Upward Management in Healthcare Six Sigma

How manyhealthcare Black Belts thinkthe biggest Six Sigma challenge is notproject management, or coaching your team, butteaching your Project Sponsor/ Executive Sponsor / Process OwneraboutSix Sigma? This is something I’ve encountered in early Six Sigma Project Waves.

The scenario I’m thinking about is the one whereyou’re meeting with leadership about your project.In public meetings, they’ve been supportive; however,to you they say things like:

“I don’t think that Green Belt will be able to attend too many of your meetings, I’ve got her on two special projects already.”

“We’re having a JCAHO inspection in March so team members won’t be available to you that month.”

“There’s no money in the budget for Six Sigma expenses like a team lunch.”

“You’ll have to go through the normal purchasing procedures if you want to buy a new fax for that department; it usually takes six months if you can talk the Director into approving the purchase in the first place – but good luck.”

You may go to your Executive Sponsor, Master Black Belt, or other Six Sigma leader, only to be told “That’s part of your job as a Black Belt to work with everyone to get them on board.” But some Directors or Vice Presidents may not acknowledge your authority to tell them to spend money, take people out of clinical care areas, or re-arrange their plans for the upcoming inspection. Certainly this is even more difficult when Six Sigma is first being introduced to a hospital or healthcare system.

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In one project that I know of, the Black Belt had to put up with a lot of negative push-back from the Executive Sponsor and Process Owner (with the Project Sponsor pretty much absentee the whole time). He persevered, though, with assistance from his MBB. By the end of his successful project (which had a large financial benefit), he had gained enough political capital to make the leadership team much more action-oriented during the next project.

What has worked for you, when you’ve come across difficulties with your leadership team? Was there something specific that helped to get them to the “aha” moment of what Six Sigma is all about? Please share your experiences.

Comments 3

  1. Dr.Jacquescoley


    You may be on to something here.

    As you aware, our industry is the last, to embrace new business or compliance models. As a result, this could be one of the leading catalyst, as it relates to your observation concerning…famaliarizing your Project Sponsor about SixSigma.

    SixSigma is a strange animal to our industry, especially hospitals and schools of medicine.

    My experience in New York, has been somewhat unique. As a health care provider and a Green Belt, I may already have the "political capital" to push some projects through, without raising too many eyebrows. What has worked for me thus far, in terms of facing some of the barriers that you mentioned include:

    1. Get your CEO’s buy-in first. This a crucial first step for the entire organization concerning process change and change behavior. If the CEO does not buy in, other senior leaders will not.

    2. Are you using the appropriate SixSigma methodology for your organization. Perhaps, Lean Six would be more appropriate or even Kaizen (due to the process maps used). Of course, this also depends on what type of engagement is entertained. For example, you mentioned that your BB had experienced "negative push-back" from the Executive Sponsor and Process Owner. This is pure speculation. Perhaps, there was something missing in the data presentation.

    3. Does your Project Charter need to be beefed-up? In an organic environment like healthcare, your charter should also include quanitfying poor quality

  2. Hakan Sodersved

    I appreciate your counterhypothesis of using skilful recourses instead of teaching predesigned "roadmaps" in (Lean) Six Sigma.
    My experience from appr 25 years from my first visit to Japan in 1982 to this day of Lean Six Sigma gives me similar reflections, backed up by local market behaviour.

    Most change in industrial och business processes are led by skilful experienced people exposed to comprehensive data and facts of evidence, very little correlation to given or lack of Black Belt Training. In Lean most learning is done in physical experience.

    Skilled people teams always need to get data and exposure of problems fast in parallel to rapidly take corrective actions on system levels. This may lead into some 4-5 sigma short term quality levels.

    But my experience says, that the finetuning of quality and speed of lean enterprises cannot be done without the theory buried in the curriculums of Lean and Six Sigma. These should, however, now be further integrated and simplified.

    Considering, that the ’Project by Project’-model by Juran in DMAIC is mixed by the Systems & Process Tools of other gurus like Goldratt, Deming, Ohno, Ford, Altschuller etc we have a world class knowlegde package that cannot be rejected – it is our destiny to master these skills these times by regular retraining of our skill’s base.

    Hakan Sodersved
    Expira AB

  3. Sue Kozlowski

    Thanks for your comments. I agree with Dr. Jaquescoley’s point about CEO buy-in being necessary, regardless of methodology. And you’ve hit on another important issue, the charter being a key deliverable that should list the process owner responsibilities as well as other project parameters. Hakan’s point about needing to further integrate our theoretical curriculum, and fine-tune it for our industry segment, really hits home for me. How can we continue the continuous process of improvement within our Six Sigma methodology, as well as in the projects we select? In my organization, that’s a hot topic at this time.

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