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A Six-Sigma Healthcare Primer

3 Responses

1. Hope Hetico RN, MHA, on June 21, 2010 at 5:28 PM said:

   Six Sigma Example:

   Scottsdale Healthcare in Arizona used consultants from Creative Healthcare USA on a project, rather than doing a full deployment of Six Sigma in its organization, to analyze its problem of emergency department (ED) “diversions.”

   Diversions happen when emergency departments are too full in capacity to handle acute emergencies and a decision is made to close its doors to patients and ambulances are diverted elsewhere. The issue of closed and diverted emergency rooms is a growing nationwide phenomenon because of fewer EDs and a growing aged and uninsured population.

   The consultants, using Six Sigma principles, mapped the ED process and found multiple bottlenecks that have a direct effect on the probability of evoking a “diversionary” status in the emergency room.

   One bottleneck process deemed “out of control,” in Six Sigma jargon, was the issue of bed control. A process is considered “in control” when operating within acceptable specification limits. It was found that the average transfer time for a patient admitted to a hospital bed from the emergency department was 80 minutes, of which half of this time, a bed is available and waiting. The process was a significant “waste of time” and, moreover, complicated by an Administrative Nurse “inspector” locating beds on different floors. Two tenements of Six Sigma level of quality were violated: one is that having an inspection is a correction for an inefficient process and two, the more steps involved the less is the potential yield of a process. Through this revelation, the hospital eliminated the Administrative Nurse, reduced cycle time by 10% in bed control, and improvement ED throughput with greater turnover thereby, improving revenue by nearly $600,000.

   The addition of a nurse inspector and waiting patients in a busy ED is an example of “Little’s Law” or sometimes referred to as the first fundamental law of system behavior. When more and more inputs are put into a system, such as more ED patients and an additional nurse employee, and when there is variation in their arrival time (no control over patient arrivals) or process variation (different people doing the same things differently), there becomes an exponential rise in “cycle time.”

   And, an examination of the project types to which healthcare provider organizations have utilized Six Sigma methodology reveals almost any hospital process is a candidate.

   Souce: http://www.amazon.com/Business-Medical-Practice-Maximization-Techniques/dp/0826123759/ref=sr_1_2?ie=UTF8&s=books&qid=1257295600&sr=1-2-spell

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2. Ann Miller RN MHA, on February 10, 2012 at 9:52 PM said:

   The 5-S Technique

   According to Mark Matthews MD, this technique was developed to allow employees to visually control their work area around visual management techniques. The principles involved in visual management include:

   • Improving workspace efficiency and productivity
   • Helping people share workstations by providing standard layouts
   • Reducing the time required to look for needed supplies or tools
   • Improving the work environment

   Each “S” in 5S stands for a step in the process:

   • Sort – classify every item in the designated area as either needed or not needed
   • Set (Straighten) – put “everything in its place”
   • Shine (Sweep) – clean all work environments for order and organization
   • Standardize – document what goes where, who will clean and who will inspect and on what schedule
   • Sustain-design a system for monitoring process, providing feedback, and rewarding good outcomes

   Prior to conducting a 5S event, a significant amount of planning is vital. It is important to scope the target area as something that is manageable, draw a physical map of the area under consideration, and assemble a list of current items in that area. This is usually accomplished by taking photographs (both before and after) of the area.

   Source: http://www.crcpress.com/product/isbn/9781439879900

   Ann Miller RN MHA
   [Executive-Director]

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3. Barbara, on July 19, 2012 at 9:55 AM said:

   LSS

   Lean Six Sigma isn’t just good for the wallet; it’s good for morale, according to hospitals going through the process.

   http://www.fiercehealthcare.com/story/lean-six-sigma-gives-employees-voice-changes/2012-07-18

   While Lean Six Sigma advocates hail the strategy as cost-effective and efficient, other supporters also praise its effects on employee satisfaction and buy-in.

   Barbara

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