Six Sigma Improves Healthcare Operations

Six Sigma Improves Healthcare Operations

• 1.
  W hat makes SixSigma different from other improvement methods is its structured process for defining, measuring and controlling an opportunity for improvement. In other words, it’s a disci- plined effort that closely examines an organization’s repetitive processes involving areas such as product design, production, supply chains and service. And this is why it can significantly reduce defects in the service industry, particularly in patient-oriented services. In the healthcare industry, Six Sigma has been proven to benefit patients with its focus on operational efficiency.1 The method helps translate patients’ needs into separate tasks and define the optimum requirements for each. The steps that follow this translation and definition can have a powerful effect on a healthcare organization’s performance, the quality of patient care and employee development. Six Sigma and healthcare Unfortunately, Six Sigma isn’t accepted in many healthcare organiza- tions, and there’s a misunderstanding of how it can be applied. When a healthcare practitioner hears the words “Six Sigma,” he or she might respond with comments such as: “Oh great, another program,” “I have patients to see and don’t have time for this,” “We do not have repetitive processes,” or “Every person is different.” Six Sigma doesn’t take the focus away from patients in search of ways to cut costs. And it doesn’t sacrifice clinical quality by seeking shortcuts or cookie-cutter medicine. There are a number of key elements in successfully implementing Six Sigma: • Start by genuinely focusing on patients and identifying their key requirements for quality care. • Ensure that your processes are designed and managed to meet these key requirements. • Have appropriate measures in place to determine how well you’re meeting patients’ requirements and to understand their perception of how well you are meeting those requirements. • Involve staff members and make sure they are appropriately equipped to challenge their processes and improve the way they work. • Approach improvement by using a systematic problem solving and process-improvement approach. Senior support Gaining senior management support is the most critical step in implement- ing a successful Six Sigma initiative. Improvement must be driven from the top down. If the individuals who determine your organization’s future C A S E S T U D Y Not Another Program SIX SIGMA IMPROVES HEALTHCARE OPERATIONS, NEW TECHNOLOGY INTEGRATION By William H. LaFollette, Accumen 28 I F E B R U A R Y 2 0 1 6 I W W W . A S Q . O R G
• 2.
  and direction arenot on board, the initiative will not succeed. Many organizations have the idea of bringing Six Sigma into their operations without leadership support, and they fail miserably. This is a mistake that’s not just financially costly, but it’s also costly for an organization’s culture, especially if it wants employees to accept other improvement programs in the future. After management agrees that Six Sigma is the right approach for the organization, it takes time and research to ensure the right people are aligned to the right processes. This can mean getting assistance from someone who has significant experience in applying Six Sigma. There are many healthcare professionals who successfully transitioned to operational quality. But in many cases, healthcare systems don’t have the resources or ability to stay inside their organizations and must look outside for help—at least when ini- tially launching a Six Sigma program. A healthcare system in the Midwest created a department focused on operational excellence that was staffed completely with engineers from outside healthcare. Rather than focus its improvements on the clinical side of the organization, the approach was to focus them on the operational side. Finding these types of experts can require nontraditional recruitment methods. ASQ’s Career Center (careers. asq.org) is a job-posting board that can be a valuable resource in finding quality professionals who can serve in healthcare. Finding opportunities With support from senior management and right staff in place, your next step is to understand what Six Sigma will look like in application. Defining the opportunity for improvement is the first step in launching a Six Sigma project. To kick off this phase, I like to quote Albert Einstein: “The significant prob- lems we face cannot be solved by the same level of thinking which caused them.”2 Opportunities for improvement could be issues such as: • Flaws in complex interactions among individuals: These could involve multiple handoffs between providers and staff members, or between depart- ments. For example: Orthopedics sends a patient to the X-ray area. The patient arrives and says he’s there for an X-ray on his shoulder and ends up getting an X-ray on a foot. In this situation, there was a lack of documented process steps and some type of process control. Had it been a more serious procedure, the results could have been catastrophic. • When there is a change in a process or opera- tional flow: A process-control point must be established to ensure the consistency of care and workflow. • Problems using new, sophisticated technology with people: When people must interact with evolving technologies, there is a large opportu- nity for errors. This is where our subject matter experts—whether they are in Six Sigma or IT— face their greatest challenge. Improvement with IT and Six Sigma Getting healthcare practitioners to use new technol- ogy is nearly an impossible task. The first hurdle to overcome is defining the technology, and this is fol- lowed by explaining how that technology will benefit the organization. Moving practitioners out of the “that’s the way we’ve always done it” mindset is never easy, but with the right focus and methods, new tech- nologies with proper controls can have a significant effect on an organization. A physician-owned healthcare system in the Midwest improved its technology and followed Six Sigma’s define, measure, analyze, improve and con- trol process to provide major improvements to its overall operational health. The healthcare system identified an opportunity to improve its patient service by reducing the amount of paper charts used by staff members. Giving providers the information they needed to consult with patients involved a courier pulling paper charts and deliver- ing them to a provider’s department. This process required the transfer of thousands of records across many floors in a 150,000-square- foot facility. It also caused a one-day delay in the process. After delivery, medical staff was required to sort through information and prep for the next day’s patients, creating additional delays. After a patient arrived for his or her appointment, a provider reviewed the paperwork and began treat- ment. The provider then sent handwritten notes to be transcribed, and the transcribed notes were added to the patient’s record. Each of these steps compound delays in the process of treating patients. The health system’s opportunity for improvement, S I X S I G M A F O R U M M A G A Z I N E I F E B R U A R Y 2 0 1 6 I 29 Not Another Program
• 3.
  therefore, was todetermine a method to eliminate paper records and the need for a courier to hand- deliver them. These process delays also had associated costs. The healthcare system calculated the cost of paper and printing, time spent transcribing and manually deliv- ering records, transcription errors from handwritten notes, and the collection of records. The system determined electronic medical records—loaded, stored and accessed through a tab- let or computer—were the most direct and valuable solution. Teams from IT, informatics, clinical quality and business quality defined the type of informa- tion that was needed, including how it should be presented, captured and reported. After the solution was implemented, not only was every project objective met, but some unexpected improvements also resulted. For example, patient sat- isfaction showed a marked improvement. In satisfac- tion surveys, patients’ statements showed they were happier to see doctors more focused and spending less time seeking information from previous visits. The overall operational effect on the healthcare system was considered a major success and has been used as a best-practice example of implementing electronic medical record technology. Process controls also were implemented to ensure the tech- nology solution was monitored and reviewed on a continuous basis. This example demonstrates just one of many ways that the healthcare industry can benefit greatly from Six Sigma. Not only is it a disciplined approach to evaluate and improve repetitive processes, it also can help implement IT solutions that often accompany these improvements. REFERENCES 1. “Excellence in Healthcare Delivery,” white paper, The Performance Management Group LLC, http://tinyurl.com/sixsigmahealthcare. 2. “Quotes on Problem Solving,” Leadershipnow.com, http://tinyurl.com/ einsteinqualityquote. WHAT DO YOU THINK OF THIS ARTICLE? Please share your comments and thoughts with the editor by emailing [email protected]. 30 I F E B R U A R Y 2 0 1 6 I W W W . A S Q . O R G Not Another Program Dilbert DILBERT©2016ScottAdams.UsedBypermissionofUNIVERSALUCLICK.Allrightsreserved. HEALTHCARE SYSTEMS DON’T HAVE THE RESOURCES OR ABILITY TO STAY INSIDE THEIR ORGANIZATIONS AND MUST LOOK OUTSIDE FOR HELP—AT LEAST WHEN INITIALLY LAUNCHING A SIX SIGMA PROGRAM.