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Harnessing the Potential of Six Sigma in Healthcare
 

Harnessing the Potential of Six Sigma in Healthcare

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    Harnessing the Potential of Six Sigma in Healthcare Harnessing the Potential of Six Sigma in Healthcare Presentation Transcript

    • James G. Springfield, FACHE President and CEO Harnessing the Potential of Six Sigma in Healthcare March 30, 2006
    • Rio Grande Valley
      • Valley Baptist Medical Center - Harlingen
        • 611 Licensed Beds
        • Lead Level 3 Trauma Center
        • State of the Art Children’s Center
        • # 1 Rated Orthopedics Service
        • Heart & Vascular Institute
        • Teaching facility for the Regional Academic Health Center of The University of Texas Health Science Center at San Antonio
      • Valley Baptist Medical Center – Brownsville
        • 243 Licensed Beds
        • Level 3 Trauma Center
        • State of the Art Imaging Center
        • Center of Diabetes Management
      • Other Entities
        • Golden Palms Retirement and Healthcare Center
        • Valley Baptist Health Plans
        • Advanced Medical Supply (DME)
        • Valley Baptist Ambulatory Surgery Center
        • Clinical Pastoral Education Center
        • Licensed Vocational Nurse School
        • Family Practice Residency Program
        • Internal Medicine Residency Program
        • Home Health & Hospice
        • Rehabilitation & Wellness
        • Behavioral Health Services
      Valley Baptist Health System
      • Strategic Initiatives
        • Integration
        • Simplicity
        • Six Sigma Quality
        • Relentless Service
        • Expansion of Services & Regionalization
      • Values
        • Disciplined
        • Entrepreneurial
        • Performance Oriented
        • Accountable
      Valley Baptist Health System
    • Valley Baptist Health System Operating Calendar September October December January February May April March July August June November 1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter Execute Initiatives: Mgmt. Mtg. Marching Orders Performance Reviews Board Retreat QOR Aug. Board Meeting (Present budget) QOR QOR QOR Talent Review / Succession, HR Planning Initiatives Dev. & Review + Sr. Mgmt. & Review and Key Mgmt. Retreat Performance Stds. Set Budget = Work product req. = Processes link Sr. Mgmt. Mtg Key Mgmt. Retreat Guidance VBHS Confidential & Proprietary Information VBHS Values VB Survey II Strategic Planning Integration Simplicity Service Expansion & Regionalization Relentless Service Six Sigma Quality VB Survey I
      • A comprehensive and flexible program for achieving, sustaining and maximizing business success that:
        • Is a management methodology with three perspectives:
          • A Measure of Quality
          • A Process for Continuous Improvement
          • An Enabler for Cultural Change
        • Is uniquely driven by a clear focus on the “Voice of the Customer”
        • Is founded in a rigorous use of facts, data and statistical analysis
        • Provides for diligent attention on managing, improving and reinventing business processes
      What is Six Sigma?
    • What is Six Sigma?
      • Integrated part of management system
      • Fact & data based decision making
      • Knowledge transfer, learning process
      • Value added focus on defect removal
      • Utilization of technology tools
      • A lasting infrastructure
      • Not a cost reduction program
      • Not a training program
      • Not a statistics program
      • Not a quality program
      • Not a quick fix
      Six Sigma Advantage, Inc.
      • Six Sigma is a statistical measure that expresses how close a service process comes to its quality goal
      • Six Sigma refers to a process that produces only 3.4 defects per million opportunities
      What is Six Sigma? 3.4 233 6,210 66,807 308,537 DPMO 99.9997% 99.9767% 99.3790% 93.3193% 69.1463% Yield 6 5 4 3 2 Sigma
    • DMAIC Methodology
    • How did we begin implementing Six Sigma?
