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Six Sigma in HealthcareToday and Tomorrow
Presented by: Julie Thompson, MBA, MQMSenior Consultant, Beacon Partners
Date: Friday, February 1, 2008
Presentation to HIMSS Management Engineering- Performance Improvement Task Force
February 1, 2008 Page 2 of 32
Today we will learn…• What is Six Sigma?• What is LEAN Process Improvement?• A Road Map to Success - A Case Study• How can we identify process improvement opportunities?• What are some of the tools available – Kaizen Event?• Lessons Learned• Real Life Examples• What is the impact of this trend on the industry? • What will the future look like?
• \
February 1, 2008 Page 3 of 32
What is Six Sigma?
• The roots of this methodology began with Deming’s approach to Quality Management
• W. Edwards Deming, Ph.D promoted quality management in the U.S. and Japan
• Japan, a recent world economic power, offers the Deming award each year to its most successful industry leaders
• U.S. preferred an approach to quality that included profit margin as well
http://www.deming.org/
February 1, 2008 Page 4 of 32
What is Six Sigma?
• Motorola developed Six Sigma Quality Management to include financial considerations
• Six Sigma has evolved over the last two decades and so has its definition.
• Three levels of definition need to be clarified:– As a metric, a literal definition– As a methodology, a concept– As a management system, a practice
February 1, 2008 Page 5 of 32
What is Six Sigma?
• Today, Six Sigma is a methodology that provides organizations with the tools to improve the capability of their business processes.
• Three key characteristics– A customer-centric management approach.– Permanently changes how management
functions.– Yields major returns on investment from
projects. Many quality programs do not address profits or ROI.
February 1, 2008 Page 6 of 32
What is LEAN Process Improvement?
Reduction of Process• Less waste• Less variation• Less inflexibility
Good Processes • Standardized, consistent• Shortest possible process time• Batch process to single flow • Quality focused workplace• Quality of care• Managed visually
February 1, 2008 Page 7 of 32
The “big idea” of LEAN THINKING?
It’s about adding value for our customersby focusing on reducing or eliminating those things which are Non-Value-Added
P R O C E S SNeedNeed
Satisfied
Improvement will be easier and more likely to succeed by focussing on & removing the non-
value added activities (waste)
Value Adding
95% 5%
Not Value Adding
February 1, 2008 Page 8 of 32
Lean Process Flow
Add
Valu
e
Wai
t
Tran
spor
t
Insp
ect
Current State – “As is”Future State – “To be”
February 1, 2008 Page 9 of 32
How does Lean and Six Sigma compare?
• Lean Time Variability Increase Speed Eliminate Waste Quick Fix Solutions
Six Sigma Process Variability Improve Quality Increase Yield Root Cause Solutions
February 1, 2008 Page 10 of 32
Combining Six Sigma and Lean Management
February 1, 2008 Page 11 of 32
Combining Six Sigma and Lean Management
Today’s Lean Six Sigma. An integrated and balanced combination of the speed and variation reduction power of both Lean and Six Sigma to achieve business management process full optimization.
February 1, 2008 Page 12 of 32
A Road Map to Success
• How can we identify process improvement opportunities?
• How do we engage executive management?
• How do we assure success?• How do we deliver rapid
improvements?• How do we apply these tools
to the real world?
February 1, 2008 Page 13 of 32
Case Study - Overview
• Build matrix of innovative Strategic Initiatives and related processes
• Identify key improvement opportunities using Pareto Charts, SPC Tools
• Measure Current State• Conduct Kaizen, Rapid
Improvement Events• Build QI maintenance
policies and procedures
February 1, 2008 Page 14 of 32
How can we identify process improvement opportunities?
Plan Implement ImproveMeasure
Assess Current Business StrategiesIdentify Strategic Processes
Plan Strategic Processes Improvements
Using an accelerated improvement path
TraceabilityQua
lity
February 1, 2008 Page 15 of 32
How can we identify process improvement opportunities?
Lean Six Sigma Align Corporate Strategies with Quality Measures
Assess Current Business Strategies
February 1, 2008 Page 16 of 32
How can we identify process improvement opportunities?
