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                             Train, Translate & Transform




Six Sigma in Hospital Operations




            ©Training House 2012
©Training House 2012
Overview

• Quality – Six Sigma View
• Hospital Management – Key Challenges
• Six Sigma in Hospital Operations




                     ©Training House 2012
Quality…a perspective
      The Classical View of Quality                           The Six Sigma View of Quality
            “99% Good” (3.8s)                                    “99.99966% Good” (6s)
• 20,000 items rejections per months                   • 7 items rejections per month

• ~15 minutes each day of unsafe drinking              • 1 minute every 7 months of unsafe
  water                                                  drinking water

• 5,000 incorrect surgical operations per              • 1.7 incorrect surgical operations per
  week                                                   week

• 2 short or long landings at most major               • 1 short or long landing at most major
  airports daily                                         airports every 5 years

• 200,000 wrong drug prescriptions each                • 68 wrong drug prescriptions each year
  year
                                                       • 1 hour without electricity every 34
• 7 hours without electricity each month                 years
                                       ©Training House 2012
Increasing Productivity

Low Cost                              Innovation

High Quality                          Intersection
                                      Customer Insight




               ©Training House 2012
Hospital Operations: Key Challenges



               Timely         Efficient           Effective
              Services        Services            Services
    Safe                                                         Data
Environment                                                   Collection




                         Patient Centric Care

                           ©Training House 2012
Six Sigma in Hospital Operations: Why?


         With the increased focus
      on customer requirements and
    pressure to deliver the best quality
every time, cost of healthcare is escalating.

    It has become of equal importance,
        to optimize the performance
         with respect to quality and
           to optimize cost of care.




                    Six Sigma addresses both these concerns
                                ©Training House 2012
Six Sigma?

                                                Six Sigma is a
                What is Six                     “data driven”
                 Sigma?                        problem solving
                                                methodology.


                                 … how you utilize and
                                    implement that
                                methodology depends on
                                         you.


• A highly Structured and Data Driven Approach for Improved Customer Quality.
• A Measurement of Our Process and our Capability to deliver services.
• Goal of Six Sigma – Attain Less Than 3.4 Defects per Million Opportunities
                                      ©Training House 2012
Six Sigma Vs Traditional Approach



      Practical
                                                              Traditional
      Problem
                                                               Approach

                     Statistical
                      Problem


                  Six Sigma
                                                Statistical
                  Approach                       Solution


                                                                            Practical
                                                                            Solution

Customer Focused . . .Bottom Line “cost” Driven

                              ©Training House 2012
Some Six Sigma Projects - Case Study

                                                              Reducing Discharge Time
Reduction in CRBSI Rate                                       Discharge Time
Infection reduction - 3.66 to 6 Sigma                         Before: 282 mins - After: 135 mins



Optimization of Dialysis Process                                                 Improving Lift Efficiency
Process Sigma Increased by 1                                                      50% Improvement in Customer Satisfaction
                                                                                  50% Process Capability increased

                                                        Six Sigma
                                                         Projects
Increase Dispatch Capacity-CPS
 Process Sigma improved by 1.22

                                                                                 Reducing Cathlab Waiting Time
                                                                                  30% improvement in    waiting time


            Optimizing Diagnostics Pricing                      Standardization of Consumable
            Avg realization – 1.78 Sigma increased             Process Sigma improved by 3.4


                                                      ©Training House 2012
CRBSI – Six Sigma approach – Case Study

                            Problem

 High rate of Catheter Related Blood Stream Infections (CRBSI) in ICUs

 Increased Length Of Stay (LOS) for patients, due to CRBSI

 Patient Dissatisfaction

 Revenue loss due to increased LOS


                               Goal

     To Standardized process & eliminate CRBSI from MHC


                                 ©Training House 2012
Case Study :- Causes for High CRBSI

      Environment                                 People
                                                                     Wire Control
                       Insertion Site                                 Contaminated Lines
                          Patient Immunity                                Periodic dressing
                                         Supervision                        Dressing Technique
Patient Movement                              Assistance                        Multiple Pricks
 Emergency /code                    Patient Behavior                                               HIGH ICU
                                                                                                 CRBSI RATES
                                     Guidelines for catheter
Sterile technique                           insertion
                                                                             TNA data available
Universal Precaution
                                  TAT for information                      Sterilized material

    C/L
  protocol                  Culture process
             Process                               Material



                                              ©Training House 2012
Case Study :-Key Improvements
              Pt. in MICU

       Doctor's decision for C/L
                                                                 Revised Standard procedures
  Site –Subclavian /Femoral/Jugular                                   - Hand Wash

