Green Belt for Healthcare


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The Healthcare industry has been embracing Lean and Six Sigma methodologies over the past few years. This presentation will decribe the role of a Green Belt within this industry and the challenges they face.

e-Zsigma is Canada’s leader in Six Sigma and Lean Enterprise coaching and deployment. Our completely integrated program of in-class and e-learning training, tools, methodology and technology enables you to rapidly customize and implement a quality improvement system and strategy that delivers the results that your Hospital and clients demand.

Our team of world class instructors and practitioners combined with our experience in Healthcare makes e-Zsigma your first choice for Six Sigma and Lean Enterprise strategies.

e-Zsigma is a Canadian based Management Consultancy, specializing in Lean Six Sigma, Project Management, and Supply Chain.

e-Zsigma is the Sponsor for the Canadian Society for Quality

e-Zsigma is a partner of the International Standard for Lean Six Sigma (ISLSS) and Manager of the LinkedIn Lean Six Sigma Group

Follow e-Zsigma Company on LinkedIn where you will find a list of our Lean Six Sigma Training and Certification Classes, both online and onsite.

Published in: Business

Green Belt for Healthcare

  1. 1. Lean Six Sigma, Leaders for Today, Innovators for Tomorrow Presented by e-Zsigma (Canada) Inc. Canada’s Leader in Lean, Six Sigma and Innovative Practices
  2. 2. CHALLENGES FOR CANADIAN PROFESSIONALS Primary Care Reform the way in which primary care and primary health care services can be organized to best serve population health needs Health Human Resource Planning the way in which a variety of health professions should be deployed to provide health care services to the population Cost and Sustainability the way in which health care services are funded and the costs for the future Role of the Private Sector the way in which health care is delivered and funded privately Quality of Care and Measurement the way in which decisions about healthcare interventions are based on evidence of effectiveness to improve quality. Source: Canadian Policy Research Networks, January, 2004 2 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  3. 3. THE DEMAND CURVE WE ARE FEELING Source: Understanding Canada’s Health Care Costs, Health Canada, 2000 3 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  4. 4. DEMAND ACCELERATORS & RESPONSES ACCELERATORS Emerging and New Technologies major joint surgery, neonatal and fetal technologies, dialysis, organ transplantation, genetic testing and therapy Increased Incidence and earlier onset of Chronic and New Diseases heart disease, diabetes, tuberculosis, Hepatitis C, HIV, and AIDS Increased demand from an aging population New Pharmaceuticals Declining Productivity Gains & Changing Expectations RESPONSES Improved management of health care systems and delivery modes Increased process and treatment efficiency and effectiveness A public that is capable of making informed & appropriate choices 4 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  5. 5. ORGANIZATIONS TURNING TO LEAN Royal Victoria Hospital, Barrie St. Michael’s Hospital, Toronto Ministry of Health & Long-Term Care University Health Network Mount Sinai Hospital Alberta Medical Association Sykes Assistance Services Health Canada Hamilton Health Sciences Joseph Brant Memorial Hospital Eagle Ridge Hospital, Vancouver 5 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  6. 6. LEAN & SIX SIGMA LEAN Patient/Customer Focused A Paradigm Shift in the Way Value is Defined 5 Key Principles & Eight Associated Sources of Waste A Value-Stream Based Approach: The “Flow” of Value (velocity) Tools & Techniques to Improve Value Creation Turn everyone’s “waste radar” on Reduce or Eliminate the Inhibitors to Value Creation Extremely Participative Problem-Solving , Event Driven, & Culturally Transforming SIX SIGMA Focus on process “problems”: Errors, Quality, Robust Process Design Key to Success: Focus on Understanding Process Variation Emphasis on data and analysis: Profound Knowledge! Project-Centric: Well Defined Goals & Measurable Results Rich & Diverse “Tool Box” for Analysis and Problem-Solving “At e-Zsigma, we teach people to do Six Sigma and we CHANGE people to do Lean” 6 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  7. 7. LEAN 101: THE EIGHT SOURCES OF WASTE Inventory: Staff “squirreling away” personal supplies & equipment Waiting or Delays: Physicians waiting for test results Over-producing: Processing extra lab samples than necessary Transportation: Moving patient across/outside hospital to receive treatment Motion: Retrieving patient file (hard copy) from central filing system Errors/Mistakes: Misdiagnosis of type of infection in patient Over-processing: Patient receives X-ray, then ultra-sound, followed later by CT scan… X-ray redundant? Underutilized human capability: Automated processes that need to be “watched” as they complete. Inspecting quality versus producing quality. 7 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  8. 8. LEAN 101: MAKING WASTE MORE VISIBLE Process Flow Maps Spaghetti Diagrams Value Stream Maps Cause and Effect Diagrams Five “Whys?” Pareto Charts Workplace Organization 5S (Sort, Set, Shine, Standardize, Sustain) Visual Workplace Process Reports, Audits and Assessments 8 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  9. 9. LEAN 101: VALUE STREAM MAPPING • Current state? • Future State? Observing the process, Capturing data & Looking for waste…. 