Transcript USING SIX SIGMA FOR PROCESS IMPROVEMENT IN HEALTHCARE Is 99% Good Enough?

USING SIX SIGMA FOR
PROCESS IMPROVEMENT IN
HEALTHCARE
Is 99% Good Enough?
Three hospital campuses
Full range acute & tertiary
380 acute care beds
110 long-term care
Bowling Green
Scottsville
• Open Heart Surgery
• Cancer Treatment
• Neonatal Intensive Care
• Psychiatric Services
• Home Health
• Emergency Medical Services
• Managed Care
• Primary Care Walk-in Clinics
• OP Rehab Center
• Physician Practices
• Free Clinic
• Long Term Acute Care Hospital
• Health and Wellness Center
Franklin
Six Sigma In Healthcare
What is Six Sigma?
Measure of Quality:
Expresses how close a process or service comes to
meeting its customers’ expectation.
Method for Continuous Improvement:
Uses a rigid framework to approach process
improvement.
Mindset for Culture Change:
When successful, Six Sigma fundamentally changes
the culture and operating philosophy of the company.
It becomes “the way to do our job”.
Six Sigma In Healthcare
Z or Sigma Level
Sigma Level
2
3
4
5
6
Defect Rate
30.8%
6.7%
0.62%
0.0233%
0.00034%
Defects per Million
308,537
66,807
6,210
233
3.4
By using the Sigma level to express how good a process is, we are able to compare
dissimilar processes. Example: Radiology report turnaround time is at 2 sigma while
an ambulance’s arrival on the scene is 4.3 sigma.
Six Sigma In Healthcare
Is 99% Good Enough?
99% Good (3.8 Sigma)
99.99966% Good (6 Sigma)
200,000 wrong drug
prescriptions each year
68 wrong prescriptions
each year
5,000 incorrect surgical
operations each week
1.7 incorrect surgical
operations each week
50 newborn babies dropped
at birth each day
One newborn baby dropped
every 2 months
Six Sigma In Healthcare
What Makes Six Sigma Different?
• Process is measured using the customer’s specification rather than
internally established thresholds
•Analysis is data driven
•Improvements are statistically valid
•Improvements are tested and proven
•Processes are controlled
•Project framework is rigid
•Methodology is robust
Six Sigma In Healthcare
Culture change
• Traditional Beliefs:
– Quality costs money
– Inspection and rework
can capture defects
– Quality of output is
enough
– Control the worst case
and the average
– 99% defect free is good
enough
– Documentation can
control quality
• Six Sigma Beliefs:
– Poor quality is extremely
expensive
– Defects must be
prevented
– Quality must be built into
the process (Sony TVs)
– Variability is the enemy
– Need to achieve 3.4
defects per million
– Mistake proof to sustain
quality
Six Sigma In Healthcare
Strategic Alignment
to Driving Results &
Leverage Resources
Six Sigma In Healthcare
Organizational Dashboard for Success
• Customer Satisfaction
Measured by Press Ganey Scores
• Quality of Service
Measured by Timeliness (a rolled “z” score)
• Efficiency
Measured by Operating Margin
(cost per unit produced at departmental level)
Six Sigma In Healthcare
Action Plan
– Customer Service/Satisfaction
 Reduced Wait Times
 Meeting Service Expectations
– Delivered Quality of Care
 Reduced Medical Errors
 Increased Safety
 Use of Appropriate Technology
– At Lower Cost
 Increased Productivity
 Decreased Cost
Six Sigma In Healthcare
Hospital CEO
&
Sponsor
EVP &
Sponsor
EVP &
Sponsor
Master
Black Belts
Press Ganey Score & Target
Timeliness Z Score & Target
Champions & Sponsors
PRESIDENT AND CEO
Functional Structure
Brown Belts
Green Belts
Cost Efficiency & Target
Change Agents
Six Sigma In Healthcare
Project Profile: Radiology Staffing Efficiency
Operational Problem: Labor
Costs Too High in Radiology
Defect: Occurs any Time Staffing
Exceeds Labor Resources Required
For Exam Volume
Baseline: .3 Sigma
DPMM = 382,000
Critical X: Staff Schedule
Improvements:
•Staff Used CAP &
Work-out™ to
Redesign Schedule
•14 Positions Eliminated
•1st Yr. Savings $860,000
Controlled Process:
1.15 Sigma
DPMM = 125,000
Six Sigma In Healthcare
Financial Returns
Radiology Cost Per Procedure
100%
90%
80%
70%
60%
50%
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Six Sigma In Healthcare
Senior Management’s Involvement
•Created Vision Statement
•Identified CTQs
•Attended CAP/Workout Training
•Attended Greenbelt Training provided by GE
•“Shadowed” Greenbelt Projects
•Participate in Formal Reviews by Greenbelts
•Driven from “top-down”
Six Sigma In Healthcare
Key Learnings
•Commitment is Critical
•Ideally From the Top
•Watch for & Address the “Holdouts”
•People Selection
•Best & Brightest
•Project Selection
•Tied to Strategic Objectives
•Financial Results & Validation
•Challenging, Challenging, Challenging
•Culture Change vs. Quality Tool
Six Sigma In Healthcare