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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 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?

• \


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/

http://www.deming.org/


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


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.


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


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


Lean Process Flow

Add

Valu

e

Wai

t

Tran

spor

t

Insp

ect

Current State – “As is”Future State – “To be”


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


Combining Six Sigma and Lean Management


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.

http://www.sixsigmainstitute.com/leansigma/lean six sigma improvement innovation kaizen maintenance


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?


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


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



Lean Six Sigma Align Corporate Strategies with Quality Measures

Assess Current Business Strategies



• 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


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


Step 1 - Study Current Conditions

• Observe the current process• Take time observations• Create Current State process flow• Determine cycles, touch points• See the WASTE


• Identify and prioritize wastes

• Identify and prioritize opportunities

• Create Future State process flow

Step 2 – Develop the New Process


Step 3 – Test The New Process

• Make changes in steps, equipment, flow

• Communicate the process changes

• Measure and modify


• 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


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!


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


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!


The Real Life Results

• Streamline admissions • Increase OR throughput• Cut patient wait times • Decrease incidence of infection • Shorten billing cycles- faster reimbursement


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.


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


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


Share the fun!


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


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


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?

• \


Questions?

Presented by: Julie Thompson, MBA, MQMSenior Consultant

[email protected]


For more information, please contact HIMSS Staff Liaison

JoAnn W. Klinedinst, CPHIMS, PMP, FHIMSS at [email protected]

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