9 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  10. 10. LEAN 101: THE 5S EVENT 1. Sort: Separate what is needed in the work area from what is not. Then… get rid of what isn’t needed! 2. Set in order: Organize what remains – in the order that it is required for the process or task 3. Shine: Clean and inspect the work area/workplace 4. Standardize: Standardize the cleaning, inspection, and safety practices – make it part of the job 5. Sustain: Establish an environment, including audits and visual cues, that ensure the culture of 5S “sticks” Note: Lean organizations have a standard that any “tool” must be able to be found within X seconds (example: 60 seconds). A tool can be a piece of equipment, a document, a file, etc. necessary for the work to proceed and value to be created. 10 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  11. 11. LEAN 101: VISUAL WORKPLACE The Challenge: People not having access to the knowledge they need to do their jobs effectively and efficiently. What tasks? What priority? What target? The “correct” way? Which tools and where can I find them? Waste: Searching, asking, waiting, retrieving, reworking! Visual workplace: Providing vital information when and where it is needed. Easily understood & unambiguous work instructions on what to do, when, and how. Tools and methods to easily and reliably identify process errors ad omissions as quickly as possible - at the source. Real-time performance feedback so employees know where they stand in terms of meeting goals or targets. Encourage alignment of activities across and up and down the organization so that they congruent with strategic goals and objectives. Promote and communicate cultural change in the organization, specifically the lean evolution. 11 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  12. 12. SIX SIGMA 101: “Y IS A FUNCTION OF X” The heart of “Six Sigma” thinking The phrase “Y is a function of X" means that the value of Y (process outcome) depends upon the value of x (process inputs), so Y can be written in terms of X. This philosophy has evolved into a robust, powerful problem-solving and process improvement methodology used by hundreds of thousands of organizations world-wide Automotive, aerospace and manufacturing Banking, insurance and financial services Hospitality and service industries Government and public sector Healthcare 12 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  13. 13. SIX SIGMA 101: THE IMPORTANT QUESTIONS 1. Do I fully understand the customer requirements? 1 (Target and Tolerance) 2. How much variation is in the process I use to meet 2 my customer’s needs? 3. How well does my process meet my customer’s needs? How often? What is the impact on Cycle 3 time? Safety? Customer Satisfaction? 4. What are the root cause(s) of the process variation? 4 Y = F(X1..Xi) 5. Can I reduce variation within the process to reduce 5 the defects? (If not, get a new process.) 6. Can I center the current process on target? 6 13 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  14. 14. SIX SIGMA 101: DMAIC APPROACH Define… process improvement goals that are consistent with customer demands and the enterprise strategy. Measure… key aspects of the current process and collect relevant data. Analyze… the data to verify cause-and-effect relationships. Determine what the relationships are, and attempt to ensure that all factors have been considered. Improve… or optimize the process based upon data analysis using techniques like Design of Experiments. Control… to ensure that any deviations from target are corrected before they result in defects. Set up pilot runs to establish process capability, move on to production, set up control mechanisms and continuously monitor the process. Source: 14 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  15. 15. LEAN SIX SIGMA 101: ROBUST “TOOL BOX” Define Phase – Key Tools •VOC (Voice Of the Customer) •Cost of poor quality •“Critical To” Tree (CT Tree) Define •Project scoping and problem statement •Change management •High level process map •Team identification •Project contract Measure Phase – Key Tools •Process Mapping (including SIPOC) •Control Charts Basics •Binomial Distribution Statistics •Rolled Throughput Yield (RTY) •Measurement System Analysis •Graphical Analysis and Techniques •Basic Statistics (MSA) •Data Collection Plan Measure •Central Limit Theorem (CLT) •Process Capability •Failure Mode & Effects Analysis (FMEA) •Cause and Effect (C&E) Matrix •Cause and Effect (C&E) Diagram Analyze Phase - Key Tools •Advanced Graphical Analysis •Statistical Analysis •Confidence Intervals oMulti-Vari Studies oHypothesis Testing •Power and Sample Size oMain Effects Plots Means Analyze oInteraction Plots Variation Chi Square Non-normal data oCorrelation Proportion Analysis of Variance oRegression Counts Analysis of Means Improve Phase - Key Tools •Modeling Designs of Experiments •Robust Design of Experiments •Screening Design of Experiments Improve •Response Surface Design of •Survey Design of Experiments •Multiple Regression Experiments Control Phase – Key Tools • Process Control Plans • Mistake Proofing • Statistical Process Control Control • Gage Control Plans • 5S • Business Case Simulation Exercise • Preventative Maintenance Control Plans • Standard Operating Procedure 15 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  16. 16. SIX SIGMA 101: PROCESS EXCELLENCE 16 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  17. 17. APPLICATION: LEAN SIX SIGMA IN E.D. 17 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  18. 