King’s Daughters’ Medical Center

1. King’s Daughters’ Medical Center Final Report November 26,2012

2. Key Management Officials Fred Jackson, President/CEO Administration Mona Thompson, Vice President Quality-Administraton

3. Overview • Located in Ashland, Kentucky • Largest Hospital in Eastern Kentucky • Offers wide variety of health services • Family Care Centers • Extended Rehabilitation/Nursing Home Care • Hospitality House • Home Health Services • Hospital (Medical Center)

4. Overview (con’t) • Sanctioned by state for mismanagement issues with double billing and Medicaid • Fined 1 million dollars • Laid off hundreds of employees • Operating under-staffed with no overtime

5. Quality Management Responsibilities Long term performance of the medical center by focusing on the delivery of services, tracking outcome data, making recommendations for change, and ensuring that KDMC meets state and national standards of excellence. King’s Daughters Medical Center, Quality Management utilizes the Benchmarking process. http://www.kdmc.com/explore/default.aspx?id=540

6. Quality Management Responsibilities (Con’t) • Enhancing quality of services for customers • Performance improvement • Protecting and ensuring customer rights • Monitoring and improving patient safety • Monitoring and improving customer outcomes • Promoting effective resource allocation • Problem identification and problem-solving • Preparing the medical center for inspections by accrediting agencies

7. Quality Management Goals • Implement a Master Production Schedule • Implement Material Requirement Plan • Applying MPS and MRP within the Quality Management Department would enhance the quality of services and performance improvement.

8. Customer Service At KDMC • All customer records on file • Pre-admission testing technique for patients • KDMC require demographic , financial, general consent and insurance authorizations for all Emergency patients, and inpatient and outpatient admissions • Pre-registration is a fast and convenient way for registration of outpatient care.

9. Use of Master Production Schedule • Utilization of MPS will provide optimal services, effective use of resources, and minimal use of inventory to reach there goal. • KDMC can apply it to determine high demand periods and supply more work at these key times to proactively meet the demand and in contrast in low demand periods run with minimum staff with works on call if needed. • Ideally can also be applied to inventory on hand and other services.

10. Use of Material Requirement Planning • MRP can be used to simplify the scheduling efforts. • KDMC could use MRP in their food services to make sure they have an adequate amount of food to serve all of their patients • KDMC could incorporate a materials requirement plan to fill their limited number of rooms available • MRP would be beneficial for KDMC in many areas to make their operations run much smoother and efficient.

11. Use of Capacity Planning • Process used to determine how much and when capacity is needed to produce a better product or begin production of a new product. • Capacity planning could be used to improve the planning, scheduling, monitoring, and control of resources. • Capacity planning would help everyone involved including clinical staff, managers, and patients.

12. Approach to Just In Time /Lean Systems • To reduce the waste or duplication of services. • Objective is to have zero inventories, transactions, and disturbances. • KDMC could benefit from implementing the critical aspect of JIT Poka-yoke. • Poka-yoke is the process of building operations so that quality is evaluated as it is created.

13. Application of Time and Motion • Designed to make business run more efficiently. • End result is a process that is both time and labor effective. • KDMC can use the time motion techniques to observe the amount of time it takes to complete a task. • Allows management to evaluate these processes and find a more time and energy effective way to complete them.

14. Suggested Improvements • Utilize capacity planning in the financial records department • Utilize MPS in the food service department • Implement the recommended Just-in-Time/Lean management approach which would improve KDMC’s customer service reputation

15. Conclusion • KDMC utilizing MRP and the Capacity Planning processes monies will be saved while providing quality health care services. • KDMC could look at what service areas are being fully utilized where cuts can be made. • KDMC’s billing/accounting departments would know which services have been billed eliminating double billing.

16. References Works Cited: • Berry, William L.; Jacobs, F. Robert; Vollmann, Thomas E.; Whybark, D. Clay. “Master Production Scheduling”. Manufacturing Planning and Control for Supply Chain Management,” (2011) 63:6 152-181. • Soares, Marcio M. and Vieira, Guiherme E. “A new multi-objective optimization method for master production scheduling problems based on genetic algorithm”. International Journal of Advanced Manufacturing Technology, (2009) 41:5/6 549-567. EBSCO (2012). • Webster, Joan; Davies, Heather; Stankiewicz, Monica; Fleming, Lesley C. “Estimating the Time Involved in Managing the 'Unoccupied Bed:' A Time and Motion Study”. Nursing Economics, (2011) 29:6 317-322. EBSCO (2012).

17. References (con’t) Websites Utilized: • http://www.kdmc.com/explore/default.aspx?id=508 • http://www.kdmc.com/explore/default.aspx?id=444 • http://www.kdmc.com/explore/default.aspx?id=468 • http://www.kdmc.com/explore/default.aspx?id=544 • http://www.kdmc.com/visitors/details.aspx?id=520 • http://www.kdmc.com/visitors/details.aspx?id=702 • http://www.kdmc.com/explore/default.aspx?id=2282 • http://www.kdmc.com/explore/default.aspx?id=540 • http://www.kdmc.com/content.aspx?id=5712 • http://www.kdmc.com/explore/default.aspx?id=2854