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Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
Akron Children’s Hospital 1st year Lean Six Sigma Journey
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Akron Children’s Hospital 1st year Lean Six Sigma Journey

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  • 1. WCBF Lean Six Sigma in Healthcare Summit Akron Children’s Hospital 1st year Lean Six Sigma Journey Chris Weisbrod, MBA, Lean Six Sigma Project LeaderAnne Musitano, RPh, PharmD, Lean Six Sigma Project Leader
  • 2. Akron Children’s Hospital1st year Lean Six Sigma Journey 44 1 9Do we have any of these problems at Akron Children’s Hospital? in e d •Deliveries of supplies delayed because of improper ordering h •Mix ups in getting supplies is correctly b l •Articles returned by other departments because they were not made p u •Employees have difficulty handling new type of equipment •Limited storage space not properly used n t •Minor injuries or illness not reported •Correct procedures not followed e •Safety equipment not being used m •Employees leave to go to other hospitals u o c •Employees pass the buck Source: Graban, Lean Hospitals D Process improvement through people development™ Copyright Childrens Hospital Medical Center of Akron 2
  • 3. Akron Children’s Hospital1st year Lean Six Sigma Journey Henry Ford – 1922 “In the ordinary hospital the nurses must make useless steps. More of their time is spent in walking than in caring for the patient.” Source: Key Concepts of Lean Healthcare, Lean Enterprise Institute Process improvement through people development™ 3 Copyright Childrens Hospital Medical Center of Akron
  • 4. Akron Children’s Hospital1st year Lean Six Sigma Journey January 2008 – February 2009 •Who’s initiative and why Lean? •Training •Setup of the department: oStaffing oSpace oPurchases •Consultants •Meetings and interviews •1st year projects •Partnerships Process improvement through people development™ 4 Copyright Childrens Hospital Medical Center of Akron
  • 5. Akron Children’s Hospital1st year Lean Six Sigma Journey Who’s Initiative and why Lean Six Sigma? Chief Operating Officer (COO) • Wanted to better the patient experience (decreasing patient wait times, access times) • Looked for a sustainable way for a hospital to improve operations • Chose 6 internal candidates from separate areas of the hospital to go to training Process improvement through people development™ 5 Copyright Childrens Hospital Medical Center of Akron
  • 6. Akron Children’s Hospital1st year Lean Six Sigma Journey Training • January 2008 o Johns Hopkins Lean Sigma Prescription for Healthcare • June 2008 o Cancer Treatment Centers of America • August 2008 o Joan Wellman and Associates Inc, Lean Leader Training Process improvement through people development™ 6 Copyright Childrens Hospital Medical Center of Akron
  • 7. Akron Children’s Hospital1st year Lean Six Sigma Journey Staffing, Space, and Purchases • October 2008 o 2 Lean Six Sigma Project Leaders started in the COE • January 2009 o 2 additional Lean Six Sigma Project Leader (4 total) joined the COE • March 2009 o Data analyst and office coordinator joined the COE • July 2009 o 1 additional Lean Six Sigma Project Leader (5 total) joined the COE Process improvement through people development™ 7 Copyright Childrens Hospital Medical Center of Akron
  • 8. Akron Children’s Hospital1st year Lean Six Sigma Journey Consultants Interviewed two firms • Initial needs from consultants were to work with the COE to: o Deploy the Akron Children’s Operating System o Develop mission and vision statements o Establish rewards and recognitions program for Lean Six Sigma programs o Establish a financial scorecard in conjunction with the Finance Department Process improvement through people development™ 8 Copyright Childrens Hospital Medical Center of Akron
  • 9. Akron Children’s Hospital1st year Lean Six Sigma Journey Spreading the word Meetings with many different departments to: • Present Lean Six Sigma concepts and ideas usually at departmental meetings • Present results of projects (A3, Green Belt, and Kaizen) • Inform the Board of Trustees of the project results (A3, Green Belt, and Kaizen) Process improvement through people development™ 9 Copyright Childrens Hospital Medical Center of Akron
