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  • 1. Successfully Implementing Six Sigma in Healthcare: An Introduction to Six Sigma Principles, Practical Exercises and Case Study Examples Matiana Gonzalez Vela, Ed.D., M.Ed., R.D. Tracy Drake-Kirkconnell, M.B.A. March 17 , 2009
  • 2. <ul><li>Premier integrated healthcare delivery system serving South </li></ul><ul><li>Texas since 1925 </li></ul><ul><li>Valley Baptist Medical Center - Harlingen </li></ul><ul><ul><li>611 Licensed Beds </li></ul></ul><ul><ul><li>Lead Level 3 Trauma Center </li></ul></ul><ul><ul><li>State of the Art Children’s Center </li></ul></ul><ul><ul><li># 1 Rated Orthopedics Service </li></ul></ul><ul><ul><li>Heart & Vascular Institute </li></ul></ul><ul><ul><li>Teaching facility for The Regional Academic Health Center of The University of Texas Health Science Center at San Antonio </li></ul></ul><ul><ul><li>Certified Stroke Center </li></ul></ul><ul><li>Other Entities </li></ul><ul><ul><li>Golden Palms Retirement and Healthcare Center </li></ul></ul><ul><ul><li>Valley Baptist Health Plans </li></ul></ul><ul><ul><li>Valley Baptist Ambulatory Surgery Center </li></ul></ul><ul><ul><li>Clinical Pastoral Education Center </li></ul></ul><ul><ul><li>Licensed Vocational Nurse School </li></ul></ul><ul><ul><li>Family Practice Residency Program </li></ul></ul><ul><ul><li>Internal Medicine Residency Program </li></ul></ul><ul><ul><li>Home Health & Hospice </li></ul></ul><ul><ul><li>Rehabilitation & Wellness </li></ul></ul><ul><ul><li>Behavioral Health Services </li></ul></ul><ul><li>Valley Baptist Medical Center – Brownsville </li></ul><ul><ul><li>243 Licensed Beds </li></ul></ul><ul><ul><li>Level 3 Trauma Center </li></ul></ul><ul><ul><li>State of the Art Imaging Center </li></ul></ul><ul><ul><li>Center of Diabetes Management </li></ul></ul><ul><ul><li>Certified Stroke Center </li></ul></ul>Valley Baptist Health System
  • 3. <ul><li>Strategic Initiatives </li></ul><ul><ul><li>Integration </li></ul></ul><ul><ul><li>Simplicity </li></ul></ul><ul><ul><li>Growth and Development </li></ul></ul><ul><ul><li>People </li></ul></ul><ul><ul><li>Quality and Excellence </li></ul></ul><ul><li>Values </li></ul><ul><ul><li>Disciplined </li></ul></ul><ul><ul><li>Entrepreneurial </li></ul></ul><ul><ul><li>Performance Oriented </li></ul></ul><ul><ul><li>Accountable </li></ul></ul>Valley Baptist Health System
  • 4. How did we begin implementing Six Sigma? <ul><li>CEO Commitment </li></ul><ul><ul><li>Vision </li></ul></ul><ul><ul><li>Leadership </li></ul></ul><ul><ul><li>Resources (time, money, people) </li></ul></ul><ul><li>Partnership with General Electric Medical Systems </li></ul><ul><ul><li>Guidance </li></ul></ul><ul><ul><li>Expert Knowledge </li></ul></ul><ul><ul><li>Training – Six Sigma, CAP, Work-Out™ </li></ul></ul><ul><ul><li>Project Mentoring </li></ul></ul><ul><ul><li>Transition Assistance </li></ul></ul>
  • 5. <ul><li>A comprehensive and flexible program for achieving, sustaining and maximizing business success that: </li></ul><ul><ul><li>Is a management methodology with three perspectives: </li></ul></ul><ul><ul><ul><li>A Measure of Quality </li></ul></ul></ul><ul><ul><ul><li>A Process for Continuous Improvement </li></ul></ul></ul><ul><ul><ul><li>An Enabler for Cultural Change </li></ul></ul></ul><ul><ul><li>Is uniquely driven by a clear focus on the “Voice of the Customer” </li></ul></ul><ul><ul><li>Is founded in a rigorous use of facts, data and statistical analysis </li></ul></ul><ul><ul><li>Provides for diligent attention on managing, improving and reinventing business processes </li></ul></ul>What is Six Sigma? Define Measure Improve Control Analyze
  • 6. What is Six Sigma? <ul><li>Integrated part of management system </li></ul><ul><li>Fact & data based decision making </li></ul><ul><li>Knowledge transfer, learning process </li></ul><ul><li>Value added focus on defect removal </li></ul><ul><li>Utilization of technology tools </li></ul><ul><li>A lasting infrastructure </li></ul><ul><li>Not a cost reduction program </li></ul><ul><li>Not a training program </li></ul><ul><li>Not a statistics program </li></ul><ul><li>Not a quality program </li></ul><ul><li>Not a quick fix </li></ul>Six Sigma Advantage, Inc.
