24/11/12Málaga

Alberto Ruiz Cantero

SomeSome Basic Basic ConceptsConceptsEFFICIENCYEFFICIENCY: Cost for each outcome unit

OUTCOME MEASURES: .

EFFECTIVE: Outcomes in an experimental situationEFFECTIVENESS: Outcome under real conditionsUTILITY: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:EVALUATION OF CLINICAL PRACTICE:SAFETY: reducing the riskEFICACYEFECTIVITYUTILITYBENEFITEFICIENCYEQUITY

II Workshop Foro Osler.November 2012

• Conference Dr.Alberto Ruiz Cantero, Head of InternalMedicine, Hospital de la Serranía, Ronda, Málaga, titled: General actions heading to Diagnostic ProcessImprovement

• SUMMARY: Some general concepts about improvingtechniques from the Industry (Lean and Six Sigma) andmore medical initiatives such as “Chossing Wisely” andNICE

24/11/12Málaga

Alberto Ruiz Cantero

lean lean manufacturingmanufacturing

• Lean is a production practice that considers the expenditure of resources forany 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 properplace and moment, with the amount correct, trying to eliminate waste and,atthe same time, being flexible and open to changes.

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

Six Sigma: concept

• Continuous efforts to achieve stable andpredictable process results (reduce processvariation)

• 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.

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

American Board of Internal Medicine

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

24/11/12Málaga

Alberto Ruiz Cantero

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