Six Sigma -why not 8or10sigma

8/7/2019 Six Sigma -why not 8or10sigma

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The Power of Six Sigma and Lean forHospitals and Healthcare Management

Dr. Ali Lakhani

10/23/2008

Copyright 2007 Dr. Ali Lakhani. All rights reserved. CONFIDENTIAL. Any Reproduction or Dissemination Strictly Prohibited. Unpublished proprietary

work available only under license from Magna Leadership Solutions LLC.


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Objectives

To understand how to advance to the nextlevel of sophistication by using Six Sigma andLean in hospitals and healthcare management

and improve patient care, quality of service,and bottom line results.

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Agenda

Part I Essence of Six Sigma and Lean Quality in Healthcare Management Six Sigma and Lean Definition The Six Sigma and Lean Approach

Q&A / Discussion

Part II Six Sigma and Lean Methodology DMAIC/DMADV/Lean Framework

o

sp a an ea care anagemen Six Sigma Toolkit Q&A / Discussion

Part III Implementing Six Sigma and Lean

Success Stories Six Sigma Training and Certification Summary / Six Takeaways Q&A / Discussion



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Part I Essence of Six Sigma and Lean

Quality in Healthcare Management

The Six Sigma and Lean Approach Q&A / Discussion

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Science

American healthcare systemis remarkable for its scientific,technological achievements.

Yet, it is considered potentiallydangerouseven lethalin itsexecution.

Quality in Healthcare

5

Human Touch 24 x 7 Care

Between 44,000 and 98,000 Americans die annually as a result of medicalerrors. Systemic issues key contributors to patient care, quality of service,and bottom line results.

Case of good people working

in bad systems.




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Healthcare Business Challenges

1. Ever-increasing costs shrinking hospital profits Despite growth in number of patient visits.

2. Limited number of special skilled resources Physicians, nurses, radiologists, etc.

3. As such, hospital processes include number of handoffs process delays, lower patient cycle time, increasing

length of stay, etc.

4. 30%-80% of activities are non-value add (NVA) Waiting in queue, updating charts, etc.

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Traditional response: Build larger hospitalsSix Sigma response: Increase patient capacity with faster throughput


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Quality

Possible qualityPossible quality Actual quality = Waste (Actual quality = Waste (MudaMuda))

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History of Quality

1313thth Century Leagues of Medieval EuropeCentury Leagues of Medieval Europe

The Industrial RevolutionThe Industrial Revolution

The Early 20The Early 20thth CenturyCentury

World War IIWorld War II

Total Quality ManagementTotal Quality Management

Beyond Total Quality ManagementBeyond Total Quality Management-- Six SigmaSix Sigma and Leanand Lean

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Total Quality Management

Total quality management (TQM) is defined as managingthe complete organization so that it does extremely well onall dimensions of products and services that are important

to the customer.

TQM Pitfalls:1. Lack of Assimilation

.

3. A Nebulous Concept4. An Unclear Target5. Classicist Attitude and Procedural Zealotry6. Failure to Break Down Internal Fences7. Incremental vs. Exponential Progress

8. Unproductive Training9. Focus on Quality of Manufactured Goods

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Six Sigma Strategy

increase customer satisfaction,shareholder value, and employeefulfillment

More than 75% of theFortune 500 companies use Six Sigma

improve the quality of processes,products and services by reducingthe variability in every aspect ofbusiness

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Six Sigma Defined

rigorous, focused, and highly effectiveimplementation of proven quality tools,principles, and techniques

Every dollar spent on Six Sigma addsfour dollars to the bottom line

a oon or serv ce processes, whichare slow and expensive and have too muchwork-in-process. 80% of service delays arecaused by 20% of activities

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Six Sigma Benchmark

THREE SIGMA (historical standard)

93.31928% Perfection

FOUR SIGMA (average standard)

SIX SIGMA (best-in-class standard)

99.99966% Perfection

SIX SIGMA means 3.4 defects or errorsper one million opportunities

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Six Sigma Approach

measure what you value and valuewhat you measure

o var a y are ce ergsthat sink organizational ships

companies need Six Sigma certifiedemployees to attack variability

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Copyright 2007 Dr. Ali Lakhani. All rights reserved. CONFIDENTIAL. Any Reproduction or Dissemination Strictly Prohibited. Unpublished proprietarywork available only under license from Magna Leadership Solutions LLC.