  • 10. Akron Children’s Hospital1st year Lean Six Sigma Journey Interviews with Executives Met with C-Level, Vice Presidents, and Key Physician Leaders and asked: • What was their prior knowledge of Lean Six Sigma concepts? • What was their prior project work with Lean Six Sigma? • What keeps them up at night? Process improvement through people development™ 10 Copyright Childrens Hospital Medical Center of Akron
  • 11. Akron Children’s Hospital1st year Lean Six Sigma Journey Partnerships Established relationships with other organizations practicing Lean, Six Sigma, and Lean Six Sigma • Goodyear Tire and Rubber • Timken Company • Little Tikes • Planned Parenthood • University of Akron • Other hospitals Process improvement through people development™ 11 Copyright Childrens Hospital Medical Center of Akron
  • 12. Akron Children’s Hospital1st year Lean Six Sigma Journey The Akron Children’s Hospital Operating System Process improvement through people development™ 12 Copyright Childrens Hospital Medical Center of Akron
  • 13. Akron Children’s Hospital1st year Lean Six Sigma JourneyDMAIC Methodology (Define, Measure, Analyze, Improve, Control)•Kaizen Events • Rapid Process Improvement Week- anywhere from 2 to 5 day events • Strategically driven by Executives • Belts = project leaders; team of 5 – 10 from dept & from dept’s customers•Green Belt and Black Belt Projects • 3 – 6 month projects • Strategically driven by Executives – VPs, C suite, etc. • Project leaders are COE staff or trained belts • Team of 5–10 from the department•A3 Projects • 8-week long projects, usually within the boundaries of the participants’ home dept • Driven by the line staff doing the work, and supported by their manager•Blue Belt • Manager training to include Gemba Walks, implement daily metrics boards and daily huddles, coaching for staff, etc. Process improvement through people development™ 13 Copyright Childrens Hospital Medical Center of Akron
  • 14. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Program •Started in January of 2009 •8-week Lean Six Sigma class designed for front-line employees •Follow DMAIC on A3 paper oProblem statement oGoal oCurrent state VSM oRoot cause analysis oFuture state VSM oImplementation plan oControl •Meet weekly for 2 hours of class time •Each participant is assigned a coach from the COE Process improvement through people development™ 14 Copyright Childrens Hospital Medical Center of Akron
  • 15. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Jackie Fuller-Human Resources •Problem Statement oHuman Resources staff spends 60 minutes per week searching for supplies in the Human Resources Work Room •SMART Goal oDecrease the amount of time spent searching for supplies from 60 minutes to 23 minutes per week by October 12, 2009 •Results oDecreased amount of time spent searching for supplies from 60 minutes to 10 minutes per week Process improvement through people development™ 15 Copyright Childrens Hospital Medical Center of Akron
  • 16. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Jackie Fuller-Human Resources Video Process improvement through people development™ 16 Copyright Childrens Hospital Medical Center of Akron
  • 17. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Heidi Kline-Infectious Disease •Problem Statement oAn increasing number of calls of various types coming into Infectious Disease are creating a large volume of non-Infectious Disease patient- related work for the nurse, medical assistant and secretary. •SMART Goal oComplete an evaluation of all calls coming into the Infectious Disease department and develop a mechanism to appropriately route the calls that are not related to Infectious Disease patients. •Results oMultiple improvement ideas implemented. Overall 67% improvement on project. Process improvement through people development™ 17 Copyright Childrens Hospital Medical Center of Akron
  • 18. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Heidi Kline-Infectious Disease Video Process improvement through people development™ 18 Copyright Childrens Hospital Medical Center of Akron
