Healthcare is a heavily regulated industry and requires substantial amounts of paperwork. Paperwork may not be as pressing as patient care, but it must be done in a timely fashion. A Lean Six Sigma project reduced the task delinquency rate in its residency program.
In this continuation of a multi-part case study, recurring problems are identified and eliminated at the diagnostic clinics’ newly established centralized laboratory.
This now five-part case study focuses on improving customer satisfaction at two of a company’s diagnostic clinics – Centers A and B. In Part One, the company worked at Center A to reduce patient turnaround time, a defining component of patient satisfaction. In Part Two, the chain’s improvement story focuses on increasing patient delight at…
Building a culture of continuous improvement within an organization goes beyond the ability to execute process improvement projects. An organization that supports continuous improvement promotes a non-blaming culture, focuses on the improvement responsibility of all employees and uses the talent of the entire workforce. Such an organization empowers employees to speak up when they see…
In the heartland of America the population of residents is shrinking. Along with a decline in population comes the fading economic market of consumers to support the service businesses of these communities. Due to aging populations and fewer people migrating to rural America, small towns confront real threats to their ways of life. Economies are…
The accounts payable shared services center (SSC) of a large Ohio-based healthcare system completed a Six Sigma operational enhancement and reporting project. This case study reviews the course of the project which endeavored to establish standard invoice processing times and develop an ongoing system for monitoring how well those standards are met. Over the last…
A 250-bed hospital had implemented total quality management (TQM) to improve customer delight in its diagnostic clinics. After that success, the management team of the hospital was ready to proceed with further process improvement. After completing a brainstorming and prioritization exercise, the team determined to next address the problem: delay in receiving test reports for patients…
This three-part case study focuses on improving customer satisfaction at two of the company’s diagnostic clinics – Centers A and B. In Part One, the company worked at Center A to reduce patient turnaround time, a defining component of patient satisfaction. In Part Two, the chain’s improvement story focuses on increasing patient delight at Center…
This three-part case study focuses on two of the company’s diagnostic clinics – Centers A and B. In Part One, the company worked at Center A to reduce patient turnaround time, a defining component of patient satisfaction. Part Two of the chain’s improvement story focuses on increasing patient delight at Center B. Part Three revisits…
The following is Part One of a three-part article. Click here to read Part Two. Click here to read Part Three. A chain of medical diagnostic clinics was developed from the ground up. After two years of hectic expansion marked by acquisitions and setting up greenfield clinics across a number of cities, it became clear…
As a career operations professional, many of my friends understand that I see process flows in nearly everything I encounter. Some friends find this entertaining, others find it a bit annoying. But mostly they allow me to exercise (not exorcise) my craft. You see, I was born of operational parents. I’m not sure if it…
Hospitals and health plans know that the high cost of care is squeezing the U.S. economy. That’s why so many of them are using Lean Six Sigma to control spending by refining internal processes – while still satisfying customers in a highly competitive market. A major health care consortium based in the Dallas-Fort Worth area…
If you didn’t have the ability to attend an iSixSigma Live! event in person during the first half of 2011 (and given the content at these world-class conferences, you really should have been there), you still have the chance to take in some of the best presentations from those programs with the iSixSigma “Best of…
Since its founding in 1990, National Committee for Quality Assurance (NCQA) has been driving improvement through the development of quality standards and measures in the healthcare field. The NCQA measures are more commonly recognized as Healthcare Effectiveness Data and Information Set (HEDIS). How can organizations incorporate Lean Six Sigma in their NCQA accreditation efforts? Lean…
Historically, medical residency teaching clinics provide the heart of medical services to an under-insured population through various government-subsidized health insurance programs. These programs provide medical coverage for eligible individuals with incomes of less than 35 percent of the federal poverty level. It is well-established that people living in poverty are at a higher risk for…
Benjamin Franklin once said that “time is money.” In the clinical world, time can be more valuable than money. When a patient is in need of attention, bedside clinical caregiver time is worth more than money. As Vice President of Support Services at Heartland Health, my job is to make sure support service departments –…
The biomedical world – which includes the equipment used in hospitals, as well as physicians’ and dentists’ offices – is ripe for Six Sigma use. As a senior biomedical engineer and a Black Belt, I embarked on a Six Sigma journey that would provide top-quality service at reduced costs to my customers. As part of…
“What kind of care would I want for a loved one who is fighting cancer?” This is the question that Julia, an outpatient clinic nurse at Cancer Treatment Centers of America (CTCA), asked herself as she observed the following process: Mrs. Smith, a patient, arrives early to the clinic to meet with her oncologist, Dr….
Director of Quality Outcomes Nidia Williams explains how the deployment in this three-hospital organization has evolved in the past two years.
The American Academy of Family Physicians (AAFP) National Research Network and the American College of Physicians released a study in the Journal of the American Board of Family Physicians (JABFM) in September showing how including both physicians and non-physicians on process improvement teams can help better facilitate change management, according to an article by David…
Dr. John Toussaint, former CEO and president of the ThedaCare healthcare system, shares his lessons learned in applying Lean in his recent book. ThedaCare Inc., a not-for-profit system of hospitals, clinics, nursing homes and other services in Northeast Wisconsin, has been practicing Lean for more than seven years. Through its use of Lean principles, the…
For patients of Virginia Mason Medical Center, trips to the hospital can actually be pleasant – or at least free of discomfort and waste. The center is a private, not-for-profit organization offering integrated health services, including a 336-bed hospital in Seattle and a network of primary and specialty care clinics throughout the Puget Sound region….
