Six-Sigma is a data driven approach to service development , which provides a problem solving methodology, which allows you to get at the facts as the basis for informing decision-making.
“ Facts are the bricks with which you will lay a path to your solution and build pillars to support it. Don't fear the facts.”
Pronounced ( Duh-May-Ick ). DMAIC refers to a data - driven quality strategy for improving processes , and is an integral part of the company's Six Sigma Quality Initiative. DMAIC is an acronym for five interconnected phases:
D efine
M easure
A nalyse
I mprove
C ontrol
Each step in the cyclical DMAIC Process is required to ensure the best possible results !!
The chart below is a Histogram showing the time taken to get a GP appointment ( all data is fictitious )! A basic understanding of statistics can help us understand the variation in the process.
Sigma stands for the standard deviation , which represents the average variation from the mean (average) value
The smaller the standard deviation the smaller the amount of variation in the process .
MEAN Average
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The Normal Distribution Naturally occurring processes often approximate to a normal frequency distribution The frequencies of events within a normal distribution have known probabilities . The standard deviation about the mean of a normal distribution is given the Greek letter (lower case) Sigma , ( )
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Sigma ( ) from the Customer’s (Pts) Perspective Very Few Defects Very Few Defects If the patient is prepared to wait between 1 and 7 days then we have.. A Six-Sigma (6 ) Process!!
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Sigma ( ) from the Customer’s (Pts) ‘Changed’ Perspective… If the patient (or LHB) is now only prepared to wait between 1 and 3 days then we have.. Very High No of Defects on this side of the distribution!! Very Few Defects No longer a Six-Sigma (6 ) Process!!
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Improving Quality We need to keep dong it so that the distribution curve gets tighter and tighter. And our customers (patients) get happier and happier Upper Service Specification Lower Service Specification 6
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From Decimals to Defects per Million Opportunities (DPM)
Probabilities are difficult to utilise eg 99.99999998% provides a confidence interval equivalent to 6 (Standard Deviations) about the mean.
Process Sigma Defects Per Million Opportunities (DPMO) 6 3.4 5 233 4 6,210 3 66,810 2 308,537
These are Motorola’s adjusted Yields and DPMO , which are shifted 1.5 from the standard normal values to account for variation associated with repeated measures
Process Sigma Yield % Defects Per Million Opportunities (DPMO) 6 99.99966 3.4 5 99.977 233 4 99.379 6,210 3 93.32 66,810 2 69.20 308,537
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‘Six-Sigma’ in Practice ‘The Paper Aeroplane Metaphor’
Based on an Idea By Neil Westwood
Instructions:
Make an aeroplane using the materials on your tables (use only one type of material)
When you have made it, bring the plane to the front of the room
When instructed throw the plane
The planes go different distances – due to variation in deigns, materials and the people making them.
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Six-Sigma’ in Practice ‘The Paper Aeroplane Metaphor’
Understanding Variation…..
Note the distances flown by each design , what is the mean and standard deviation .
What are causing the aeroplanes to fly different distances?
Why are they not flying the same distance?
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Six-Sigma’ in Practice ‘The Paper Aeroplane Metaphor’ Fishbone Diagrams are used to identify the root causes of variation Define Measure Analyse Improve Control Causes Causes Causes Causes Causes Causes Some aeroplanes fly different distances The different types of paper e.g. card, tracing paper, No clear instructions provided The people have different skills/ideas Different throwing styles Some Tables had scissors and rulers to help Problem
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Six-Sigma’ in Practice ‘The Paper Aeroplane Metaphor’
How can we reduce variation ?
Train people [Improve]
Provide Instructions [Improve]
Provide the same materials [Improve]
Develop process measures and use to control process variance – apply SPC. [Control]
Define Measure Analyse Improve Control
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Six-Sigma’ in Practice ‘The Paper Aeroplane Metaphor’
Towards a solution (ie to reduction in process variation )!!
Make another aeroplane – following the instructions . (Perhaps we have a master designer or Modernisation Director who is able to demonstrate)
Use the A4 white paper provided , 80g/m2 (everyone to use the same material.
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Six-Sigma’ in Practice ’The Paper Aeroplane Metaphor’ – INSTRUCTIONS (1 of 3)
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Six-Sigma’ in Practice ’The Paper Aeroplane Metaphor’ - INSTRUCTIONS (2 of 3)
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Six-Sigma’ in Practice ’The Paper Aeroplane Metaphor’ - INSTRUCTIONS (3 of 3)
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Six-Sigma’ in Practice ‘The Paper Aeroplane Metaphor’
Analysing the results of the experiment
Now note the mean and standard deviation of the distances flown
Do we have a more stable process ?
Is it capable ?
We need to know the upper and lower service specification!!
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Six Sigma Implementation in the NW Wales NHS Trust – Why are we doing it? Engendering Service Improvement by providing the impetuous for sustainable Cultural Change! The development of cost effective, patient (customer) centred & evidence based services derived form a rigours approach to systems analysis and redesign. Leading to …
Reduction in do not attend rates (DNAs) for compulsory patient handling training to ensure 100% compliance with Trust Policy and HSE (Statutory) guidelines. [Root Cause Analysis – Undertaken]
Reduce cycle time in relation to lease care application process ensuring 100% compliance with Trust Policy F6(a)
Reduction in the N o of Non BACs transactions to zero .
[2.5 – 3.2 ]
Improve contractor compliance with the audit requirements of the cleaning contract towards a target of 100% compliance with relevant clauses. [0.9 – 3.9 ]
Reduction in the time spent on pre & post payroll checks.
Development of a universal approach to solving problems which enforces:-
Business led approach to the selection of improvement projects, (Project charter incorporating an outline business case – facilitating strategic integration)
Customer/Patient centred ( VOC )
Systemic perspective ( SIPOC , Process Mapping/Redesign )
Focus on measurement ( SPC )
Scientific approach to Root Cause Analysis – Fact NOT assumption! ( Y = F(x1, x2, x3 … xn ))
Rational DOE underpinning P-D-S-A (Fast prototyping)
Rational selection of solutions against a range of CTQs
The importance of developing a strong business case underpinning the improvement opportunity – strategic integration.
The critical importance of the project sponsors role – action not tokenism!
The importance of embedding black, green and yellow belt roles within job descriptions and other artefacts of culture – staff appraisal.
The importance of organising work to allow dedicated space and time for six-sigma practice.
Encouraging accountability for project outcomes by embedding the tollgate reviews within the directorate review process and local performance management arrangements.
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