  • 19. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Deborah DePree-Patient Accounts •Problem Statement oFaxed information related to insurance, divorce, Dr. change of codes, and updated BCMH information is received and not distributed to the correct person in a timely manner. This results in a delay in claims processing and lost faxes. •SMART Goal oBy March 4, 2009, reduce the number of faxes received in patient accounts to be distributed each morning from 25 to 5. •Results oNumber of faxes waiting to be distributed went from 25 to an average of < 5 per day Process improvement through people development™ 19 Copyright Childrens Hospital Medical Center of Akron
  • 20. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Deborah DePree-Patient Accounts Video Process improvement through people development™ 20 Copyright Childrens Hospital Medical Center of Akron
  • 21. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Matt Hirsh-Maintenance •Problem Statement oThe mechanics have difficulty locating materials and parts for plumbing fixture repairs. •SMART Goal oReduce the time for material procurement for plumbing fixture repairs by 50% by March 4, 2009 •Results oReduced part location time from 15 minutes to 7.5 Minutes for a 50% improvement Process improvement through people development™ 21 Copyright Childrens Hospital Medical Center of Akron
  • 22. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects Matt Hirsh-Maintenance Video Process improvement through people development™ 22 Copyright Childrens Hospital Medical Center of Akron
  • 23. Akron Children’s Hospital1st year Lean Six Sigma Journey 23
  • 24. Akron Children’s Hospital1st year Lean Six Sigma Journey A3 Projects 2009 review •Goal is to train entire front line staff •119 front-line staff participated in the program •295 patient wait days eliminated •155,138 hours of lead time reduced •Mean of 69% project improvement •$411,557 indirect financial impact •$641,996 direct financial impact Process improvement through people development™ 24 Copyright Childrens Hospital Medical Center of Akron
  • 25. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Program •18 employees sent to Johns Hopkins Lean Sigma Prescription for Healthcare training •10 certified Green Belts o8 through Johns Hopkins o2 hired with Green Belt certification Process improvement through people development™ 25 Copyright Childrens Hospital Medical Center of Akron
  • 26. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Projects Cytogenetics Laboratory •Problem statement oIncreased test volume in Cytogenetics has resulted in the need for staff to put in an average of 71 overtime hours per week •SMART Goal oBy March 6, reduce recorded and silent (supervisor) overtime hours per week by at least 40% (from 71 hours to 43 hours) •Results oOvertime reduced from 71 hours per week to 6 hours per week Process improvement through people development™ 26 Copyright Childrens Hospital Medical Center of Akron
  • 27. Akron Children’s Hospital1st year Lean Six Sigma Journey Paid Overtime Baseline DefMeasAnal Improve Control 120 Improvement in T ech Overtime From Baseline through Improve 100 Phase = 83.6% Overtime Hours 80 60 40 1 20 Mean = 55.4 Mean = 44.8 Mean = 9.1 UCL=11.8 _ X=6.0 0 1 1 LCL=0.3 08 08 0 8 08 08 0 8 08 08 08 09 0 9 09 09 0 9 09 09 09 09 09 3/ 3 1/ 28 / 26/ 2 3/ 20/ 18/ 15 / 13/ 1 0/ 07 / 07/ 0 4/ 02/ 30/ 27 / 25/ 2 2/ 1 2/ /0 / / / / / / / / / / / / / / / / / / 05 05 06 0 7 08 09 1 0 11 12 01 02 0 3 04 05 05 06 0 7 08 09 Week Ending 27
  • 28. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Projects Flash Sterilization •Problem statement oThe Sterile Processing Department cannot currently meet case demand for surgical instruments without a weekly 13.1% flash sterilization rate •SMART Goal oReduce weekly flash sterilization rate in the OR to ≤ 3% •Results oReduced weekly flash sterilization rate from 13.1% to 2% Process improvement through people development™ 28 Copyright Childrens Hospital Medical Center of Akron
  • 29. Akron Children’s Hospital1st year Lean Six Sigma Journey Flash Sterilization Rate by LSS Project Phase (P Chart) [Excl Procedures Outside ORs; Oct 2007-present; Target < 3%] Baseline Pre-Implementation/ Implementation C ontrol 0.25 0.20 UCL=0.1967 UCL=0.1895 0.15 _ P=0.1307 _ P=0.1132 0.10 UCL=0.0906 LCL=0.0648 _ P=0.0483 0.05 LCL=0.0368 0.00 LCL=0.0061 1 8 15 22 29 36 43 50 57 64 71 Tests performed with unequal sample sizes 29