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Six Sigma Belts

Certified Master Black BeltCertified Master Black Belt- are the technical leaders of the Six Sigma program- have deep understanding of statistical theories, gift for

project management, coaching, and consulting

Certified Black BeltCertified Black Belt- are leaders of the Six Sigma projects- need not be trained statisticians or engineers

- have mastery of the Six Sigma tools and concepts

Certified Green BeltCertified Green Belt- are Six Sigma team leaders- are capable of forming and facilitating Six Sigma teams

Certified Yellow BeltCertified Yellow Belt- are trained to help the data gathering and analysis role- help the Green and Black Belts with problem solving

and solution implementation

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Six Sigma Quality

The scientific goal of SixSigma methodology is toreduce process variationsuch that the quantity of

undesirable output is nomore than 3.4 defects permillion opportunities.

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Why Not Eight Sigma or Ten Sigma?

Poor quality

Total Cost of Quality

Costs in dollars of

raising quality level Low defects -> High process precision ->Higher cost

costs

Precision Cost

Six Sigma* Number of defects

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Six Sigma

How Six Sigma Addresses the Drawbacks in TQM:1. Links to the Business and Personal End Results

2. Leadership at the Forefront3. A Consistently Repeated, Uncomplicated Message4. Setting a Straightforward, Striving Goal5. Adapting Tools and Degree of Thoroughness

6. Priority on Cross Functional Method Management7. Incremental and Exponential Transformation8. Training: Belts, Certification Standard9. Concentration on All Business Processes

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Lean Strategy

Minimize waste in the value streamsystematically. CLOSEDMITTS.

Lean and Six Sigma are being adopted bybusiness all over the world as a way to improve

efficiency and to serve customers better.

Focus on time, motion, materials,and output that meets customer needs

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Case for Six Sigma and Lean

Six Sigma and Lean Recognize opportunities and eliminates defects Remove the variation hindering high quality services

Maximize process velocity Quantify and eliminate cost of complexity

As a result Product/service quality improves and costs go down Customer satisfaction rises and bottom line results improve Your ability to compete and lead increases

One who locates and appropriates the knowledge one needs becomesthe hammer rather than the anvil.

Goethe

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End of Part I of III

Q&A /Discussion

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Part II Six Sigma and Lean Methodology

DMAIC DMADV Lean Framewor Hospital and Healthcare Management Six Sigma Toolkit Q&A / Discussion

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Six Sigma DMAIC Model

DMAIC is a systematic methodology

DMAICDefine, Measure, Analyze,Improve, Control--is the improvementframework deployed by Six Sigma

customer expectations at Six Sigmaquality levels.

Define the goals of the improvement activity

Measure the existing systemAnalyze ways to eliminate the gap between current and desiredImprove the system using statistical modeling and validationControl the new system by institutionalizing the improvements.

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Six Sigma DMAIC Cycle

Recognize

Business-

related CTs

Define

Business

Problem

Fine-tune

ProjectFMEA Execute DOE

Optimize and

Refine Solution

Understand

Solution

Brainstorm

Possible

Projects

Scope Problem

into a Project

Process

Mapping

Graphical

AnalysisDefine y = f(x)

Control Xs and

Monitor Yx

Track Project

Gains

Recognize Identify-

Diagnose Define Measure Analyze Improve Control Fulfill

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Project-related

CTs

Metrics and

Goals

Reduction

Analysis

Changes

-

Project

Projects

Rank-order

Project Ideas

Quantity

Business

Impact

Capability

MeasurementKick-off DOE

Form Team

and Kick-Off

Project

Collect Data

Measure

Process

Capability



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Design for Six Sigma (DFSS)

DFSS is a systematic methodologyfor designing products and processesthat meet customer expectations atSix Sigma quality levels.

DMADVDefine, Measure, Analyze,Design, Verify--is the frameworkdeployed by DFSS

Define the goals of the design activity

Measure customer inputs to determine what is critical to qualityAnalyze innovative concepts for products to create valueDesign new processes, products, and services to deliver valueVerify that new systems perform as expected sustainably.