  • 7. A Measure of Quality <ul><li>Six Sigma is a statistical measure that expresses how close a service process comes to its quality goal </li></ul><ul><li>Six Sigma refers to a process that produces only 3.4 defects per million opportunities </li></ul>Sigma DPMO Yield 2 308,537 69.1463% 3 66,807 93.3193% 4 6,210 99.3790% 5 233 99.9767% 6 3.4 99.9997%
  • 8. Sigma Score vs. Percentage Yield
  • 9. DMAIC Methodology
  • 10. Lean Six Sigma <ul><li>5 Ss </li></ul><ul><ul><li>Seiri ………….…..Sort </li></ul></ul><ul><ul><li>Seiton ……………Standardize </li></ul></ul><ul><ul><li>Seiketsu …………Simplify </li></ul></ul><ul><ul><li>Seiso …………….Sweep </li></ul></ul><ul><ul><li>Shitsuke …………Sustain </li></ul></ul><ul><li>Value Added vs. Non-Value Added activity </li></ul>
  • 11. <ul><li>Genuine Focus on the customer </li></ul><ul><li>Data and Fact Driven Management </li></ul><ul><li>Process focus, management and improvement </li></ul><ul><li>Proactive management </li></ul><ul><li>Boundaryless collaboration </li></ul><ul><li>Drive for perfection; tolerance for failure </li></ul>Six Sigma Themes
  • 12. <ul><li>Traditional Quality Programs </li></ul><ul><ul><li>Driven internally </li></ul></ul><ul><ul><li>Focuses on outcomes </li></ul></ul><ul><ul><li>Fixes defects </li></ul></ul><ul><ul><li>Improves quality </li></ul></ul><ul><ul><li>Looks backwards </li></ul></ul><ul><ul><li>Concentrates on products </li></ul></ul><ul><ul><li>High on theory and people </li></ul></ul>The Six Sigma Difference <ul><li>Six Sigma </li></ul><ul><ul><li>Driven by the customer </li></ul></ul><ul><ul><li>Focuses on processes </li></ul></ul><ul><ul><li>Prevents defects </li></ul></ul><ul><ul><li>Improves bottom line </li></ul></ul><ul><ul><li>Looks forward </li></ul></ul><ul><ul><li>Concentrates on CTQs </li></ul></ul><ul><ul><li>High on methodology and data </li></ul></ul><ul><ul><li>Forces disciplined decision making </li></ul></ul>
  • 13. <ul><li>Dependant </li></ul><ul><li>Output </li></ul><ul><li>Effect </li></ul><ul><li>Symptom </li></ul><ul><li>Monitor </li></ul><ul><li>Independent </li></ul><ul><li>Input & Process </li></ul><ul><li>Causes </li></ul><ul><li>Problems </li></ul><ul><li>Control </li></ul>Six Sigma Focus Y = ƒ(x) Y X 1 … X n
  • 14. The Effectiveness (E) of the result is equal to the Quality (Q) of the solution times the Acceptance (A) of the idea times the Accountability (A) to solution execution Q x A 2 = E Six Sigma Effectiveness Six Sigma Methodology Change Acceleration Process Effective Results Work-Out TM
  • 15. Art Spirituality Science Fundamentals/Foundation Six Sigma and the Art of Medicine PATIENT CARE PATIENT CARE 6 σ Accuracy and Speed Medication Management Turnaround times Wait Times Research Based Disease Management Ventilator Associated Pneumonia Core Measures AMI CHF Pneumonia CABG VBHS Confidential & Proprietary Information
  • 16. Performance Measurements Not just about formulas…. Cultural Acceptance Change Management A² = Acceptance & Accountability Defines Success or Failure Foundations of Success VBHS Confidential & Proprietary Information Respect People Recognize Effort Reward Performance
  • 17. System Executive Council Entity Leadership Department Managers Individual Annual Goals Monthly Reports Quarterly Evaluations System Executive Council Board of Directors Accountability
