Six Sigma in Healthcare 6 σ

Content What is Six Sigma? How Six Sigma works? Six Sigma as a Metric. Six Sigma as a Process Improvement Methodology. Characteristics of Six Sigma Impact of Six Sigma. Why Six SIGMA Works? Six Sigma in Healthcare. Benefit from Six Sigma Six Sigma in Hinduja Group. Some successful projects in Healthcare industry. Six Sigma Application in Healthcare. Need for using Six Sigma in Healthcare.

What is Six Sigma?

How Six Sigma works?

Six Sigma as a Metric.

Six Sigma as a Process Improvement Methodology.

Characteristics of Six Sigma

Impact of Six Sigma.

Why Six SIGMA Works?

Six Sigma in Healthcare.

Benefit from Six Sigma

Six Sigma in Hinduja Group.

Some successful projects in Healthcare industry.

Six Sigma Application in Healthcare.

Need for using Six Sigma in Healthcare.

Six Sigma training is the best thing that had happened to our employees, it is even better than sending them to Harvard business school. - Statement by Jack Welch, former CEO of GE

Six Sigma training is the best thing that had happened to our

employees, it is even better than sending them to Harvard

business school.

- Statement by Jack Welch, former CEO of GE

What is Six Sigma? Sigma is a yardstick on which the performance of the process and improvements can be gauged upon. Six Sigma is an Improvement methodology which uses a structured approach to drive business improvement. Six Sigma is a Measure for Quality Process For Continuous Improvement Enabler for Culture Change.

Six Sigma is a

Measure for Quality

Process For Continuous Improvement

Enabler for Culture Change.

Six sigma is a business strategy which deploys various set of tools, techniques & methodologies to bring in – Rapid & Breakthrough process improvement. Enhanced customer focus. Data & Fact based decision making. Creating culture for continuous & tangible improvements. Structured problem solving.

Six sigma is a business strategy which deploys various set of tools, techniques & methodologies to bring in –

Rapid & Breakthrough process improvement.

Enhanced customer focus.

Data & Fact based decision making.

Creating culture for continuous & tangible improvements.

Structured problem solving.

How Six Sigma works? Y = f(X i ) The outcome Y is a function of inputs X i ,…… Traditional approach towards Problem solving is to approach the problem directly and try to identify a solution for it. Six Sigma challenges that school of thought and advocates a detailed Root Cause analysis to identify the factors impacting the problem, validating them using statistical tools and then finding solutions for the significant causes.

A six sigma project accelerates the performance of the CTQ in a comparatively smaller span of time. The unit of deployment of six sigma in an organization is the number of six sigma projects. A six sigma project is executed in a time frame of 5-6 months by a task force type team of 4-5 members. CTQ – The parameter chosen to make improvement through a Six Sigma project CTQ Performance Current Performance Six Sigma Project Future Performance

Six Sigma as a Metric Sigma is a measure of spread of a process ‘  ’ is the standard deviation of the process (variation in performance of the process), Sigma value ‘z’ is the measure of the capability of the process. Lower the standard deviation the better the process is, Higher the sigma value better the process is. As ‘  ’ Standard Deviation decreases Sigma Value ‘z’ increases  z

As variation in the process decreases, it results in reduction of standard deviation & data points lying closer to the mean. The Z value increases. Z value is the measure of process capability. Z = 2, 69% Z = 3, 93.3% Z = 4, 99.3% Z = 5, 99.97% Z = 6, 99.9997% USL LSL Mean

Six Sigma as a Process Improvement Methodology Six Sigma is a structured problem solving tool which deploys Brainstorming & Statistical tools to identify the vital root causes and finding a solution so as to optimize the Output. It follows DMAIC approach for problem solving. Define the project ( Assignment ) goals and customer (internal and external) deliverables. Measure the process to determine current performance. Analyze and determine the root causes of the defects. Improve the process by working on the validated root causes Control the improved process performance to ensure sustainable results. Define Measure Analyze Improve Control

Characteristics of Six Sigma Approach The extensive focus on customer requirements The direct link to business strategy and financial results The required commitment of top leadership up-front. Each project delivers bottom line results in a short time The disciplined improvement methodology based on measurement and analysis Full-time Six Sigma team leaders who are extensively trained in statistical thinking as well as team and project skills The integration of Six Sigma thinking into the business infrastructure through incentives and rewards

The extensive focus on customer requirements

The direct link to business strategy and financial results

The required commitment of top leadership up-front.

