Microsoft PowerPoint - 5a DAY ONE 1340A Rick Beaver
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Microsoft PowerPoint - 5a DAY ONE 1340A Rick Beaver Microsoft PowerPoint - 5a DAY ONE 1340A Rick Beaver Presentation Transcript

  • Successfully Applying Six Sigma in a Healthcare Organization Rick Beaver VP-Quality Heritage Valley Health System Sewickley/Beaver, PA SSC Six Sigma Connections for Healthcare
  • Presentation Objectives • Understand Integration of Six Sigma into an Organization for 1st Year Profitability • Identify Areas of Business Application for Six Sigma • Discuss Examples of Project Outcomes • Identify Various Options for Six Sigma Implementation SSC Six Sigma Connections for Healthcare
  • Understanding Education and Alignment of Senior Six Sigma Leadership Integration and Profitability
  • Understanding Six Sigma Integration and Profitability • Identification of Key Stakeholders – Senior Management Team • For organization success, senior leadership support is needed • If you want Six Sigma to live beyond one person, group or project, senior leadership support is needed SSC Six Sigma Connections for Healthcare
  • Understanding Education and Alignment of Senior Leadership Six Sigma Board Members and Physician Integration Leader Retreat and Profitability
  • Understanding Six Sigma Integration and Profitability • Identification of Key Stakeholders – Board Members and Physician Leaders • Addresses global needs of the organization • Unified commitment • Common language
  • Understanding Education and Alignment of Senior Six Sigma Leadership Integration Board Members and Physician Leader Retreat and Operations Leaders and Profitability Physicians Provided Awareness Training
  • Understanding Six Sigma Integration and Profitability • Identification of Key Stakeholders – Operations Leaders and Physicians • Physicians Relate to the Metric Component of Six Sigma • Sets the awareness of operations and physicians to understand the path set by the organization • Provides an awareness to operations and physicians of how students are approaching projects SSC Six Sigma Connections for Healthcare
  • Understanding Education and Alignment of Senior Six Sigma Leadership Integration Board Members and Physician Leader Retreat and Operations Leaders and Physicians Profitability Provided Awareness Training Project Selection Aligned with Org Goals
  • Understanding Six Sigma Integration and Profitability • Alignment of Projects to Strategic Imperatives of Organization – Provides a balanced project portfolio – Ensures support of all aspects of the organization (IT, HR, $, Q, Growth) – Allows incorporation of a specific project set in the mix – Project selection is a data driven approach, using FMEA methods and prioritization SSC Six Sigma Connections for Healthcare
  • Project Selection via FMEA Criterion Value Scores Impact on Imperative Finance Quality HR IT Growth Very High Positive Impact > $750 = 1.00 1.00 1.00 1.00 1.00 High Positive Impact $500-$750 = .75 0.75 0.75 0.75 0.75 Medium Positive Impact $250-$500 = .50 0.50 0.50 0.50 0.50 Low Positive Impact $100-$250 = .25 0.25 0.25 0.25 0.25 Very Low Positive Impact < $100 = .10 0.10 0.10 0.10 0.10 Projects Cardiology Business Deployment 1.00 1.00 0.75 0.75 1.00 4.5 Phys Office EMR 0.75 1.00 0.75 1.00 1.00 4.5 TMC Registration 1.00 1.00 0.50 1.00 0.75 4.25 E/R Business Deployment 0.50 1.00 0.75 0.75 1.00 4 Regional Cancer Center Evaluation 1.00 1.00 0.50 0.50 1.00 4 Improve Customer Satisfaction (needs scoped) 0.10 1.00 1.00 0.50 1.00 3.6 Revenue Capture (1% improvement) 1.00 0.50 0.75 0.75 0.10 3.1 Nursing Overtime 1.00 0.75 1.00 0.10 0.25 3.1 Retail Rx at TMC 0.25 1 1 0.1 0.75 3.1 Reduce FMLA/Missed Days Due to Injury 1.00 0.75 1.00 0.10 0.10 2.95 E.D. Physicians to Private 0.75 0.75 0.50 0.10 0.75 2.85 Human Resources - Payroll 0.25 0.75 0.75 1.00 0.10 2.85 Inventory Management (Fixed & Non) 1.00 0.25 0.50 1.00 0.10 2.85 Family Practice Relocation 0.75 0.75 0.75 0.1 0.5 2.85 Retinal Surgery 0.10 1.00 0.50 0.10 1.00 2.7 Medical Ambulatory Unit 0.25 1 0.75 0.1 0.5 2.6 Robotic Rx 0.25 1 0.25 0.75 0.25 2.5 Child Psychiatry 0.1 1 0.25 0.1 1 2.45
