.Covering the fundamentals and terminologyneeded to understand this discipline, he suppliesthe insight and strategies needed to master it.

• Highlights the differences between healthcarepayment systems

• Shows you the best ways to categorize specificthird-party payer requirements

• Explains what you need to know aboutMedicare’s use of different payment systems

• Provides the understanding needed to negoti-ate better contracts

This self-contained guide provides an overview anddiscussion of topics that one must understand tooptimize usage of various systems. Ultimately, it willhelp you begin to develop the solid core of skills andknowledge needed to confidently manage thesesystems for improved revenue cycles and higherlevels of profitability.

Contents:

Healthcare Providers. Types of Healthcare PaymentSystems. Healthcare Provider OrganizationalStructuring. Revenue Cycle versus ReimbursementCycle. Claims Generation and Adjudication. HIPAAAdministrative Simplification. Compliance.Research, Problem Solving, and Knowledge BaseDevelopment. Case Study Listing. Acronym Listing.


Compliance for Coding,Billing &ReimbursementSecond Edition, A SystematicApproach toDeveloping aComprehensiveProgramDuane C. AbbeyAbbey & Abbey Consultants, Inc., Ames, Iowa, USA

Includes a CD Packed with Regulations andInformation

Compliance for Coding, Billing & Reimbursement,Second Edition provides an organized way to dealwith the complex coding, billing, and reimburse-ment (CBR) processes. Revised to account forrecent changes and evolving terminology, thisaccessible resource covers statutorily based pro-grams and contract-based relationships, as well asways to efficiently handle those situations that donot involve formal relationships.

Based on 25 years of direct client consultation anddrawing on teaching techniques developed in suc-cessful workshops, Dr. Duane Abbey offers a logi-cal approach to CBR compliance. Designed tofacilitate efficient reimbursements that don’t runafoul of laws and regulations, this resource –

• Addresses the seven key elements promulgatedby the OIG for any compliance program

• Discusses numerous types of compliance issuesfor all type of healthcare providers

• Offers access to online resources that providecontinually updated information

• Cuts through the morass of terminology andacronyms with a comprehensive glossary

In addition to offering salient information illustrat-ed by case studies, Dr. Abbey provides healthcareproviders and administrators, as well as consult-ants and attorneys, with the mindset and attituderequired to meet this very real challenge withsavvy, humor, and perseverance.






DischargePlanningHandbook forHealthcareTop 10 Secrets toUnlocking a NewRevenue PipelineAli BirjandiOperational PerformanceImprovement, ProMedicaHealth System, Toledo, Ohio, USA

Lisa M. BraggWaterville, Ohio, USA

Hidden opportunities to improve profits in thehealthcare industry abound in the area of dis-charge planning. The Discharge PlanningHandbook for Healthcare: Top Ten Secrets toUnlocking a New Revenue Pipeline providesinnovative new solutions that will show hospitaladministrators how to turn one of the most anti-quated aspects of healthcare into one of the mostproductive. The performance-improvement con-cepts and approaches discussed in this volumebalance all aspects of existing business models andprovide a new approach to managing the dis-charge planning process.

Management engineer and Six Sigma Black BeltAli Birjandi and registered nurse and administra-tive director Lisa M. Bragg employ innovative solu-tions to help readers:

• Redefine the concept of discharge planning

• Assign the proper metrics

• Implement the COS-Q snapshot

• Employ Lean concepts in redesign

• Apply a practical approach to improvement

• Create a culture that produces results

An extended case study invites managers andadministrators to take an interactive approach tothe learning and application of these concepts. Aspreadsheet tool is included to help readers stayon task in their quest to improve efficiency andquality of care. The approach and methods taughtin this book have led to dramatic results in a num-ber of institutions. When adopted by your organi-zation, they can help you improve performanceand boost revenue.


PursuingExcellence inHealthcarePreservingAmerica'sAcademicMedical CentersArthur M. FeldmanJefferson Medical College,Philadelphia, PA, USA

"… a terrific resource for anyone interested inunderstanding the indispensable role of the aca-demic health center. ... A book all health care lead-ers should read and then read again."

—Michael M.E. Johns, MD, Chancellor, EmoryUniversity

“Scientist, scholar, educator, entrepreneur, and,especially, clinician, Dr. Feldman has given us aprovocative and passionate insider’s view. It arrivesjust in time to stimulate our thinking at thismoment of great opportunity."

—Andrew L. Epstein, MD, Managing Director,Navigant Consulting, Inc.

"… I recommend it for anyone who wants to knowabout the elements that have shaped and contin-ue to influence the structure and functioning ofacademic medical centers in the United States."

—Paul K. Whelton, MB, MD. M.Sc., President andCEO, Loyola University Health System, Loyola

University Medical Center

"… a landmark work, documenting the plight ofthe U.S. academic medical center (AMC), high-lighting its importance, and charting a course forsecuring its successful future."—Marvin A. Konstam, MD, Chief Physician Executive,

The CardioVascular Center, Tufts Medical Center

For over 100 years, academic medical centers(AMCs) have been the bastion of medicine.Delineating the issues that have lead to the currentcrisis in AMCs, this book provides a radically dif-ferent model for achieving success. The modelpresents four intersecting spheres of action, eachof which is necessary but none of which can standalone. The book presents an in depth analysis ofthe issues and challenges facing AMCs and offersrecommendations for delivering outstandingpatient care.




For those who are tired of just talking about health care reform

Adopting the principles and practices of the ToyotaProduction System,Virginia Mason hasmoved from the redinto the black whileimproving on allmeasures ofpatient care.

While the journey is not an easy one, it is possible for any medical facility to transitionitself to one that delivers superb medical care while at the same time controlling costs.And more and more are coming to Virginia Mason to find out how…

At the newly improved Virginia Mason Medical Center:

See pag

e 3

• Nurses now spend 90 percent of their time in direct patient care

• Liability insurance costs have dropped by over a third

• Rates of central line infections, injurious falls, and surgical site infections are nowsome of the lowest anywhere

• Profits are strong enough that all staff receive bonuses


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2010-2011 healthcare management - november 2010

Documents

improvement of healthcare

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