Each project delivers bottom line results in a short time

The disciplined improvement methodology based on measurement and analysis

Full-time Six Sigma team leaders who are extensively trained in statistical thinking as well as team and project skills

The integration of Six Sigma thinking into the business infrastructure through incentives and rewards

Impact of Six Sigma 20,000 lost articles of mail per hour Unsafe drinking water almost 15 minutes each day 5,000 incorrect surgical operations per week 2 short or long landings at most major airports daily 200,000 wrong drug prescriptions each year No electricity for almost 7 hours each month The Classical View of Quality “ 99% Good” (3.8  ) Seven lost articles of mail per hour One minute of unsafe drinking water every seven months 1.7 incorrect surgical operations per week One short or long landing at most major airports every five years 68 wrong drug prescriptions per year One hour without electricity every 34 years The Six Sigma View of Quality “ 99.9997% Good” (6  )

Why Six Sigma Delivers? Six Sigma Project Top Management Commitment Disciplined Approach Use of Statistical & Problem Solving Tools Support from Highly trained BBs & MBBs

Six Sigma in Healthcare Six Sigma has been successfully deployed by many Healthcare organizations across the globe, some of them are: Commonwealth Health Corporation GE Healthcare Hinduja Group, Bombay. Apollo Hospitals

Six Sigma has been successfully deployed by many Healthcare organizations across the globe, some of them are:

Commonwealth Health Corporation

GE Healthcare

Hinduja Group, Bombay.

Apollo Hospitals

Benefits from Six Sigma Benefit to Hospitals Translating to fewer errors Better processes Increased patient satisfaction & care. Increased physician satisfaction Reduce cost/ cost savings. Benefit to Individuals Structured problem solving methodologies. How to apply statistical analysis tools to problem solving Team Management & Leadership skills. Six Sigma Certification.

Benefit to Hospitals

Translating to fewer errors

Better processes

Increased patient satisfaction & care.

Increased physician satisfaction

Reduce cost/ cost savings.

Benefit to Individuals

Structured problem solving methodologies.

How to apply statistical analysis tools to problem solving

Team Management & Leadership skills.

Six Sigma Certification.

Example - 1 Example 1: Projected Savings from a project reducing turnaround time per operation / theatre by 15 minutes. No of operations that can be done in a 12 hr day (assuming each operation takes 60 minutes.) = 12 No of operations that can be done (assuming revised turnaround time of 45 minutes.)= 16 Increased revenue per day= 4x5000= 20000. Increased revenue annualized = 20000 x 26 x 12 = Rs 62,40,000 *Assumption: Approximate cost per operation = Rs 5000. Operation TAT was earlier 60 min which has been reduced to 45 min

Example 1: Projected Savings from a project reducing turnaround time

per operation / theatre by 15 minutes.

No of operations that can be done in a 12 hr day (assuming each operation takes 60 minutes.) = 12

No of operations that can be done (assuming revised turnaround time of 45 minutes.)= 16

Increased revenue per day= 4x5000= 20000.

Increased revenue annualized = 20000 x 26 x 12 = Rs 62,40,000

*Assumption:

Approximate cost per operation = Rs 5000.

Operation TAT was earlier 60 min which has been reduced to 45 min

Example 2 Example 2: Projected Savings from a project reducing patient discharge time by 2 hrs for a 100 bed hospital. Using Six Sigma tools we may reduce the bed waiting time by 2 hrs. Then No of hrs saved in a day = 2 x 100 = 200 hrs/day No of hrs saved in a year= 200 x 26 x 12 = 62400 hrs/year. No of days saved in a year= 62400/24= 2600 days Cost of 1 bed per day= Rs 1000 Savings in a year = 1000 x 2600 = Rs 26,00,000. * Assumption: Every bed gets a new patient every day. Approximate cost of 1 bed/day = Rs 1000.

