Frndak, Diane C
(2009)
DEVELOPING AND IMPLEMENTING A PRACTICAL MODEL OF REAL-TIME REDESIGN AND PROBLEM SOLVING FOR FRONTLINE HEALTHCARE PROFESSIONALS.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
This research develops and implements a practical model of real-time redesign and problem solving for front line healthcare professionals using systems thinking methodologies. Healthcare quality, safety and service issues have been well-documented and lamented, calling into question the current approaches for addressing these issues. The work environment for healthcare professionals has become overburdened with time pressure, workarounds, waste, and failure to learn from the small events which occur on a frequent basis at the front-line. Desensitization may occur until sentinel events stimulate an organizational reaction. Other industries have developed system engineering methodologies, including the Toyota production system, theory of constraints, six sigma and others, to address manufacturing quality, service and safety issues. Many of these concepts were developed within the context of a linear manufacturing environment, with solutions often derived "off-line" by external experts. Healthcare reality is considered more complex and requires adaptive approaches, suggesting that modifications based on complex adaptive systems theory may be necessary. The development of the model evolved based on key systems thinking principles adapted to meet the needs of the healthcare experience and introduced to front-line healthcare workers using on-line problem solving. This research includes real-time understanding of what is working or not working in the current condition as it occurs, the ideas of the staff to improve the patient experience, including asset-based problem-solving and introduction of system thinking and design principles using ideas from various systems engineering methodologies in a healthcare worker friendly way. The research focuses on the deep systems of the organization (or clinical microsystem) and ability of front line teams to redesign processes in real-time using rapid cycle mini-experiments and the results of the redesign. Using case study and action research design, the research analyzes the experiences of an intact work group of a clinical microsystem to test the implementation of a model, labeled an Excellence Makeover. The researcher acts as a participant-observer of the emergent experience and solutions from the staff. The model will then be analyzed and additional refinements will be suggested for additional research.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
28 January 2009 |
| Date Type: |
Completion |
| Defense Date: |
23 September 2008 |
| Approval Date: |
28 January 2009 |
| Submission Date: |
2 December 2008 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Health and Rehabilitation Sciences > Rehabilitation Science |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
complex adaptive systems; frontline; healthcare quality; patient safety; problem solving; real-time; systems thinking; Toyota production system |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-12022008-091139/, etd-12022008-091139 |
| Date Deposited: |
10 Nov 2011 20:07 |
| Last Modified: |
15 Nov 2016 13:52 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/9957 |
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