Patient consent & procedure explanation

        Procedure preparation

      Hand Wash & Dr. Assistant                                                  Drying time for
                                                                              site, increased to 3-5
                                                                               mins., as per WHO
  Patient preparation & C/L insertion
                                                                                     standards
               Suturing

             Site Drying

                                                                            Established
            Site dressing                                                  measurements
                                                                              system
             Monitoring


                                          ©Training House 2012
Case Study :-Achievement…


The Classical View of Quality
  “98.45% Good” (3.66s)
 CRBSI Rate in MICU – 4

                                    The Classical View of Quality
                                        “99.61% Good” (4.16s)
                                        CRBSI Rate in MICU – 1



                                                          The Six Sigma View of Quality
                                                             “99.99966% Good” (6s)
                                                            CRBSI Rate in MICU – 0




                                ©Training House 2012
Six Sigma Scope in Hospital Services



                                                  Bed related Inpatient Functions

   Medical Operations                             Out patients related Functions

                                                  Diagnostics and Treatment Functions

                                                  Administrative Functions

   Administrative Operations                      Research and Teaching Functions

                                                  Supply Chain




Focus on Process Capability, Utilization, Cycle Time, Cost Optimization


                                   ©Training House 2012
Six Sigma Infrastructure


                                       Six Sigma Champion

 Resources         Master Black Belt         Black Belt            Green Belt           Yellow Belt


                    Culture change                             Identify opportunity
Primary Role             agent            Mentor Project        & Execute Project     Execute Project



Role Duration         24 Months             18 Months               12 Months            6 Months



The actual infrastructure and number of roles will be dependent on the size and complexity
of an Organization &maturity stage of deployment of Six Sigma.


                                        ©Training House 2012
Essential of for Six Sigma



• LEADERSHIP COMMITMENT
    Time
    Effort
    Resources

• MANAGING WITH DATA
    Design-measure-analyze-improve-control

• TRAINING AND CULTURAL CHANGES
    Integrated business strategy
    Impact on career paths



                             ©Training House 2012
Six Sigma and Health Care - Statistics

An increasing number of hospitals are adopting a Six Sigma process as a way to
increase patient satisfaction and reduce errors by improving processes.
Statistics compiled by the US Bureau of Labor Statistics show that health care
costs have increased five to six times faster than much of the rest of the economy
during the past 5 years.

Six Sigma is a program of quality that is grounded in statistical analysis of gathered
data.




                                    ©Training House 2012
Contact US

    Business Enquiries                           business@traininghouse.in

    Investors Enquiries                          investors@traininghouse.in

                                                 mediaenquiries@trainingho
    Media Enquiries                              use.in

    Jobs Enquiries                               jobs@traininghouse.in

    Trainers Enquiries                            trainers@traininghouse.in

     Contact Person                              santhoshi@traininghouse.in


                          ©Training House 2012
THANK YOU…

Hope to See you in Training Class




           ©Training House 2012

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Six Sigma Workshop For Hospitals