18. INITIAL TRIAL RESULTS Metric Current Performance Trial Results Time to PIA CTAS 3 >2 Hours 30 Mins. Ave: 45 Mins. CTAS 4 >2 Hours 70% Reduction Length of Stay CTAS 3 >4 Hours 30 Mins. Ave: 3 Hrs. 23 Mins 25% Reduction CTAS 4 >3 Hours %LWBS 6-7% Zero (Expected to be <1% ongoing) 18 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  19. 19. LEAN SIX SIGMA BENEFITS Reduced Patient Length of Stay D.I. – less batching, better flow Increased Patient satisfaction Inside Clerk Patient sees physician much quicker Less batching of patients/work LWBS drastically reduced Simpler process Faster patient flow Less phone calls and interruptions Improved patient safety Less stress and greater job satisfaction Physicians see patients sooner The Lab RN Fewer unnecessary tests More time for patient care Fewer add-ons Greater % of time on VA activities Less batching of ER tests Peace of mind (Pt. seen by Dr. first) Less need to phone ER Better waiting room attitude Phlebotomist Fewer interruptions at Triage One visit per patient Less stress and Greater job No Hallway draws satisfaction Less batching Housekeeping – less batching Less frustration and greater satisfaction For RVH C.I.T. has earlier intervention improved reputation and image R.T. sees patient sooner Potential future funding Barrie Community has a better ER opportunities September 9, 2010
  20. 20. E-ZSIGMA (CANADA) INC. Canada’s leader in Lean, Six Sigma & Innovation strategy, consulting and training Canada’s only Certificate in Lean Six Sigma for Health Care Schulich School of Business Lean Six Sigma Centre of Excellence Master’s Certificate in Healthcare Management Some of our Health Care clients; St. Michael’s Hospital • Lean Six Sigma Strategic Deployment Mt. Sinai Hospital • On-site Lean Six Sigma Training Ontario Ministry of Health • Lean Six Sigma Project Management LHIN, FHITs, Strategy, etc. • Open Enrollment (Public) Training Health Canada • Process Design, Modeling & Simulation Royal Victoria Hospital • Master Black Belt Project Coaching Hamilton Health Sciences & Mentoring London Health Sciences Canadian Blood Services • Lean Six Sigma Certification Centre for Addiction & Mental Health • Comprehensive e-Learning Program Alberta Medical Association Joseph Brant Memorial Hospital 20 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  21. 21. RAPID START: GREEN BELT FOR HEALTHCARE Lean Six Sigma for Healthcare focuses first on the processes, tasks and activities that define world-class healthcare service and patient care. It enables the delivery of consistently high levels of quality & value while banishing waste & non value-added activities. The result is lower costs and more desirable outcomes for patients and caregivers alike. 8 Day Program GBH096 (Toronto) Session 1: October 4 - 7, 2010 Session 2: November 1 - 4, 2010 21 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  22. 22. COURSE OVERVIEW Six Sigma fundamentals and methodology Lean fundamentals and methodology Differences and synergies of Lean and Six Sigma Six Sigma measures and statistics The eight step Six Sigma strategy Managing Lean Six Sigma projects using DMAIC approach Opportunities for defects Customer focus -The CT tree and Quality Function Deployment Sigma level and Cost of Quality The importance of the people side of managing improvement projects 22 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  23. 23. E-ZSIGMA SERVICES HEALTH CARE SPECIFIC TRAINING PROGRAMS E-Zsigma has designed an 8-day Lean Six Sigma Healthcare program tailored specifically for the Canadian Healthcare industry. This program is the first of its kind in Canada. CUSTOMIZED SOLUTIONS Our training programs can be customized to suit your needs and be delivered at your location. PROJECT MANAGEMENT & LEADERSHIP Allowing our senior Master Black Belts to help you lead rapid and highly successful lean six sigma improvement projects Patient flow and wait times Information technology implementations Process improvement projects where they are needs and when they are needed E-LEARNING SOLUTIONS We understand the hectic schedule of the healthcare professional. Therefore we offer a comprehensive e-Learning program designed to meet your needs on your schedule. 23 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  24. 24. HEALTHCARE QUALITY CAMPUS 24 Lean & Six Sigma March 5, 2010
  25. 25. YOUR EXPECTATIONS FOR LEAN SIX SIGMA Improved patient experience and satisfaction Faster response to patient needs Increased job satisfaction & reduced stress for caregivers Improved, standardized & repeatable processes that are more predictable Between 20% and 60% reduction in Process Cycle Time Ability to focus resources on more value-added activities Greater than 50% Improvement in resource utilization Improved asset utilization: people, equipment & technology Reduced unit costs through increased capability Improved flow through elimination of bottlenecks (delays) and constraints (limiters) Greater than 30% gain in process capability Dramatic improvement in scheduling predictability – better process management Participative problem-solving Engaging the people who know and do the work… the team Recognition of the “human” side of lean and the need to manage change 25 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010
  26. 26. CONTACT INFORMATION E-Zsigma (Canada) Inc. One Dundas St W, suite 2500 Toronto, ON O: 416.593.8026 F: 416.204.1939 Thank you for joining us today! 26 Lean & Six Sigma: A Prescription for Healthcare September 9, 2010