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Six Sigma DMADV Cycle

Define Measure Analyze Design Verify

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Define

STEPS

Make business case for the project Identify the customer Current state map Future state map Layout the scope of the project Deliverables Due date

TOOLS

Project Charter

VOC Tools (surveys, focus groups, etc.) Process map Quality Function Deployment (QFD) SIPOC Benchmarking

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Measure

STEPS

Identify the key metrics for the process Ensure metrics are reliable and valid

Collect data on the process Create metrics for measuring success

TOOLS

Measurement systems analysis

Exploratory data analysis Descriptive statistics Data mining Run charts Pareto analysis

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Analyze

STEPS

Perform analysis of current state Explore the optimal state possible

Identify resource requirements Comprehend obstacles and risks

Cause-and-effect diagrams Tree diagrams Brainstorming Process behavior charts (SPC)

Process maps Design of experiments (DOE) Inferential statistics FMEA Simulation

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Improve/Design

STEPS

Identify the work breakdown structure List specific activities needed to meet goals

Comprehend integration of subprojects

TOOLS

Force field diagrams 7M tools

Project planning and management tools Prototype and pilot studies

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Control/Verify

STEPS

Control risk, quality, cost, schedule Institute monitors

Ensure that gains are sustained

TOOLS

Statistical process control (SPC) Failure Mode Effects Analysis (FMEA)

ISO 900x Reporting system

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End of Part II/IIIEnd of Part II/IIIEnd of Part II/IIIEnd of Part II/III

Q&A /Q&A /Q&A /Q&A /DiscussionDiscussionDiscussionDiscussion

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Part III Implementing Six Sigma and Lean

Success Stories

Six Sigma Training and Certification Summary / Six Takeaways Q&A / Discussion

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Success Story #1: Baptist Hospital Inc.

Problem: Low satisfaction marks from patients, staff, anddoctors.

Solution: Implementation of a Six Sigma-based CARE program(Clinical Accountability Report of Excellence) thatcaptures and monitors clinical quality data resultsand trends throughout the facility.

Results:

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Success Story #2: Pocono Medical Center

Problem: Delays in lab results causing treatment delays.

Solution: Implementation of a Six Sigma-based process flowchange going from batch-flow to one-piece flow ofspecimens.

Results:

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Success Story #3: Mercy Medical Center

Problem: Patient satisfaction scores slides into the 30th

percentile.

Solution: Implementation of a Lean-based process flowresulting in a remapping of the patient flow andrevenue cycle stages.

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Success Story #4: Nebraska Medical Center

Problem: 29% of orders werent available prior to patientsarrivals. 59% of the time orders were incomplete,illegible, or incorrect.

Solution: Implementation of a Six Sigma-based process flowresulting in a redesign of Order Central (no catch-allbin, call balancing, monitors for incomplete data, etc.)

Results:

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Success Story #5: St. Lukes Hospital

Problem: In-patient satisfaction measure dipped to the64th percentile level when compared to otherhospitals in the country.

Solution: Implementation of a Six Sigma-based process flowresulting in a redesign of all major processes andinstitution of a follow-up process to check up on

.

Results:

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Six Sigma Training and Certification

Six Sigma Master Black Belt Certification (12 Weeks Online / 6 Days On-Ground)November 10 .......OnlineNovember 8.....Sacramento

Six Sigma Black Belt Certification (8 Weeks Online / 4 Days On-Ground)

November 10 .......OnlineNovember 8 ....Sacramento

Six Sigma Green Belt Certification (4 Weeks Online / 2 Days On-Ground)November 10 .......Online

Click for Pricing and Registration:http://www.magnaleadership.com/product_offerings/certifications/SixSigma/sixsigma_details.htm

....

Six Sigma Yellow Belt Certification (2 Weeks Online / 1 Day On-Ground)November 10 .......OnlineNovember 8 ....Sacramento

For more information, contact sixsigma@magnaleadership.com.

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You are halfway there!