      • CEO Commitment
        • Vision
        • Leadership
        • Resources (time, money, people)
      • Partnership with General Electric Medical Systems
        • Guidance
        • Expert Knowledge
        • Training – Six Sigma, CAP, Work-Out™
        • Project Mentoring
        • Transition Assistance
    • Roles at VBHS
      • Master Black Belt – 6 Sigma mentor and educator
      • Black Belt – 6 Sigma trained specialist who works on 6 Sigma improvement initiatives on a full time basis
      • Green Belt – 6 Sigma trained specialist who uses the Six Sigma methodology to solve problems as a function of their normal work
      • Yellow Belt – Physicians and Executives trained in basic 6 Sigma methods who assist with problem solving, initiative sponsorship and solution implementation
      • Sponsor – Executive with responsibility to identify 6 Sigma initiatives, assign resources and remove barriers
      • Change Agent - Expert in the application of CAP and Work-Out™ tools
    • Six Sigma Practitioners at VBHS
      • Master Black Belts (5)
        • 3 Certified
        • 2 Seeking Certification
      • Black Belts (4)
        • 3 Harlingen
        • 1 Brownsville
      • Green Belts (61)
        • 31 Certified
        • 30 Seeking Certification
      • Yellow Belts (34)
        • 15 Executives
        • 19 Physicians
      • Master Change Agents (2)
      • Change Agents (237)
        • 190 Harlingen
        • 47 Brownsville
      • Future
        • All Executives will be trained to Yellow Belt level
        • All Directors and Managers to Green Belt certification
    • Physician Yellow Belts
      • Jose Ayala, DPM
      • Maria T. Camacho, MD
      • Miguel Cintron, MD
      • Chandler E. Deal, MD
      • Luis Gaitan, MD
      • Alfredo Garcia, MD
      • Giovanna Ghafoori, MD
      • Khadim Hussain, MD
      • Garner Klein, MD
      • Robert A. Lozano, MD
      • Raul Maldonado, DPM
      • Juan Mancillas, MD
      • Carlos Medina, MD
      • John A. Partin, MD
      • Eric Six, MD
      • Adela S. Valdez, MD
      • Daniel F. Villarreal, MD
      • Gerald Witson, DDS
      • Robert T. Wright, DO
    • Six Sigma Physician Council Members
      • Miguel Cintron, MD
      • Lisa Dix-Emperador, MD
      • Luis Gaitan, MD
      • Giovanna Ghafoori, MD
      • Tomas A. Gonzalez, MD
      • Christopher Hansen, MD
      • Khadim Hussain, MD
      • Garner Klein, MD
      • Bruce Leibert, MD
      • Juan J. Mancillas, MD
      • Clay W. Ross, MD
      • Michael Simpson, MD
      • Eric Six, MD
      • Adela S. Valdez, MD
      • Gerald Whitson, MD
      • Robert Wright, MD
    • VBHS Timeline
      • May 2002
        • Engagement with GEMS
        • Wave 1: 6 initiatives
        • Green Belts trained
      • March 2003
        • Wave 2: 6 initiatives
        • 3 Full Time Black Belts appointed
      • April 2003
        • 3 Full Time Master Black Belts appointed and trained
      • June 2003
        • Wave 3: 8 initiatives
        • Green Belts trained
        • 2 Master Change Agents trained
      • March 2004
        • Wave 4: 15 initiatives
        • Green Belts trained
      • July 2005
        • Wave 5/1: 13 initiatives
        • Green Belts trained
      • September 2005
        • Wave 6/2/1: 14 initiatives; Wave 6 at VBMC-H, Wave 2 at VBMC-B, Wave 1 at System
        • Green Belts trained
    • 72 Completed Training and Translation Initiatives
      • Wave 1
        • ED Wait Times
        • Diabetes Management
        • Pharmacy Order Verification
        • OR Turnaround Time
        • Staff Scheduling
        • Nursing Order Activation
      • Wave 2
        • ED Wait Times
        • Laboratory Turnaround
        • Admissions Process
        • OR Turnaround Time
        • Radiology Turnaround
        • Discharge Process
      • Wave 3
        • ED Wait Times
        • Surgery Patient Preparation & PATT
        • DRG Assurance of Accuracy
        • RN Admissions Assessment
        • Patient Registration Accuracy
        • Outpatient Service Redesign
        • Performance Management
        • RN New Hire Process
      • Timely Utilization of Ancillary Services in the ED
      • Inpatient Floor to Floor Transfers
      • Event Response
      • Golden Palms MDS Coding Accuracy
      • CHF
      • Stroke Care
      • AMI
      • Forms Management
      • Pain Management
      • STO Turnaround Time
      • Patient Identification
      • Outpatient Services Integration
      • Timely & Safe Medication Turnaround
      • Abbreviations
      • Pathology Process Flow Improvement
      Wave 4 Initiatives
      • VBMC-Harlingen
      • Wave 5
      • ED Registration & Accuracy
      • Pneumonia Core Measures
      • Interdisciplinary Communication
      • VBMC-H Accessibility
      • Ancillary Departments Results Availability
      • Physician Pay for Performance
      • ED Charges
      • VBMC-Brownsville
      • Wave 1
      • Emergency Department Hold Time
      • Me dical Records / Transcription Turnaround Process
      • ICU Care Management Process
      • Outpatient Registration Turnaround Time
      • Length of Stay Planning & Mgmt Process
      • Radiology Turnaround Time
      Wave 5/1 Initiatives
      • Wave 6 (Harlingen)
        • Cardiac Catheterization Lab Capacity
        • Medication Reconciliation
        • On-Time Discharges
        • Critical Care Glucose Management
        • Coronary Bypass Graft Core Measures
      • Wave 2 (Brownsville)
        • Wound Care
        • Women’s Services Throughput
        • Respiratory Care Management
        • Surgical Case Time Management
        • Critical Care Medication Administration Turnaround Time
      Wave 6/2/1 Initiatives
      • Wave 1 (System)