  • 1. Train, Translate & Transform Six Sigma in Hospital Operations ©Training House 2012
  • 3. Overview • Quality – Six Sigma View • Hospital Management – Key Challenges • Six Sigma in Hospital Operations ©Training House 2012
  • 4. Quality…a perspective The Classical View of Quality The Six Sigma View of Quality “99% Good” (3.8s) “99.99966% Good” (6s) • 20,000 items rejections per months • 7 items rejections per month • ~15 minutes each day of unsafe drinking • 1 minute every 7 months of unsafe water drinking water • 5,000 incorrect surgical operations per • 1.7 incorrect surgical operations per week week • 2 short or long landings at most major • 1 short or long landing at most major airports daily airports every 5 years • 200,000 wrong drug prescriptions each • 68 wrong drug prescriptions each year year • 1 hour without electricity every 34 • 7 hours without electricity each month years ©Training House 2012
  • 5. Increasing Productivity Low Cost Innovation High Quality Intersection Customer Insight ©Training House 2012
  • 6. Hospital Operations: Key Challenges Timely Efficient Effective Services Services Services Safe Data Environment Collection Patient Centric Care ©Training House 2012
  • 7. Six Sigma in Hospital Operations: Why? With the increased focus on customer requirements and pressure to deliver the best quality every time, cost of healthcare is escalating. It has become of equal importance, to optimize the performance with respect to quality and to optimize cost of care. Six Sigma addresses both these concerns ©Training House 2012
  • 8. Six Sigma? Six Sigma is a What is Six “data driven” Sigma? problem solving methodology. … how you utilize and implement that methodology depends on you. • A highly Structured and Data Driven Approach for Improved Customer Quality. • A Measurement of Our Process and our Capability to deliver services. • Goal of Six Sigma – Attain Less Than 3.4 Defects per Million Opportunities ©Training House 2012
  • 9. Six Sigma Vs Traditional Approach Practical Traditional Problem Approach Statistical Problem Six Sigma Statistical Approach Solution Practical Solution Customer Focused . . .Bottom Line “cost” Driven ©Training House 2012
  • 10. Some Six Sigma Projects - Case Study Reducing Discharge Time Reduction in CRBSI Rate Discharge Time Infection reduction - 3.66 to 6 Sigma Before: 282 mins - After: 135 mins Optimization of Dialysis Process Improving Lift Efficiency Process Sigma Increased by 1  50% Improvement in Customer Satisfaction  50% Process Capability increased Six Sigma Projects Increase Dispatch Capacity-CPS  Process Sigma improved by 1.22 Reducing Cathlab Waiting Time  30% improvement in waiting time Optimizing Diagnostics Pricing Standardization of Consumable Avg realization – 1.78 Sigma increased Process Sigma improved by 3.4 ©Training House 2012
  • 11. CRBSI – Six Sigma approach – Case Study Problem  High rate of Catheter Related Blood Stream Infections (CRBSI) in ICUs  Increased Length Of Stay (LOS) for patients, due to CRBSI  Patient Dissatisfaction  Revenue loss due to increased LOS Goal To Standardized process & eliminate CRBSI from MHC ©Training House 2012
  • 12. Case Study :- Causes for High CRBSI Environment People Wire Control Insertion Site Contaminated Lines Patient Immunity Periodic dressing Supervision Dressing Technique Patient Movement Assistance Multiple Pricks Emergency /code Patient Behavior HIGH ICU CRBSI RATES Guidelines for catheter Sterile technique insertion TNA data available Universal Precaution TAT for information Sterilized material C/L protocol Culture process Process Material ©Training House 2012
  • 13. Case Study :-Key Improvements Pt. in MICU Doctor's decision for C/L Revised Standard procedures Site –Subclavian /Femoral/Jugular - Hand Wash Patient consent & procedure explanation Procedure preparation Hand Wash & Dr. Assistant Drying time for site, increased to 3-5 mins., as per WHO Patient preparation & C/L insertion standards Suturing Site Drying Established Site dressing measurements system Monitoring ©Training House 2012
  • 14. Case Study :-Achievement… The Classical View of Quality “98.45% Good” (3.66s) CRBSI Rate in MICU – 4 The Classical View of Quality “99.61% Good” (4.16s) CRBSI Rate in MICU – 1 The Six Sigma View of Quality “99.99966% Good” (6s) CRBSI Rate in MICU – 0 ©Training House 2012
  • 15. Six Sigma Scope in Hospital Services  Bed related Inpatient Functions Medical Operations  Out patients related Functions  Diagnostics and Treatment Functions  Administrative Functions Administrative Operations  Research and Teaching Functions  Supply Chain Focus on Process Capability, Utilization, Cycle Time, Cost Optimization ©Training House 2012
  • 16. Six Sigma Infrastructure Six Sigma Champion Resources Master Black Belt Black Belt Green Belt Yellow Belt Culture change Identify opportunity Primary Role agent Mentor Project & Execute Project Execute Project Role Duration 24 Months 18 Months 12 Months 6 Months The actual infrastructure and number of roles will be dependent on the size and complexity of an Organization &maturity stage of deployment of Six Sigma. ©Training House 2012
  • 17. Essential of for Six Sigma • LEADERSHIP COMMITMENT  Time  Effort  Resources • MANAGING WITH DATA  Design-measure-analyze-improve-control • TRAINING AND CULTURAL CHANGES  Integrated business strategy  Impact on career paths ©Training House 2012
  • 18. Six Sigma and Health Care - Statistics An increasing number of hospitals are adopting a Six Sigma process as a way to increase patient satisfaction and reduce errors by improving processes. Statistics compiled by the US Bureau of Labor Statistics show that health care costs have increased five to six times faster than much of the rest of the economy during the past 5 years. Six Sigma is a program of quality that is grounded in statistical analysis of gathered data. ©Training House 2012
  • 19. Contact US Business Enquiries business@traininghouse.in Investors Enquiries investors@traininghouse.in mediaenquiries@trainingho Media Enquiries use.in Jobs Enquiries jobs@traininghouse.in Trainers Enquiries trainers@traininghouse.in Contact Person santhoshi@traininghouse.in ©Training House 2012
  • 20. THANK YOU… Hope to See you in Training Class ©Training House 2012