Adding Rigor to Clinical Care Delivery Processes - Lean and Six Sigma to Improve Patient Safety Tomas A. Gonzalez, MD, MBA...
<ul><li>Valley Baptist Medical Center - Harlingen </li></ul><ul><ul><li>611 Licensed Beds </li></ul></ul><ul><ul><li>Lead ...
Valley Baptist Health System <ul><li>Mission: </li></ul><ul><ul><li>Valley Baptist Health System is a community health ser...
<ul><li>Strategic Initiatives </li></ul><ul><ul><li>Disciplined Offering of Services </li></ul></ul><ul><ul><li>E-Business...
<ul><li>A comprehensive and flexible program for achieving, sustaining and maximizing business success that: </li></ul><ul...
<ul><li>Six Sigma is a statistical measure that expresses how close a service process comes to its quality goal </li></ul>...
DMAIC Methodology:
Lean Six Sigma <ul><li>5 S’s </li></ul><ul><ul><li>Seiri ………….…..Sort </li></ul></ul><ul><ul><li>Seiton ……………Standardize <...
<ul><li>Genuine Focus on the customer </li></ul><ul><li>Data and Fact Driven Management </li></ul><ul><li>Process focus, m...
<ul><li>Traditional Quality Programs </li></ul><ul><ul><li>Driven internally </li></ul></ul><ul><ul><li>Focuses on outcome...
<ul><li>Dependant </li></ul><ul><li>Output </li></ul><ul><li>Effect </li></ul><ul><li>Symptom </li></ul><ul><li>Monitor </...
The Effectiveness (E) of the result is equal to the Quality (Q) of the solution  times  the Acceptance (A) of the idea. Q ...
How did we begin implementing Six Sigma? <ul><li>CEO Commitment </li></ul><ul><ul><li>Vision </li></ul></ul><ul><ul><li>Le...
Six Sigma Practitioners:  <ul><li>3 Certified Six Sigma Master Black Belts </li></ul><ul><li>4 Full Time Black Belts </li>...
Wave 4 Initiatives: <ul><li>Timely Utilization of Ancillary Services in the ED </li></ul><ul><li>Inpatient Floor to Floor ...
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Improving Patient Safety - Adding Rigor to Clinical Care Delivery Processes

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Improving Patient Safety - Adding Rigor to Clinical Care Delivery Processes

  1. 1. Adding Rigor to Clinical Care Delivery Processes - Lean and Six Sigma to Improve Patient Safety Tomas A. Gonzalez, MD, MBA Vice President of Quality Initiatives
  2. 2. <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><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><li>Other Entities </li></ul><ul><ul><li>Golden Palms Retirement and Healthcare Center </li></ul></ul><ul><ul><li>Valley Health Plans </li></ul></ul><ul><ul><li>Advanced Medical Supply (DME) </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>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>Attributes </li></ul><ul><ul><li>Leading area employer </li></ul></ul><ul><ul><li>Major economic contributor </li></ul></ul><ul><ul><li>Community resource </li></ul></ul>Valley Baptist Health System
  3. 3. Valley Baptist Health System <ul><li>Mission: </li></ul><ul><ul><li>Valley Baptist Health System is a community health service performing spiritually based health, education and charitable programs in accordance with the teachings and healing ministry of Jesus Christ. </li></ul></ul><ul><li>Core Beliefs: </li></ul><ul><ul><li>In all we do we value the whole person – body, mind and spirit. </li></ul></ul><ul><ul><li>We treat all people with dignity and respect. </li></ul></ul><ul><ul><li>We pursue excellence. </li></ul></ul><ul><ul><li>We collaborate with others in the delivery of service. </li></ul></ul><ul><ul><li>We are earnest stewards of our organization and community resources. </li></ul></ul><ul><ul><li>Integrity and honesty are the foundation of all our relationships. </li></ul></ul><ul><li>Vision: </li></ul><ul><ul><li>Valley Baptist Health System will be a faith based regional health care system serving patients and people throughout South Texas. It will be distinguished by high quality care, outstanding service and excellent operations. </li></ul></ul>
  4. 4. <ul><li>Strategic Initiatives </li></ul><ul><ul><li>Disciplined Offering of Services </li></ul></ul><ul><ul><li>E-Business </li></ul></ul><ul><ul><li>Six Sigma </li></ul></ul><ul><ul><li>Innovation </li></ul></ul><ul><ul><li>Relentless Customer Service </li></ul></ul><ul><ul><li>Employee Partnerships </li></ul></ul><ul><ul><li>Growth </li></ul></ul><ul><li>Values </li></ul><ul><ul><li>Disciplined </li></ul></ul><ul><ul><li>Accountable </li></ul></ul><ul><ul><li>Entrepreneurial </li></ul></ul><ul><ul><li>Performance Oriented </li></ul></ul><ul><li>With Six Sigma as our operating system, the others are possible!! </li></ul>Valley Baptist Health System
  5. 5. <ul><li>A comprehensive and flexible program for achieving, sustaining and maximizing business success that: </li></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><ul><ul><li>Is an 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>What is Six Sigma?
  6. 6. <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>A Measure of Quality: 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
  7. 7. DMAIC Methodology:
  8. 8. Lean Six Sigma <ul><li>5 S’s </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>
  9. 9. <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:
  10. 10. <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><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>The Six Sigma Difference:
  11. 11. <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
  12. 12. The Effectiveness (E) of the result is equal to the Quality (Q) of the solution times the Acceptance (A) of the idea. Q x A = E Six Sigma Effectiveness: Six Sigma Methodology Change Acceleration Process Effective Results Work-Out TM
  13. 13. 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, etc.) </li></ul></ul><ul><li>Partnership with General Electric Medical Systems –Performance Solutions </li></ul><ul><ul><li>Guidance </li></ul></ul><ul><ul><li>Expert Knowledge </li></ul></ul><ul><ul><li>Training – Six Sigma, Change Acceleration Process (CAP), Work-Out™ </li></ul></ul><ul><ul><li>Initiative Mentoring </li></ul></ul><ul><ul><li>Transition Assistance </li></ul></ul><ul><li>Personnel selection – Best and Brightest; Future Leaders </li></ul><ul><li>Initiative Selection – Line of Sight </li></ul>
  14. 14. Six Sigma Practitioners: <ul><li>3 Certified Six Sigma Master Black Belts </li></ul><ul><li>4 Full Time Black Belts </li></ul><ul><li>28 Certified Six Sigma Green Belts </li></ul><ul><li>30 Yellow Belts </li></ul><ul><li>2 Master Change Agents </li></ul><ul><li>150 Change Agents-(and growing rapidly) </li></ul><ul><li>Future – All managers will be trained to Green Belt certification; Executives to Yellow Belt level </li></ul>
  15. 15. Wave 4 Initiatives: <ul><li>Timely Utilization of Ancillary Services in the ED </li></ul><ul><li>Inpatient Floor to Floor Transfers </li></ul><ul><li>Event Response </li></ul><ul><li>Late Charges </li></ul><ul><li>Golden Palms MDS Coding Accuracy </li></ul><ul><li>CHF </li></ul><ul><li>Stroke Care </li></ul><ul><li>AMI </li></ul><ul><li>Forms Management </li></ul><ul><li>Pain Management </li></ul><ul><li>STO Turnaround Time </li></ul><ul><li>Patient Identification </li></ul><ul><li>Outpatient Services Integration </li></ul><ul><li>Timely & Safe Medication Turnaround </li></ul><ul><li>Abbreviations </li></ul><ul><li>Pathology Process Flow Improvement </li></ul>
  16. 16. Case Studies
  17. 17. Questions?

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