Transcript Six Sigma - PAWS - Western Carolina University

Six Sigma Method for QI & PI
MHS 665
William C. Brannan, MD
Classic Components
of Quality
12
10
8
6
4
2
0
Outcomes
Customer
Satisfaction
Cost
Process
Improvement
Institute of Medicine’s
New Components of QI
Safety
Effective
Patient Centered
Timeliness
Efficiency
Equity
0
2
4
6
8
10
12
Relationship of Classic & New
Components of Quality
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Not one or the other
Not competitive
They are to complement each other
They form the matrix or fabric for
Quality Management (QM) in either
Quality Assessment (QA) or Quality
Improvement (QI)
The Fabric of QI
Safety
Effective
Pt. Centered
Timeliness
Efficiency
Equity
Outcomes
Customer
Satisfaction
Cost
Process
Improve
History of Six Sigma
 Developed by Motorola & General
Motors in mid-1980’s
 Data-driven quality methodology
 Seeks to eliminate variation (and its
associated costs) from a process
Sigma Levels
Sigma
Defects Per Million
Opportunities (DPMO)
1
690,000
2
308,537
3
66,807
4
6,210
5
233
6
3.4
Sigma Comparison
of Industries
1,000,000
100,000
10,000
1,000
100
10
1
0
1
2
3
4
5
6
IRS Advice
Acute Back Pain
Post-MI Meds
Mammography
Abx Overuse
IP Med Errors
Airline Baggage
Px Hosp Deaths
Prescriptions
Surg Instr Left
Anesthesia
Airline Fatality
What is Six Sigma?
 A process must not produce more than
3.4 defects per million opportunities.
 In Healthcare it means not more than
3.4 medication errors in 1 million doses.
 Not more than 3.4 foreign bodies left in
patient during 1 million surgeries.
 Not more than 3.4 no shows per
1 million appointments.
The Six Sigma Cycle
Define
objectives,
set goals
Training
Implementation
Designate Black Belts.
Develop
Train SS methodology.
Projects
Involve organizationwide projects.
Staff advancement
in SS
Continue training
new staff
Continue identifying
new projects
Define
Measure
Analyze
Improve
Control
Key Six Sigma Roles
CEO
Champion
Master Black Belts
Black Belts * Experts * Guides
Green Belts
Central Components - Existing
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Define
Measure
Analyze
Improve
Control
Central Components - New
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Define
Measure
Analyze
Design
Verify
Define
 What is the business case for this
project?
 Current state map vs future state map.
 What is the project’s scope?
 Due date determined.
Measure
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What are the metrics for this process?
Are they valid and reliable?
How will I measure progress?
How will I measure success?
Analyze
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Can the process be improved?
Who will help make the changes?
What resources are required?
What could cause this change effort to
fail?
Improve
 What is the work breakdown structure?
 What specific activities are necessary to
meet project goals?
 How will I reintegrate various
subprojects?
Control
 How will I control quality, cost, schedule,
scope and changes to the plan?
 How will I ensure that the business
goals of the project were accomplished?
 How will I keep the gains I made?
Implementation Step 1
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Begin with senior leaders.
Train them in the principles and tools.
Direct the management infrastructure.
Cultivate the environment for innovation
and creativity.
 Reduce organizational hierarchy.
 Remove barriers to experimentation and
change.
Implementation Step 2
 Develop external quality measures.
 Communicate with patients, employees,
stakeholders and suppliers.
 Develop rigorous methods to obtain input
 Conduct baseline studies of starting point.
 Identify cultural, policy and procedural
obstacles to change.
Implementation Step 3
 Rigorously assess and conduct top-tobottom training in systems-improvement
tools, techniques and philosophies.
Implementation Step 4
 Develop a framework for continuous
process improvement.
 Monitor progress and success.
 Metrics should focus on strategic goals,
drivers and key business processes.
Implementation Step 5
 Managers & staff with intimate process
knowledge at all levels of the
organization choose processes for
improvement.
 Improve business performance linked to
measurable financial results.
Implementation Step 6
 Individual employees and teams, led by
Green Belts, conduct Six Sigma
projects.
Medical Error Reductions
 Reducing patient falls
 Reducing ADE’s from medications
 Reducing ordering & administration
errors
 Improving turnaround time for pharmacy
orders
Business Operations
 Improving revenue cycle
 Improving nurse or pharmacy technician
recruitment
 Improving employee retention
 Increasing OR throughput
Patient Case Management
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Decreasing stroke patient LOS
Decreasing CHF LOS
Reducing lost MRI films
Improving MRI exam scheduling
Reducing emergency department
diversions
Patient Satisfaction
 Reducing ED wait times
 Improving patient satisfaction in ED
WEB SITE
www.isixsigma.com
Six Sigma @ Mission
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CEO
Champion
Master Black Belt
Black Belts
Green Belts
 DMAIC
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Bob Burgin
Bill Brannan
Tom Knoebber
PI Consultants
Collaborative
Practice Team
 FOCUS-PDCA
QI Process @ Mission
Board Quality Committee
Medical Administrative Committee
Operations Leadership Team
Vice-President of Quality
Chief Medical Officer
PI Director
Service Line
Quality Committee of Service Line