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Advanced Performance Improvement in Health Care: Principles and Methods

Author(s): Donald Lighter, MD, MBA, FAAP, Director, The Institute for Healthcare Quality Research and Education
  • ISBN-13: 9780763764494
  • Paperback    446 pages      © 2011
Price: $164.95 US List
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Instructor Resources: Answer Key, PowerPoints


Sample chapters are now available in Chapter 1.

Sample chapters are now available in Chapter 2.

Amidst a deepening crisis in U.S. health care, Advanced Performance Improvement in Health Care provides a results-oriented approach to rehabilitating an ailing healthcare system. With his innovative, instructive strategies, Lighter offers a welcome road map to guide meaningful change in the industry and to equip healthcare managers to meet 21st century challenges.


Advanced Performance Improvement in Health Care: Principles and Methods provides healthcare educators, leaders, and clinicians with the specific knowledge and tools vital for creating and advocating for quality-centric, next-generation healthcare organizations.


This unique compilation of management, analytical, and statistical methods and techniques serves as a comprehensive guide to harnessing today’s technology and developing a culture of quality that delivers sustainable, quantifiable value in healthcare organizations.


• Offers a comprehensive methodology for improving quality in healthcare organizations.
• Details a Process Analysis Toolkit with dozens of proven techniques.
• Illustrated with easy-to-follow diagrams and flow charts.
• Provides best practices for measuring value and performance.
• Includes extensive discussion of medical informatics, Lean, Six-Sigma, and more.

Chapter  1  The Business Case for Quality
Mandate for Improvement
Value Proposition: How Does Quality Relate to Performance?
How Do Organizations Measure the Value Proposition?
Measurement Is the Key to Performance Incentives
The Marketplace Wins in the End
Discussion Questions
Additional Resources
Appendix 1.1: CM S Physicians Quality Reporting Initiative ( PQRI) Measures
Chapter  2  Teams in Healthcare Performance Improvement
Teamwork Is Key for Improving Performance
Choosing a Project
Team Development
Application of the Team Approach
Steps in Creating Teams
Team Selection
Teamwork Tools
Discussion Questions
Additional Resources

Chapter  3  Process Tools
All Work Consists of Processes
What Is the Value Proposition?
Process Analysis Toolkit
Application of Improvement Tools
Discussion Questions
Additional Resources

Chapter  4  Medical Informatics and Information Resources for Quality Improvement
What Is Medical Informatics and Why Is It Important?
Types of Measurement Systems
Microsystem Data
Medical Record Systems
Analysis Packages
Discussion Questions
Additional Resources
Appendix 4.1: CAHPS Survey for Pediatric Primary Care
Appendix 4.2: Sou rces for Benchmarking Data and Operational Definitions
Appendix 4.3: Resource-Based Relative Value System

Chapter  5  Essentials of Statistical Thinking and Analysis
Art and Science of Statistical Thinking
Statistical Process Control Puts Statistical Thinking Into Practice
SPC Basics
Control Chart: Shewhart’s Genius
Types of Control Charts
Choosing and Using Continuous Variable Charts
Limitations of SPC and “Bumps in the Road”
Analysis Packages for SPC
Approaches to Refining SPC Analyses
Barriers to Implementation of SPC
Advanced Statistical Tools
Discussion Questions
Additional Reading

Chapter  6  Approaches to Improvement – Standardization and Lean Process Management
Standardization: Is It Really a “Four-Letter Word"?
Principles of Lean Management
Lean Improvement Cycle
The Lean Toolbox
Application of Standardization: Clinical Practice Guidelines
Discussion Questions
Additional Reading
Lean Glossary and Concepts

Chapter  7  Six Sigma – Principles and Applications in Health Care
Six Sigma: Tool for Process Effectiveness
History of Six Sigma
Basics of Six Sigma: Statistical Background
Six Sigma Metrics
Six Sigma Improvement Model (SSIM)
Voices of Six Sigma
Gauge Repeatability and Reproducibility
DMAIC: The Six Sigma Improvement Model
Design For Six Sigma: Starting Right
Discussion Questions
Additional Resources
Six Sigma Glossary

Chapter  8  Alignment and Integration of Performance Improvement Systems – the Malcolm Baldrige National Quality Award
History and Background
Baldrige Organizational Structure
Baldrige Award Process
Baldrige Core Values
Baldrige Criteria: Basis for Evaluation
Structure of a Baldrige Application
Healthcare Recipients 2002–2008
Conducting a Self-Assessment
Discussion Questions
Baldrige Award Glossary

Donald Lighter, MD, MBA, FAAP-Director, The Institute for Healthcare Quality Research and Education

Dr. Donald E. Lighter currently serves as the Associate Medical Director for Clinical Outcomes Programs for the Shriners Hospitals for Children, where he is responsible for leading the design and implementation of programs to evaluate and improve the care of children in the Shriners system.  Shriners’ unique hospital system provides free care for children with serious orthopaedic abnormalities and burns.  After finishing his medical degree at St. Louis University Medical School, Dr. Lighter completed a pediatric residency and practiced general pediatrics in both private practice and academic settings for over twenty-five years.  Dr. Lighter’s experience in managed care has spanned nearly twenty years, having led the formation of two IPAs and three HMOs.  Over the past ten years, Dr. Lighter has worked both with commercial and Medicaid HMOs, and presently he is Director at The Institute for Healthcare Research and Education and a founder of CyberCE, Inc., an online educational consulting company.  Additionally, Dr. Lighter is a professor and a member of the core faculty for The University of Tennessee’s Physicians’ Executive MBA program, an innovative curriculum that relies heavily on the Internet to provide didactic material for physicians working toward a Masters in Business Administration degree.  He also serves as a Senior Examiner in the Malcolm Baldrige National Quality Award Program.

Additional Titles by this Author
  • "The content is highly relevant to advanced nursing practice."

    —Andrea C. Gregg, DSN, RN, University of Florida, College of Nursing

The following instructor resources are available to qualified instructors for download

ISBN-13: 9780763764494

Answers to In-Text Questions
Slides in PowerPoint Format

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