This live project was bestowed the "Harrington Award - Best Thesis" for the plan, simplicity of understanding and seamless execution along with a detailed analysis.
1. Presented By
Dr. Vinod Prabhu & Sameer Murdeshwar
Institute of Management Technology, Dubai (DIAC)
2. Objectives of the Study
Brief History of Six Sigma
Six Sigma in the Healthcare Industry
Time frame
End Outcome
The DMAIC Methodology
◦ Define
◦ Measure
◦ Analyze
◦ Improve
◦ Control
3. To look for an existing process in the hospital
which has a scope for significant
improvement
Six Sigma methodology would be the choice
for the process improvement
Chosen focus area is the Medication Delivery
Turnaround Time for newly admitted patients
4. Blakslee (1999, July) refers to Six Sigma as “a
high-performance, data-driven approach to
analyzing the root causes of business
problems and solving them”
Originally developed by Bill Smith, a reliability
engineer working for Motorola in 1986
Adopted by GE in the 1990s
5. Ever-growing number of health care
organizations are using Six Sigma to improve
processes from admissions to discharges and
all the administrative and clinical processes in
between
Driven by several factors including the need
to improve the organization’s bottom-
line, eliminate medical errors and position
themselves for an imminent global customer
- centred health care revolution
6. Using the DMAIC methodology, the study was
spilt into five phases
◦ Define phase (10 days)
◦ Measure phase (30 days)
◦ Analyze phase (10 days)
◦ Improve phase (15 days)
◦ Control phase (5 days)
7. Significant improvement in the existing
process
Greater customer & employee satisfaction
Streamlining of the process
Savings in terms of time – Medication Delivery
Turnaround Time for newly admitted in-
patients
8. Flexible, but powerful set of five steps for
making improvements happen and stick
The team works from a statement of the
problem to the implementation of the
solution, with statistical driven activities in
between
9. Define the problem
Identifies potential projects, selects and
defines a project, and sets up the project
team
Selection of the project depends on it’s
feasibility, significance and measurability
Started out with mapping the complete
process for three processes
◦ Patient admission (IP)
◦ Outpatient procedure
◦ Working of pharmacy
10. Initially chose OP process but…
Finally, focus area shifted to the IP process
for newly admitted patients requiring
medications upon admission
Main reason being the complexity of
interactions & process flow and the larger
number of variables
Drew up a timeline & chalked out a project
blueprint
11. Organization: Zulekha Hospital, Sharjah
Champion: Dr. Suresh Menon
Project Owner: Dr. Alexander Varghese
Project leader: Ms. Pooja George
Project: Medication Delivery TAT for Newly admitted
patients
Problem statement: Long waiting times for a newly
admitted patient to receive their first medication
Project objective: To reduce the patient waiting times
for medication
Project Team: Dr. Vinod Prabhu & Sameer
Murdeshwar
Metrics: Minutes
CTQ: Quicker drug dispensation
12. Data is gathered to validate and to quantify the problem /
opportunity
Begin testing out facts and numbers that offer clues about
the causes of the problem
Identify key parameters and process characteristics
Process was observed for 3 – 4 days
Questioned people involved for clarification
Process was divided into 9 distinct steps and individually
measured
Total of 40 cases were measured, across all three wards
and different shift timings
Daycare cases and delayed medication cases were not
taken into consideration
Took care to be as discreet as possible so as to not
introduce bias into the study
13.
14.
15. Identifies the causes of the problem
From the various causes, the focus will be on the
root cause(s)
Begins by combining data, experience, a review
of the process, and then forming an initial
hypothesis of the cause
Root Cause analysis performed
Ishikawa (Cause & Effect) Diagram was
constructed
Pareto Analysis performed
Quantitative drill down of the measured numbers
– Averages, Max time, Min time & Frequency
distribution
16.
17. 25.00
Average Time of Each Process
20.00
Time in Minutes
15.00
10.00
5.00
0.00
1 2 3 4 5 6 7 8 9
Series1 5.99 10.61 6.40 2.58 0.78 8.15 3.26 2.69 23.73
18. % Contribution of each Step to Total Time
40
35
30
25
Percentage
20
15
10
5
0
1 2 3 4 5 6 7 8 9
Series1 9.33 16.54 9.97 4.01 1.22 12.7 5.07 4.19 36.97
19. Pareto Chart for Stage Wise Delay
120
100
80
Percentage
60
40
20
0
k c h de ab i j f g
Series1 36.974878 16.535150 12.699513 9.9696202 9.3324245 5.0726387 4.1850048 4.0144109 1.2163583
Series2 36.974878 53.510029 66.209542 76.179162 85.511587 90.584225 94.769230 98.783641 100
20. Major Causes Instances
Multitasking-doctor enquiries and patient room calls 10
Nurses handling other recent admissions 9
Nurses focus on doing the paper work 6
Indent not kept on shelf immediately after print out taken 6
HK busy with their primary work 5
Distractions-Telephone calls 2
21. Designs a remedy, help prove its
effectiveness, and prepares an
implementation plan
Several potential solutions have to be
proposed
Criteria, including costs and likely benefits
are used to select the most practical solutions
22. Process Re-Design
Dedicated Housekeeping staff to deliver
medications from pharmacy to all wards
Medical file re-design
Use of digital clocks
Printing priority
Discharge sheet proposal
23. Avoiding the “snap” back to old habits and
processes
Ensuring that the solution has a long-term
impact
Developing a monitoring process to keep
track of the changes
Creating a response plan for dealing with
problems that may arise