  • 18. Roles at VBHS <ul><li>Master Black Belt – 6 Sigma mentor and educator </li></ul><ul><li>Black Belt – 6 Sigma trained specialist who works on 6 Sigma improvement initiatives on a full time basis </li></ul><ul><li>Green Belt – 6 Sigma trained specialist who uses the Six Sigma methodology to solve problems as a function of their normal work </li></ul><ul><li>Yellow Belt – Physicians and Executives trained in basic 6 Sigma methods who assist with problem solving, initiative sponsorship and solution implementation </li></ul><ul><li>Sponsor – Executive with responsibility to identify 6 Sigma initiatives, assign resources and remove barriers </li></ul><ul><li>Change Agent - Expert in the application of CAP and Work-Out™ tools </li></ul>
  • 19. Six Sigma Practitioners at VBHS <ul><li>Master Black Belts (5) </li></ul><ul><ul><li>5 Certified </li></ul></ul><ul><ul><li>Black Belts (9) </li></ul></ul><ul><ul><li>3 Harlingen </li></ul></ul><ul><ul><li>2 Brownsville </li></ul></ul><ul><ul><li>2 Corporate </li></ul></ul><ul><ul><li>2 Seeking Certification </li></ul></ul><ul><li>Green Belts (93) </li></ul><ul><ul><li>73 Certified </li></ul></ul><ul><ul><li>20 Seeking Certification </li></ul></ul><ul><li>Yellow Belts (43) </li></ul><ul><ul><li>17 Executives </li></ul></ul><ul><ul><li>26 Physicians </li></ul></ul><ul><li>16 Six Sigma Physicians’ Council members </li></ul><ul><li>CEO Expectation: </li></ul><ul><li>All Executives will be trained to Yellow Belt level </li></ul><ul><li>All Directors and Managers to Green Belt certification </li></ul><ul><li>Master Change Agents (2) </li></ul><ul><li>Change Agents (263) </li></ul><ul><ul><li>196 Harlingen </li></ul></ul><ul><ul><li>67 Brownsville </li></ul></ul>
  • 20. VBHS Timeline <ul><li>May 2002 </li></ul><ul><ul><li>Engagement with GEMS </li></ul></ul><ul><ul><li>Wave 1: 6 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><li>March 2003 </li></ul><ul><ul><li>Wave 2: 6 initiatives </li></ul></ul><ul><ul><li>3 Full Time Black Belts appointed </li></ul></ul><ul><li>April 2003 </li></ul><ul><ul><li>3 Full Time Master Black Belts appointed and trained </li></ul></ul><ul><li>June 2003 </li></ul><ul><ul><li>Wave 3: 8 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><ul><li>2 Master Change Agents trained </li></ul></ul><ul><li>March 2004 </li></ul><ul><ul><li>Wave 4: 15 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><li>July 2005 </li></ul><ul><ul><li>Wave 5/1: 13 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><li>September 2005 </li></ul><ul><ul><li>Wave 6/2/1: 14 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><li>May 2006 </li></ul><ul><ul><li>Wave 7/3/2: 14 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><li>November 2006 </li></ul><ul><ul><li>Wave 8/4/3: 16 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><li>May 2008 </li></ul><ul><ul><li>Wave 9/5: 8 initiatives </li></ul></ul><ul><ul><li>Green Belts trained </li></ul></ul><ul><li>May 2009 </li></ul><ul><ul><li>Wave 10/6; 12 initiatives </li></ul></ul>95 Completed Training and Translation Initiatives
  • 21. <ul><li>Examples of Clinical and </li></ul><ul><li>Operational Initiatives </li></ul>
  • 22. Case Study 1
  • 23. Case Study 2
  • 24. Questions?

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