  • 30. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Projects Resident Rounding •Problem statement oResidents are currently limited to working a maximum of 80 hours per week, and this limit will likely be reduced to 55-60 hours in the next 2-3 years. In order to provide excellent patient care and drive educational value, the entire resident rounds process, which comprises roughly 50% of the day, must be improved in terms of efficiency. •SMART Goal oReduce the non-value-add time, including necessary non-value-add, currently present in the pre-rounding and rounding process by 25% in 6 months •Results oTime spent rounding has been reduced by 50% Process improvement through people development™ 30 Copyright Childrens Hospital Medical Center of Akron
  • 31. Akron Children’s Hospital1st year Lean Six Sigma Journey 2% 1%1% 3% 6% 6% Family Centered Care Administrative Walking Personal 10% Signout Physician Interaction 53% Data Collection Education Waiting 16% Interaction with physicians and nurses, as well as education, now occurs with the family present * 5 rounding sessions covering 86 total patients, including family-centered care for 8 primary patients covered by the observed residents Source: Resident rounds observation data, Spring/Summer 2009 Process improvement through people development™ 31 Copyright Childrens Hospital Medical Center of Akron
  • 32. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Projects Hospitalist-Dr. David Chand Video Process improvement through people development™ 32 Copyright Childrens Hospital Medical Center of Akron
  • 33. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Projects •6200 Central Supply oReduce the NVA time nurses spend searching and gathering supplies •Out Patient Pharmacy oIncrease in the percentage of prescriptions completed under 30 minutes Process improvement through people development™ 33 Copyright Childrens Hospital Medical Center of Akron
  • 34. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Projects •Rehabilitation Retention oIncrease the yearly retention Therapists and Assistants in Rehab by 3.0 people before August 7th Process improvement through people development™ 34 Copyright Childrens Hospital Medical Center of Akron
  • 35. Akron Children’s Hospital1st year Lean Six Sigma Journey Green Belt Projects 2009 review •7 projects completed •5 started and ongoing oRehab Retention oProphylactic Antibiotics oOR Special Orders o6200/Central Supply oHBS Abandon Call Rate •53% improvement percentage per project •$42,650 of indirect financial impact •$301,248 of direct financial impact Process improvement through people development™ 35 Copyright Childrens Hospital Medical Center of Akron
  • 36. Akron Children’s Hospital1st year Lean Six Sigma Journey Kaizens Sterile Processing •Problem statement oEquipment, layout, staffing levels, and inventory in Sterile Processing are not sufficient to support current and future surgical volumes at Akron Children’s Hospital. •SMART Goal oRedesign Sterile Processing to meet the future surgical volumes within the existing footprint from 13,000 cases annually to 16,000 cases annually along with satisfying AMMI and AORN environmental standards. Process improvement through people development™ 36 Copyright Childrens Hospital Medical Center of Akron
  • 37. Akron Children’s Hospital1st year Lean Six Sigma Journey Sterile Processing Kaizen Results Decontamination Process improvement through people development™ 37 Copyright Childrens Hospital Medical Center of Akron
  • 38. Akron Children’s Hospital1st year Lean Six Sigma Journey Sterile Processing Kaizen Results Assembly Process improvement through people development™ 38 Copyright Childrens Hospital Medical Center of Akron
  • 39. Akron Children’s Hospital1st year Lean Six Sigma Journey Kaizen Sterile Processing Department-Jim Seymour Video Process improvement through people development™ 39 Copyright Childrens Hospital Medical Center of Akron
  • 40. Akron Children’s Hospital1st year Lean Six Sigma Journey Kaizens Centralized Core Lab •Problem statement oThe Processing Area of the Centralized Core Lab is the intake area for the seven value streams within the CCL as well as the other clinical laboratories. Backlogs within the Processing Area have a direct impact on the throughput of specimens and the subsequent reporting of laboratory test results delaying clinical decision making. •SMART Goal oBy November 1, reduce the median lead time per specimen within the CCL Processing Area (from the time the specimen is picked up by the processing staff to delivery and staff return from value stream) from an average of 125 seconds to 75 seconds. •Results o 5 out of 5 test categories have seen statistically significant reduction in median lead time . Process improvement through people development™ 40 Copyright Childrens Hospital Medical Center of Akron