Example 2: Projected Savings from a project reducing patient discharge time

by 2 hrs for a 100 bed hospital.

Using Six Sigma tools we may reduce the bed waiting time by 2 hrs. Then

No of hrs saved in a day = 2 x 100 = 200 hrs/day

No of hrs saved in a year= 200 x 26 x 12 = 62400 hrs/year.

No of days saved in a year= 62400/24= 2600 days

Cost of 1 bed per day= Rs 1000

Savings in a year = 1000 x 2600 = Rs 26,00,000.

* Assumption:

Every bed gets a new patient every day.

Approximate cost of 1 bed/day = Rs 1000.

Six Sigma in Hinduja Group Hinduja Group deployed six sigma to improve patient satisfaction, physician satisfaction and reduce costs. They conducted a brainstorming and came up with over 70 ideas for improvement and took some of them up as projects, the areas that were improved upon are: Turn around time for laboratory reports Patient discharge time OPD waiting time TAT for blood availability Patient satisfaction index Turnover time for rooms and beds Prescription accuracy

Hinduja Group deployed six sigma to improve patient satisfaction, physician satisfaction and reduce costs. They conducted a brainstorming and came up with over 70 ideas for improvement and took some of them up as projects, the areas that were improved upon are:

Turn around time for laboratory reports

Patient discharge time

OPD waiting time

TAT for blood availability

Patient satisfaction index

Turnover time for rooms and beds

Prescription accuracy

Some successful projects in Healthcare industry Outpatient blood lab – reduction in 10 weeks of process time from an average of 19 minutes to 4.2 minutes. Pre-admission testing – reduction by 38% of avoidable testing procedures, resulting in savings of >$116,000. Improved process to reduce bed turnover time, savings of >$100,000. Reduce number of medication errors from 81 to 9 for a three month period. Increased speed of delivery of medications to floor by 20% Reduce average time to get radiology reports by over 25% 130% increase in surgical procedures. Reduce operating room setup time between surgeries by 40%. Reduce unnecessary length of stay by over 25%

Outpatient blood lab – reduction in 10 weeks of process time from an

average of 19 minutes to 4.2 minutes.

Pre-admission testing – reduction by 38% of avoidable testing procedures,

resulting in savings of >$116,000.

Improved process to reduce bed turnover time, savings of >$100,000.

Reduce number of medication errors from 81 to 9 for a three month period.

Increased speed of delivery of medications to floor by 20%

Reduce average time to get radiology reports by over 25%

130% increase in surgical procedures.

Reduce operating room setup time between surgeries by 40%.

Reduce unnecessary length of stay by over 25%

Six Sigma Application in Healthcare Beyond the areas listed on the previous slide, six sigma can be applied to many more areas in the : Ease of registration Prescription accuracy Number of infections post operations Success rate of operations Noise level in pre-operative care OT Supplies support – time taken to provide supplies OPD waiting time Patient discharge time

Beyond the areas listed on the previous slide, six sigma can be applied to many more areas in the :

Ease of registration

Prescription accuracy

Number of infections post operations

Success rate of operations

Noise level in pre-operative care

OT Supplies support – time taken to provide supplies

OPD waiting time

Patient discharge time

Need for using Six Sigma in Healthcare In a country like India, bed availability per 1000 people is one of the lowest in the world. Millions of people suffer from problem due to lack of proper healthcare infrastructure, so as to provide healthcare facilities to maximum people we need to utilize the available resources in the most optimum manners and that is where well proven methodologies like Lean and Six Sigma can be of great help. Also, in the wake of developing medical tourism to India, the healthcare service providers need to improve their utilization of resources, patient satisfaction, quality of healthcare and many more so as to develop medical tourism as an industry.

Thank You Contact: Atul Kumar Jha – Business Development Manager Office: +91 124 4271990 Mb: +91 98114 22831