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Some Basic Concepts
EFFICIENCY: Cost for each outcome unit

OUTCOME MEASURES: .

EFFECTIVE: Outcomes in an experimental situation
EFFECTIVENESS: Outcome under real conditions
UTILITY:Outcomes expresed considering time and Quality of Life.
BENEFIT: Outcome evaluated in terms of money.

HEALTH QUALITY: How much efectiveness is closer to effective

EVALUATION OF CLINICAL PRACTICE:
SAFETY: reducing the risk
EFICACY
EFECTIVITY
UTILITY
BENEFIT
EFICIENCY
EQUITY

24/11/12                      Alberto Ruiz Cantero
Málaga
II Workshop Foro Osler.
               November 2012
• Conference Dr.Alberto Ruiz Cantero, Head of Internal
  Medicine, Hospital de la Serranía, Ronda, Málaga, titled:
  General actions heading to Diagnostic Process
  Improvement

• SUMMARY: Some general concepts about improving
  techniques from the Industry (Lean and Six Sigma) and
  more medical initiatives such as “Chossing Wisely” and
  NICE
lean
                                                   manufacturing

•     Lean is a production practice that considers the expenditure of resources for
      any goal other than the creation of value for the customer to be wasteful,
      and thus a target for elimination.
•     Value: any action or process that a customer would be willing to pay for.

•     Lean basically is everything around to do the proper thing, at the proper
      place and moment, with the amount correct, trying to eliminate waste and,at
      the same time, being flexible and open to changes.


•     Do you find a meaning for that in clinical practice? I,M sure yes: considering
      time, asking for the proper test, reducing waste and in Medicine also
      reducing risk for the patient.




    24/11/12                        Alberto Ruiz Cantero
    Málaga
Six Sigma: concept
• Continuous efforts to achieve stable and
  predictable process results (reduce process
  variation)
• Process have characteristics that can be
  measured, analyzed, improved and controlled.
• Commitment from the entire organization
Six Sigma procedures

•   Define the problem
•   Measure key aspects
•   Analyze data
•   Improve or optimize the current process
•   Control the future state process to ensure
    that any deviations from target are
    corrected before they result in defects.
24/11/12   Alberto Ruiz Cantero
Málaga
American Board of Internal Medicine




24/11/12    Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
24/11/12   Alberto Ruiz Cantero
Málaga
Less is more



24/11/12       Alberto Ruiz Cantero
Málaga

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Improving diagnosis leansixsigma

  • 1. Some Basic Concepts EFFICIENCY: Cost for each outcome unit OUTCOME MEASURES: . EFFECTIVE: Outcomes in an experimental situation EFFECTIVENESS: Outcome under real conditions UTILITY:Outcomes expresed considering time and Quality of Life. BENEFIT: Outcome evaluated in terms of money. HEALTH QUALITY: How much efectiveness is closer to effective EVALUATION OF CLINICAL PRACTICE: SAFETY: reducing the risk EFICACY EFECTIVITY UTILITY BENEFIT EFICIENCY EQUITY 24/11/12 Alberto Ruiz Cantero Málaga
  • 2. II Workshop Foro Osler. November 2012 • Conference Dr.Alberto Ruiz Cantero, Head of Internal Medicine, Hospital de la Serranía, Ronda, Málaga, titled: General actions heading to Diagnostic Process Improvement • SUMMARY: Some general concepts about improving techniques from the Industry (Lean and Six Sigma) and more medical initiatives such as “Chossing Wisely” and NICE
  • 3. lean manufacturing • Lean is a production practice that considers the expenditure of resources for any goal other than the creation of value for the customer to be wasteful, and thus a target for elimination. • Value: any action or process that a customer would be willing to pay for. • Lean basically is everything around to do the proper thing, at the proper place and moment, with the amount correct, trying to eliminate waste and,at the same time, being flexible and open to changes. • Do you find a meaning for that in clinical practice? I,M sure yes: considering time, asking for the proper test, reducing waste and in Medicine also reducing risk for the patient. 24/11/12 Alberto Ruiz Cantero Málaga
  • 4. Six Sigma: concept • Continuous efforts to achieve stable and predictable process results (reduce process variation) • Process have characteristics that can be measured, analyzed, improved and controlled. • Commitment from the entire organization
  • 5. Six Sigma procedures • Define the problem • Measure key aspects • Analyze data • Improve or optimize the current process • Control the future state process to ensure that any deviations from target are corrected before they result in defects.
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  • 7. American Board of Internal Medicine 24/11/12 Alberto Ruiz Cantero Málaga
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  • 20. Less is more 24/11/12 Alberto Ruiz Cantero Málaga