  • 41. Akron Children’s Hospital1st year Lean Six Sigma Journey CCL Kaizen Results Andon lights installed Process improvement through people development™ 41 Copyright Childrens Hospital Medical Center of Akron
  • 42. Akron Children’s Hospital1st year Lean Six Sigma Journey CCL Kaizen Results Process improvement through people development™ 42 Copyright Childrens Hospital Medical Center of Akron
  • 43. Akron Children’s Hospital1st year Lean Six Sigma Journey Kaizens MRI •Problem statement oThere is currently capacity for additional patients to be scanned on MRI #1 and MRI #2. •SMART Goal oIncrease the number of weekly exams performed on MRI #1 and MRI #2 from 86 to 112 by August 24th. •Results o Increased weekly exams performed by 19% . Process improvement through people development™ 43 Copyright Childrens Hospital Medical Center of Akron
  • 44. Akron Children’s Hospital1st year Lean Six Sigma Journey Kaizens •MRI . Process improvement through people development™ 44 Copyright Childrens Hospital Medical Center of Akron
  • 45. Akron Children’s Hospital1st year Lean Six Sigma Journey Kaizens Projects 2009 Review •3 completed Kaizens •$1,631,000 in direct financial impact •$3,569,000 in indirect financial impact . Process improvement through people development™ 45 Copyright Childrens Hospital Medical Center of Akron
  • 46. Akron Children’s Hospital1st year Lean Six Sigma Journey Developing Hoshin Konri in the Radiology Department •Completed 8 A3 projects •1 Green Belt project •1 Kaizen •One of the more engaged departments throughout Akron Children’s Hospital •COE decided to roll out Blue Belt program in Radiology . Process improvement through people development™ 46 Copyright Childrens Hospital Medical Center of Akron
  • 47. Akron Children’s Hospital1st year Lean Six Sigma Journey Developing Hoshin Konri in Radiology Radiology Department-Diane Tarray . Video Process improvement through people development™ 47 Copyright Childrens Hospital Medical Center of Akron
  • 48. Akron Children’s Hospital1st year Lean Six Sigma Journey Goals of Blue Belt Certification •Visibility oProblems/Opportunities are transparent so that they can be fixed •Accountability oFor operations, safety and quality •Metrics oHave to know what you are measuring •Environment of continuous learning and coaching •Gemba walks oDaily walks through the work areas •Daily huddle around metric boards •Teach ideas of waste and basic Lean Six Sigma tools Process improvement through people development™ 48 Copyright Childrens Hospital Medical Center of Akron
  • 49. Akron Children’s Hospital1st year Lean Six Sigma Journey Developing Hoshin Konri in Radiology Radiology Department-Terry Tarray . Video Process improvement through people development™ 49 Copyright Childrens Hospital Medical Center of Akron
  • 50. Akron Children’s Hospital1st year Lean Six Sigma Journey Challenges • Time for Green Belt projects oWorking full time and doing projects • Managing change • Full engagement of middle management • Validating data, especially to leadership • Control phase oSustaining the gains • Support services oMaintenance oIS oEnvironmental services Process improvement through people development™ 50 Copyright Childrens Hospital Medical Center of Akron
  • 51. Akron Children’s Hospital1st year Lean Six Sigma Journey Keys to success •C-level support of the Lean Six Sigma initiative •Dedicated full time staff •Front line engagement •Middle management engagement •VP level engagement •Experienced Lean Six Sigma consulting firm for first 2 years . Process improvement through people development™ 51 Copyright Childrens Hospital Medical Center of Akron
  • 52. Akron Children’s Hospital1st year Lean Six Sigma Journey Outside the box thinking Process improvement through people development™ 52 Copyright Childrens Hospital Medical Center of Akron
  • 53. Akron Children’s Hospital1st year Lean Six Sigma Journey Questions? Process improvement through people development™ 53 Copyright Childrens Hospital Medical Center of Akron

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