  • Understanding Education and Alignment of Senior Six Sigma Leadership Integration Board Members and Physician Leader Retreat and Operations Leaders and Physicians Provided Awareness Training Profitability Project Assignment Project Selection Aligned Prior to Class with Org Goals
  • Understanding Six Sigma Integration and Profitability • Project Assignments Prior to Start of Classes –Students arrive at class day 1 with a specific project and timeline defined –When student leaves class, work starts as soon as they hit the operations floor If What We Teach Today –“ Can’t Be Applied Tomorrow on the Floor, the Training is SSC Not Fully Effective” Six Sigma Connections for Healthcare
  • Understanding Education and Alignment of Senior Six Sigma Leadership Integration Board Members and Physician Leader Retreat and Operations Leaders and Physicians Provided Awareness Training Profitability Project Assignment Project Selection Aligned Prior to Class with Org Goals Students Aligned with Champions Black Belt Training
  • Understanding Six Sigma Integration and Profitability • Champion / Student Alignment is Critical – Both the student AND champion are responsible for project outcome – Champion ensures use of tools and metrics – Champion helps to break barriers to success – Champion participates in every student presentation SSC Six Sigma Connections for Healthcare
  • Champions Support Students During Class SSC Six Sigma Connections for Healthcare
  • Six Sigma Implementation Time Line Board of Directors and Leadership Web Physician Leadership Seminars Training 6 Sigma Champion Senior Leader Physician and Resident Training Student Selection Awareness Training Program Developed 1st Wave of Project Idea Bank Developed Students Trained 1st Set Of Projects Run to Completion Oct 4 Feb 1 Aug 20 Aug 22 Sept 30 Nov 1 July 03 2002 2003
  • Where Can Six Sigma Be Applied in the Organization? •There are no limitations to its application if Six Sigma is going to be “a way of doing business”
  • Examples of Six Sigma Applications HR (OT Reduction, FMLA Management, Staff Retention) Maintenance (Work Order Turn Around Time, Mean Time Between Failure for Clinical Equipment, Clinical Alarms) ED Design/Construction (Selection of Design/Architectural firms, Selection of fund raising company) Process Projects to Support ED Pre-Design (Door to Doc, Registration, ED Radiology, Bed Clean Cycle, Lab Turn-Around-Time)
  • Examples of Project Outcomes 17:1 Return on $260,000 Investment
  • Heart Failure Patients Given Education Control Chart - HF Discharge Instructions UCL=99.608 120 CEN=82.85 100 80 UCL=56.546 60 CEN=48.433 UCL=44.587 LCL=66.092 40 CEN=28.344 LCL=40.32 20 0 LCL=12.1 Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- 02 02 02 02 02 02 03 03 03 03 03 03 03 03 03 03 03 03 04 04 04 04 04 PROCESS CHANGE •FMEA completed by two nursing groups Jan-03. •Heart Failure Program nurses education in proper documentation Feb-03. First PROCESS •Education of nursing Apr-03 and Nov- Process CHANGE 03. Change •Case Control Data Baseline Data: •Pilot of Heart Failure Discharge Data: managers Mean = 82.85 Mean = 28.344 Summary form which included HF Mean = began to use Sigma Sigma Capability specific information May-03. 48.433 HF Case Capacity = = <1.0 •System wide implementation of new Sigma Management ~2.5 DPM=723360 forms Nov-03. Capability = tool to DPM = 165676 •Follow-up with individual nurses <1.5 monitor HF regarding their documentation if not in DPM = indicators compliance Nov-03. 481000 Apr-04 •Informational laminated pocket cards given to all cardiac nurses. •Communicate updates in newsletters and staff meetings - ongoing.
