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Elevating the Health of Healthcare: A Four Step Guide
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DRIVE WINTER 2014
PROGRAM MBADS (SEM 4/SEM 6)
MBAFLEX/ MBA (SEM 4)
PGDOMN (SEM 2)
SUBJECT CODE & NAME OM 0016 – QUALITY MANAGEMENT
BK ID B2009
CREDIT 4
MARKS 60
1 Answer the following questions:
a. What is the need for quality management?
b. What are the advantages of ISO 9000 standards?
c. What is the structure of Quality Management System (QMS)?
d. Explain any four attributes of a quality leader.
2 Write short notes on:
QS 9000
Attaining quality culture through employees
Importance of quality control
Double sampling plan
3Forces of change are the factors that drive or stimulate the need for a change in an organisation. Some of
these are external, arising from outside the organisation whereas others are internal, arising from sources
within the organisation. Discuss the external and internal forces of change.
2. 4 “Six Sigma In Healthcare
Published: Jun 12 2004, 00:00 IST
Written by Mr. GopalKulkarni, Master Black Belt - Six Sigma and Founder & Managing Director, Synagoge
Knowledge Services
Six Sigma is a powerful problem solving technique that helps in reducing variation in any process by using
powerful statistical tools for analysis. Six sigma has been successfully used by various organizations as an
enabler for business strategies leading to huge additions in their yearly turnover and at the same time
improving customer satisfaction by quantum leaps. This article describes how this methodology can be used
in hospitals to enhance customer care activities and reduce wastage to improve the bottom line.
Healthcare In India
A huge percentage of the expenditure in the healthcare segment is borne by the government sector. A large
chunk of money spend on healthcare by private organizations is limited to urban areas. There is a growth in
investment from private organizations in the tertiary healthcare sector. They provide for the multi-specialty
hospitals and super specialty hospitals. A large part of the government funds go into primary healthcare and
the rest goes into the upkeep of large hospitals.
When we consider the large hospitals (private or government) there is increasing pressure on the
organization to better their performance in customer care and at the same time suffer huge price pressures
because of the increasing influence of insurance in healthcare. Rapidly changing technologies, escalating
manpower costs, increased regulations and consumer activism leads to further pressures to reduce costs
and enhance productivity and ROI.
How does six sigma help? Let us take an example of a patient undergoing a diagnostic examination. The
process steps for the diagnostic examination would be: Let us look at this process from two angles: One
from the customer’s (patient) point of view and another from the hospitals’ point of view.
From a patient’s angle his need would be that of a defect free report in the shortest possible time. He would
also expect reasonable charges for the service, comfortable environment and a courteous staff.
From the hospitals angle, the need would be to maximize the number of patients attended to within an
available time period so as to minimize the cost of examination and ensure customer loyalty.
Given these two needs you will find that the goals of both the hospital and the patient are one and the
same. If the hospital is able to minimize the time for turnaround, it can maximize the number of
examinations and utilize its diagnostic equipment to the fullest.
This is where six sigma can help. It can reduce the variation in the time taken for a particular process.
For example, let us try to reduce the variation in the time taken for a diagnostic scan. The time taken is
defined as the time period from when the patient enters the hospital / clinic to the time he gets the report.
When data of this time is collected over a period of time, it can be represented by a normal distribution
3. curve as shown below. As the curve becomes flatter, the variation is higher. Let us assume that the mean
time is 4 hours and standard deviation (a measure of variation) 1 hour.
Going by the characteristics of the normal curve it would mean that 99.73% of the patients get their reports
between one and seven hours. If the standard deviation is reduced by half it would mean that the same
process can give an output within 2.5 to 5.5 hrs.
How does one go about reducing the variation or even the mean? The output (time taken for scanning) can
be represented in a mathematical form:
Y is the output and the X’s are the variables affecting the output. The power of six sigma lies in identifying
those X variables that have the maximum impact on the variation and also those X’s that have the
maximum impac on the mean time. Using tools like hypothesis testing, simulation design of experiments
etc, we can arrive at the critical X’s. When we control these X’s, we can reach our goal of minimizing the
time taken for scanning.
What benefits does the hospital derive from this?
• Reduced output time, leading to better utilization of time
• Higher productivity, savings on manpower cost per patient
• Improved cycle time, leading to customer satisfaction and more loyalty
We can replace the diagnostic time by any other parameter like: Reduced pharma inventories, Reduction in
discharge time, Price realization, Cost/bed, Bed utilization, Plugging revenue leakage, Asset utilization and
Reducing patient queues.
Improvements
Six Sigma methodology can still be applied to improve these parameters. The robustness and foolproof data
collection needed for the application of Six sigma in services is achieved by the increased use of information
technology. Although, the solution itself is derived from the six sigma process the use of IT in the method
ensures consistency and reduction in variation.
In conclusion it can be said that the absence of a physical product as in the healthcare sector does not stop
or limit the usage of this excellent tool that can streamline your business and increase the turnover. All that
is required would be rigorous data collection and data based decision making.”
Source: KulkarniGopal. http://www.financialexpress.com/news/six-sigma-in-healthcare/107164/0
Question:
From the above articles evaluate how six sigma can aid enhance healthcare.
5Elaborate on Quality Function Deployment (QFD).
4. 6a. Explain the different modes of failures.
b. What is terotechnology?
c. What are reasons for using gap models?
d. Explain the types of Knowledge Support System (KSS).
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