Application of Six Sigma in Hospitals

8/7/2019 Application of Six Sigma in Hospitals

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Presentation by

Dr. G. Jagadeep Gandhi


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Six Sigma simply means ameasure of quality that strives

for perfection. It is disciplined, has a data-

driven approach andmethodology for eliminatingdefect in any process.


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Six Sigma provides a methodologyto continue our improvement in

everything we do. It is aorganizational philosophy inestablishing the belief of doingthings right, first time and everytime.


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There is a need to breakdown thetraditional boundaries that separate

physicians, hospital administrators,pharmacists, technicians and nursesby shifting away from a culture of

blame and by working together tosystematically design safer, moreeffective and efficient systems.


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Six Sigma methodologies can help in thisand can change the face of modern

hospital and healthcare delivery system.Six Sigma can reduce variability andwaste, translating to fewer errors,improve customer satisfaction, provide

better processes, greater patientsatisfaction rates, and happier and moreproductive staff


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The term Six Sigma means standard deviation.

Standard deviation measures how muchvariation exists in a distribution of data.

Standard deviation is the key factor indetermining the acceptable number ofdefective units found in a population.

The target for perfection is the achievement ofno more than 3.4 defects per millionopportunities.


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The principles can apply to a wide variety ofprocesses and services.

Six Sigma projects normally follow a five-phaseimprovement process called DMAIC (Define,

Measure, Analyse, Improve and Control). Six Sigma requires commitment from the whole

organisation. Six Sigma healthcare organisations have the ability

and willingness to adopt contrary objectives, likereducing medical errors and getting things donefaster.

It is customer focussed and raises performance atbreakthrough level.


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The key players in Six Sigma initiative are:Champions & Sponsors, Master Black Belt(MBB), Black Belt (BB) and Green Belt (GB).

Champion & Sponsors: Six Sigma championsare high-level individuals who understand SixSigma and are committed to its success.Sponsors are the owners of processes andsystems who help initiate and co-ordinate SixSigma improvement activities in their areas ofresponsibilities.


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Black Belt: He/she is a person that is part ofthe leadership structure for processimprovement team called 'Black Belts'. They

are highly-regarded personnel who have anability to lead teams as well as to advise themanagement.

Green Belt: He/she is person trained in SixSigma methodology and is a team member of aSix Sigma process improvement action team.


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Understand who your consumers are and whatyour service is.

Review consumer surveys, concession reports andother data.

Screen and prioritise issues by severity,frequently/likelihood of occurrence etc.

Determine the internal processes causing the mostdissatisfaction and pain.

Find out why and where the defects are occurring.

Devise ways to address these defects effectively.

Set up good metrics (Measurement).


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Implementing Six Sigma within your healthcareorganization is similar to implementing any other company-wide initiative. Six Sigma training is the most importantfactor that contributes to and helps modify and shape anorganization's culture. Main training centres are:

1) GE Medical System delivers a Six Sigma Master Black Beltcourse designed exclusively for healthcare professionals.

2) Indian Statistical Institute7, SJS Sansanwal Marg, New Delhi 16Phone : 011 - 51493967

3) Quality Council of IndiaInstitute of Engineers BuildingBSZ Marg, New Delhi 02Phone - 011 - 23379321


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Define: Define the problem and improvement activity.

Measure: Measure the target metric and confirm thatthe measurement system is accurate. Measure theexisting system. Establish valid and reliable metrics to

help monitor progress towards the goals defined at theprevious step. Begin by determining the currentbaseline.Use exploratory and descriptive data analysisto help you understand the data.

Analyse: Analyse the system to identify ways toeliminate the gaps between the current performance ofthe system or process and desired goal. Use statistics tofind the root cause of the problem and generate aprioritised listing of them.


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Improve: Enhance the healthcare delivery system.Be creative in finding new ways to do thingsbetter, cheaper, or faster. Use project management

and other operations, planning and managementtools to implement new approach. Use facts andstatistical methods to validate improvement.

Control: Monitor the new system. Institutionalise

the improved system by modifying compensationand incentive systems, policies, procedures,services and other management systems.


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Increased Customer/Patient SatisfactionAnd Care

Higher satisfaction.

Fewer complaints. Improved billing. Increased prescription accuracy. Reduced waiting time and variation. S

afer and more efficient emergency services. Fewer medical errors and defects. Increased service orientation. Eliminate the 'I don't know' factor.


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Increased Physician Satisfaction Reduced scheduling delays. Fewer physician complaints.

Improved working condition of clinician and staff.

Reduced Cost & Savings Better financial and higher annual savings.

Optimised materials management chain. Less rework and waste.

Better recruiting and retention power.

Stronger growth.


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If you make Six Sigma a strategy in yourhospital, the end result will get reflected insustainable bottom line improvement. The

average time taken to develop a plan andimprove a process takes 3-12 months,depending on the scope and goals of theorganisation. Successful Six Sigma project

requires cross-functional teams.


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Six Sigma Conversion Table

Sigma Yield Defect Per Million Opportunities (DPMO)

1 31.00% 6,90,000

2 69.20% 3,08,000

3 93.30% 66,800

4 99.40% 6,210

5 99.97% 230

6 99.99966% 3.4


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Quality (Q) X Acceptance (A) = Effectiveness (E)

Hence, the effectiveness of the result is equal to thequality of the solution time and acceptance of the

idea.


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Application of Six Sigma in Hospitals