  • Maintenance Department Work Order Turn-Around Time SVH Engineering Work Order Turn-Around Time Control Chart Control Chart 80 70 60 50 40 UCL=38.106 30 CEN=18.026 UCL=6.9689 20 10 CEN=3.2965 0 LCL=0.0 LCL=0.0 Baseline Data (Prior to implementation of Control Phase - Month 1 Data Control Phase - Month 2 Data Control Phase - Month 3 Data Six Sigma Process Improvements) Sigma Capability: 4.52 Sigma Capability: 4.22 Sigma Capability: 4.45 Sigma Capability: 2.25 DPM: 1,250 DPM: 3,244 DPM: 1,566 DPM: 225,463 Mean: 1.05 Days Mean: 1.22 Days Mean: 1.08 Days Mean: 4.70 Days 6σ Engineering Six Sigma Team
  • Nursing: % OT Hours Paid on 7W 8% $54,536.58 7% Paid in OT $$ Average Census-144 Census-24 6% 5% Census-25 4% $23,871.65 Paid in OT $$ Census-23 3% Goal Census-19 Average Census-131 2.5% Census-21 2% Census-24 Census-20 1% Census-19 Census-21 0% 02/ 09- 02/ 23- 03/ 1 07/ 1 07/ 27- 08/ 1 08/24- 09/ 07- 09/21 0- 3- 0- - 02/22 03/09 03/22 07/26 08/09 08/ 23 09/ 06 09/ 20 10/04 Pay period dates
  • Cataract Surgery Surgeons Supported Project by: • Discussing Technique Differences for Eye Anesthesia • Pre-Scripting Medications • Eliminated Pre-Admission Testing on Topical Anesthesia Cases • Common Supplies Accepted • Types of Ophthalmic Solutions • Keratomes and Knife Preferences 44% Variation in • Drapes Supply Cost • Custom Packs • Lens Supplier Improved Profit Margin: from –16% to +7% Improved Customer Satisfaction: to Over 90%
  • Options for Implementation • Definitions: – Pilot Scale 1 or 2 Projects – Large Scale 10 to 30+ Projects • Risks/Benefits of a Pilot Scale Approach – Risks: • Possible incorrect conclusion of Six Sigma if project/student selection is not well done (i.e., 1 of 2 projects not fully successful) • Support for the project is not readily available because the organization is not properly informed of the effort – Benefits: • Short time horizon • Reduced investment up front
  • Risks/Benefits of a “Large Scale” Approach • Risks: – Larger investment up front – Involving Board, Senior management and physician leaders may be problematic in some organizations • Benefits: – Provides a true evaluation of the six sigma deployment – Mitigates failure due to poor project/student selection – Optimizes financial returns of the deployment – Assures alignment of projects with needs of the organization – Promotes the long term success of six sigma
  • Sustaining the Six Sigma Effort for the Long Term • Incorporate Six Sigma in Internal MBA or Continuing Education Program – Train the organization; change the culture – A strategy that embraces employee turnover • Create a structure around Six Sigma – Regular agenda items for operations meetings – Include in monthly newsletters – Poster presentations placed in strategic areas of the hospital
  • Are Partnerships with Six Sigma Organizations Worthwhile? • Partnerships can facilitate deployment and reduce initial costs • Benefits of leveraging the experience of a partner: – Project Leader interaction between organizations – Shared learnings – Prevents redundancy • Example: Partner adopted a project on nursing overtime in their organization for $100,000 annual gain
  • Summary • Profitability can be achieved in first years of Six Sigma implementation by: – Achieving organization awareness and support prior to start of training – Diligent selection of projects and students – Alignment of students with champions – Identification of project set balanced across company imperatives – Partner with organization experienced in Six Sigma methodology with demonstrated success SSC Six Sigma Connections for Healthcare
  • Questions? SSC Six Sigma Connections for Healthcare SixSigmaConnections.org