Earn your Six Sigma Yellow Belt in Healthcare Management by

1. Attending a two-hour conference call on 10/29/082. Reviewing Yellow Belt slide set provided by Dr. Ali Lakhani3. Reading six chapters from a prescribed book

4. Passing a one-hour open book, multiple choice test on concepts covered

Click for Pricing and Registration:http://www.magnaleadership.com/product_offerings/certifications/SixSigma/sixsigma_details.htm

For more information, contact sixsigma@magnaleadership.com.

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S / Si T k


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Summary / Six Takeaways1. Huge opportunities for improvement (to the tune of $1 trillion

per year) exist in the healthcare industry.

2. Six Sigma and Lean are increasingly being adopted by thehealthcare businesses all over the world.

3. Six Sigma and Lean are high-ROI ways of delivering betterpatient care, improving efficiencies, and optimizing profits.

4. Healthcare professionals with certifications in Six Sigma andLean are highly prized employees who are readily recruitedto key management positions.

5. Six Sigma certified employees earn up to 50% more than

their uncertified counterparts.

6. Remember, businesses dont exist because of the productsand services they deliver. They exist because of customers.

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End of Part III/IIIEnd of Part III/IIIEnd of Part III/IIIEnd of Part III/III

Q&A /Q&A /Q&A /Q&A /DiscussionDiscussionDiscussionDiscussion

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More questions?

sixsigma@magnaleadership.com

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References and Additional Resources

American Society for Quality (2008). Retrieved from http://www.asq.org June 2008.

Aveta Solutions, Six Sigma Online SSC Certified Training, 2007,

Benbow, Donald W., and T.M. Kubiak, Certified Six Sigma Black Belt Handbook, Milwaukee, WI: ASQ Quality Press, 2005.

Breakthrough Management Group, Six Sigma eCourses, 2007.

Breyfogle, Forrest, Implementing Six Sigma: Smarter Solutions Using Statistical Methods, 2nd ed., Hoboken, N.J.: Wiley, 2003.

Chase, Jacobs & Aquilano. (2005). Operations management for competitive advantage, 11th ed. New York: McGraw-Hill.

Cavanagh, Roland R., Robert P. Neuman, and Peter S. Pande, The Six Sigma Way: How GE, Motorola, and Other TopCompanies are Honin Their Performance, New York: McGraw-Hill, 2000.

George, Michael L., Lean Six Sigma for Service: How to Use Lean Speed and Six Sigma Quality to Improve Services andTransactions, New York: McGraw-Hill, 2003.

George, Michael L., John Maxey, David T. Rowlands, and Mark Price, The Lean Six Sigma Pocket Toolbook: A Quick ReferenceGuide to nearly 100 Tools for Improving Quality, Speed, and Complexity, New York: McGraw-Hill, 2005. ISBN 0071441190

I Six Sigma (2008). Retrieved from http://isixsigma.com/June 2008.

Juran, J.M., and A. Blanton Godfrey, Jurans Quality Handbook, 5th ed., New York, McGraw-Hill, 1999.

Lind. (2005). Statistical techniques in business and economics(12th ed.). New York: McGraw-Hill.

Lowenthal, Jeffrey N., Six Sigma Project Management, Milwaukee, WI: ASQ Quality Press, 2002.

Montgomery, Douglas C., Design & Analysis of Experiments, 6th ed., New York: John Wiley and Sons, 2004.

43Copyright 2007 Dr. Ali Lakhani. All rights reserved. CONFIDENTIAL. Any Reproduction or Dissemination Strictly Prohibited. Unpublished proprietarywork available only under license from Magna Leadership Solutions LLC.


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References and Additional Resources

Pyzdek, Thomas., The Six Sigma Handbook. New York, McGraw-Hill, 2006.

Naumann, Earl, and Steven Hoisington, Customer Centered Six Sigma: Linking Customers, Process Improvement, andFinancial Results, Milwaukee, WI: ASQ Quality Press, 2001.

Rath and Strong, Six Sigma Pocket Guide, Lexington, MA: Rath and Strong, 2000. ISBN 0970507909

Womack, James, and Daniel T Jones, Lean Thinking: Banish Waste and Create Wealth in Your Corporation, Revised and

Updated, New York: Free Press, 2003. ISBN 0743249275

Yang, Kai, Design for Six Sigma for Service, New York: McGraw-Hill, 2005.

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