        • Decision Support Turnaround Time
        • Advance Directives
        • Family Practice Residency Program Patient Throughput
        • Event Response
    • Translation Initiatives
      • Acute Myocardial Infarction
      • Heart Failure Management
      • Patient ID (Mother Baby)
      • Patient ID (Ancillary Services)
      • Surgical Preparation (Inpatient)
      • Surgical Preparation (Day Surgery)
      • Abbreviations
      • Pharmacy Order Verification
      • Nursing Activation of Orders
      • DRG Assurance of Accuracy
    • Examples of the VBHS application of Six Sigma
      • 61 minutes
      • on average in
      • 2002
      Operating Room (Harlingen) Amount of time it takes to turnaround surgical suites from one case to the next Decreased 34% 40 minutes on average in 2006
      • 110 minutes
      • on average in
      • 2002
      Pharmacy (Harlingen) Amount of time it takes the pharmacy to verify a physician order Decreased 80% 22 minutes on average in 2006
      • Accuracy rate of
      • 75% in
      • 2003
      Diagnostic Related Group (Harlingen) Code assignment on 16 DRGs Improved 33% Six Sigma performance in 2006
      • Compliance rate
      • 96.8% in
      • 2004
      Patient Identification (Harlingen) & (Brownsville) Proper patient identification prior to medical procedures Six Sigma performance in 2006
      • 42 hours on
      • average in
      • February 2005
      Radiology (Brownsville) Amount of time it takes for the final report to be posted in the patient’s chart after the radiological exam is ordered Decreased 64% 15 hours on average in January 2006
      • 566 minutes on
      • average in
      • March 2005
      Emergency Department (Brownsville) Amount of time it takes a patient to leave the ED after the MD order for admission is written Decreased 69% 177 minutes on average in January 2006
      • 33 minutes on
      • average in
      • 2003
      Emergency Department (Harlingen) Amount of time it takes to discharge a patient after the doctor has determined the discharge disposition Decreased 30% 23 minutes on average in 2006
      • 226 minutes on
      • average in
      • 2004
      Emergency Department (Harlingen) Amount of time it takes a patient to arrive to an inpatient bed from the ED after the doctor has written the admission order Decreased 49% 116 minutes on average in 2006
      • 102 minutes on
      • average in
      • 2003
      Nursing (Harlingen) Amount of time it takes to complete the Nursing Assessment on inpatients at VBMC-H Decreased 70% 30 minutes on average in 2006
      • Compliance rate
      • 73% in
      • 2004
      Nursing (Harlingen) Pain Management assessment and follow up Compliance rate 90% in 2006 Improved 23%
      • 88 minutes on
      • average in
      • 2002
      Nursing (Harlingen) Amount of time it takes the nursing department to activate physician orders Decreased 73% 24 minutes on average in 2006
      • 94.6% in
      • 2004
      Evidence Based Medicine (Harlingen) Compliance with the JCAHO’s core measures for Acute Myocardial Infarction Improved 5.4% Six Sigma performance in 2006
      • 81.4% in
      • April 2005
      Evidence Based Medicine (Brownsville) Compliance with the JCAHO’s core measures for Acute Myocardial Infarction Improved 23% Six Sigma performance in January 2006
      • 58% in
      • 2004
      Evidence Based Medicine (Harlingen) Compliance with the JCAHO’s core measures for Heart Failure Management Improved 72% Six Sigma performance in 2006
    • Displayed with Permission of Modern Healthcare.  Copyright Crain Communications, Inc., 2005 Modern Healthcare Magazine “Right on the Money” November 14, 2005
      • Launched October 2003 with 268 hospital participants
      • Cash rewards for total of $8.85 million to 123 hospitals the top 20% performers in five clinical areas:
        • heart failure, pneumonia, bypass surgery, heart attack and hip and knee replacement.
      • Hospitals graded on quality measures, earning a composite quality score in any given focus area.
      CMS Pay for Performance
      • 53% in
      • April 2005
      Evidence Based Medicine (Brownsville) Compliance with the JCAHO’s core measures for Heart Failure Management Improved 89% Six Sigma performance in January 2006
    • Stroke Care (Harlingen)
      • Letter dated September 27, 2005 from Joint Commission’s Executive Vice President, Russell P. Massaro, MD, FACPE:
      • The Joint Commission is pleased to award Disease – Specific Certification to your organization’s primary stroke center as a result of the September 2, 2005 review at Valley Baptist Medical Center
      • This certification is effective for two years from September 3, 2005, and is indicative of your program’s compliance with consensus-based national standards; effective use of established clinical practice guidelines to manage and optimize care; and performance measurement and improvement activities.
    • Initiatives Achieving Six Sigma Performance
      • VBMC – Harlingen
      • Acute Myocardial Infarction
      • Heart Failure Management
      • Inpatient Identification Process – Mother Baby Unit
      • Inpatient Identification Process – Ancillary Departments
      • Surgical Preparation – Day Surgery
      • CT turnaround time to ED
      • Inappropriate Abbreviations
      • VBMC-Brownsville
      • Acute Myocardial Infarction
      • Heart Failure Management
      • Inpatient Identification Process – Mother Baby Unit
      • Inpatient Identification Process – Ancillary Departments
      • VBHS
      • Forms Management
      • MDS Accuracy – Golden Palms
      • DRG Assurance of Accuracy
    • Questions? Contact information: [email_address]