• Identify key strategic processes• Measure error rates, ask why?• Focus on the largest error rate• Set up a Kaizen Event
Identify Strategic Process and Quality Measures
February 1, 2008 Page 17 of 32
FormingFormingTestingTesting••PolitePolite••ImpersonalImpersonal••WatchfulWatchful••GuardedGuarded
StormingStormingInfightingInfighting••Controlling ConflictsControlling Conflicts••Confronting PeopleConfronting People••Opting OutOpting Out••Feeling StuckFeeling Stuck
NormingNormingGetting OrganizedGetting Organized
••Developing SkillsDeveloping Skills••Giving FeedbackGiving Feedback
••Establishing Establishing ProceduresProcedures
PerformingPerformingClosenessCloseness
••ResourcefulResourceful••FlexibleFlexible
••OpenOpen••EffectiveEffective
Step 4Finalize and document standard work flow & control plan
Step 1Current state map & identification of wastes
Step 3Implement and test the new process
Step 2Elimination of wastes & creation of new process
Step 5Communicate Success
Rapid Improvement ProcessPlan Strategic Processes Improvements
February 1, 2008 Page 18 of 32
Step 1 - Study Current Conditions
• Observe the current process• Take time observations• Create Current State process flow• Determine cycles, touch points• See the WASTE
February 1, 2008 Page 19 of 32
• Identify and prioritize wastes
• Identify and prioritize opportunities
• Create Future State process flow
Step 2 – Develop the New Process
February 1, 2008 Page 20 of 32
Step 3 – Test The New Process
• Make changes in steps, equipment, flow
• Communicate the process changes
• Measure and modify
February 1, 2008 Page 21 of 32
• Brainstorm additional solutions• Finalize and document standard work flow• Prepare Summary for Corp Communication • Prepare for Detailed Report for Departments
Step 4 – Finalize Standard Process
February 1, 2008 Page 22 of 32
Day 5 – Communicate Success
• Present improvement results• Communicate Process Review Maintenance Plan• Roll out final process changes in Future State• Celebrate the success of your team• Communicate, communicate, communicate!
February 1, 2008 Page 23 of 32
Before Lean Six Sigma
• Teams of 10-20 people• Meetings monthly• Projects lasted years• Accomplishments were minimal and often
un-measurable• Staff started to run and hide when asked to join
new project teams
February 1, 2008 Page 24 of 32
After Lean Six Sigma Key Learnings
• Big Staff participation improvement• Staff was proud to take ownership• Ongoing assessment and improvements• Keep all staff informed of the changes• Lessons learned are transferable to other
Rapid Improvement Teams• Staff now asking about the next Rapid
Improvement Team Meetings!
February 1, 2008 Page 25 of 32
The Real Life Results
• Streamline admissions • Increase OR throughput• Cut patient wait times • Decrease incidence of infection • Shorten billing cycles- faster reimbursement
February 1, 2008 Page 26 of 32
The Real Life Results
• GE/IDX determines the optimal number for FTEs using AR data and Six Sigma tools
• Presbyterian Health System improves group, member enrollment processes reducing process steps from 60 to 36 by replacing separate systems with a single integrated software system.
February 1, 2008 Page 27 of 32
Valley Baptist Health System
June, 2007, Rio Grande Valley, Texas • Improvements made through Six Sigma
have led to national recognition for Valley Baptist.
• The U.S. Centers for Medicare & Medicaid Services has ranked Valley Baptist Medical Center-Harlingen #1 in the nation in the treatment of heart failure, and #2 in the state for treatment of heart attack
February 1, 2008 Page 28 of 32
Collaboration - Empowerment
" We are so used to having decisions made for us and having to implement them. It was nice to actually make decisions ourselves and actually see them implemented."
Source: Staff RN
February 1, 2008 Page 29 of 32
Share the fun!
February 1, 2008 Page 30 of 32
What is the impact of this trend on the industry?
• Embracing Lean Six Sigma has become a competitive advantage
• Physician Incentives will be increased• Reimbursement advantages are clear• Smoother business operations will
mean lower cost• All improvements will lead to higher
patient satisfaction• Patients overall well-being will
improve
February 1, 2008 Page 31 of 32
What will the future look like?
• Executive role for Quality Management Leadership (CQM)
• Companies will build strategies around award recognition
• Improvement measurements will be embedded in our daily work
• Staff meetings will become improvement meetings based on corporate strategic goals
• IT will play a key role in providing quality measurements
February 1, 2008 Page 32 of 32
Today we will learn…• What is Six Sigma?• What is LEAN Process Improvement?• A Road Map to Success - A Case Study• How can we identify process improvement opportunities?• What are some of the tools available – Kaizen Event?• Lessons Learned• Real Life Examples• What is the impact of this trend on the industry? • What will the future look like?
• \
February 1, 2008 Page 33 of 32
Questions?
Presented by: Julie Thompson, MBA, MQMSenior Consultant
February 1, 2008 Page 34 of 32
For more information, please contact HIMSS Staff Liaison
JoAnn W. Klinedinst, CPHIMS, PMP, FHIMSS at [email protected]