When the clock is ticking in time-bound, customer-sensitive operations, using Lean Six Sigma can be a smart move toward achieving operational excellence and customer satisfaction. In this case study, one large insurance company executed a Lean Six Sigma project to cut operational costs for property and casualty (P&C) insurance claims and improve customer satisfaction. The…
Recognizing accomplishments is an important part of a Lean Six Sigma deployment, both for the honor that it brings to the practitioners and for the visibility it brings to the program. Covidien plc, a $10 billion global leader in healthcare products, has embraced that concept wholeheartedly in its annual Bring Home the Gold competition. The…
Four times a year, I donate blood at a local blood bank and receive readings on my cholesterol, blood pressure and pulse. Although donating blood does not improve a person’s health, the regular readings of the vital signs, along with analysis and actions stemming from this data, can be significant in the fight against heart…
Contaminated needle sticks are a risk for healthcare workers. These injuries are frightening because the patient whose blood was pricked into the nurse, medical assistant, lab tech or other healthcare worker can be contaminated with Hepatitis B or C, or HIV/AIDS. Once the blood-borne pathogen exposure has occurred, the employee has to undergo tests to…
“We’re different!” Practitioners often hear these words while attempting to deploy Lean Six Sigma. While the phrase is sometimes viewed as an excuse to avoid change, in the case of the marketing and sales function within a pharmaceutical organization, it may hold some validity. This article explores ten reasons why sales and marketing claim to…
The success of any change is enhanced by building a culture of alignment, accountability and acceptance. This is evident in the implementation and deployment of Six Sigma at Virtua Health, a comprehensive healthcare system consisting of four hospitals and headquartered in Marlton, NJ, USA. Throughout its more than eight year deployment, the organization has worked…
Merriam-Webster’s dictionary states, “skepticism implies an unwillingness to believe without conclusive evidence.” Sometimes a little skepticism – or at least curiosity – can be a healthy thing. For instance, one should probably not begin taking a new medication without asking a few pertinent questions such as, “What are the side effects,” “How will this interact…
In an era of complexity and contradiction, many healthcare organizations are seeking bold strategies for leading and managing change. While concepts behind the balanced scorecard and core Six Sigma methodologies are not new, a powerful management tool can be crafted through the unification of these two proven strategies. An approach that combines the targeted performance…
Driven by nationwide technologist shortages, an industry-wide focus on quality and rising consumer demand, healthcare is feeling the pressure to deliver more with less. Given this challenging environment, some organizations have come to the conclusion that taking the path of least resistance may not be the best approach. For many, delivering quality patient care is…
This article provides an example of how an operational department (like a cardiac catheterization lab) can be transformed from a low sigma level to a higher sigma level, and what that would mean to the overall organization. Patient satisfaction, physician satisfaction, reduced overtime, reduced patient wait times, increased revenues and an enhanced quality of life…
What is clear is that Six Sigma can drive bigger improvements in patient care and cost reduction, and potentially, do it faster. In the handful of hospitals that have successfully implemented Six Sigma, the results are impressive. Hard financial savings in the hundreds of thousands of dollars range per Six Sigma project have been reported….
Located in Lafayette, Louisiana, Our Lady of Lourdes Regional Medical Center recently began working with GE Medical Systems to implement Six Sigma as a method for achieving quality and process improvement. Since patient throughput and bed availability are among the organization’s top concerns, the team began by focusing on this issue. Following a process of…
As one of three Six Sigma Master Black Belts at Commonwealth Health Corporation (CHC), Nick Nauman mentors 35 Green Belts. At the time of this interview, CHC’s team had a total of approximately 180 completed or ongoing Six Sigma projects throughout the institution, focused on a range of issues involving both operational and clinical improvement….
Located in Harlingen, Texas, Valley Baptist Health System is a full-service, not-for-profit community health network ably serving the population of south Texas and beyond. The system is comprised of multiple organizations including Valley Baptist Medical Center, a 611-bed acute care hospital providing the number one rated orthopedics service in Texas, a state of the art…
A Master Black Belt (MBB) has been trained as a Six Sigma Black Belt and demonstrated proficiency in statistical tools and expertise in leading and teaching others. Within the healthcare organization, the MBB trains Black Belts and Green Belts, helping to select, scope and mentor projects. MBBs also guide the organization in addressing quality from…
Measurable improvements in radiology added up to greater efficiency and better quality. In this study, staffing was reduced by 14 full-time equivalents, entirely through attrition; identification errors were reduced through bar coding, and processes were improved. A higher sigma indicates a lower rate of defects and more efficient processes. In many corners of the corporate…
A recent report from the Centers for Disease Control and Prevention indicates that over the past decade trips to emergency departments (ED) rose 20 percent, while the number of available emergency centers fell by 15 percent. Another study from the American Hospital Association indicated that 62 percent of hospitals feel they are at or over…
All healthcare stakeholders, from the board on down, want to find ways to make their organizations perform better. Increasingly, healthcare leaders have also realized they must reevaluate their institution’s culture, along with their overall management strategies, to maintain a competitive edge and keep pace with an evolving industry. They’re recognizing that managers must be encouraged…
Ms. Collette D’Bills, patient accounting, has gathered data related to accounts receivable, entering it to an Excel spreadsheet. In fact, she has several years’ worth of data in her Excel files, but has not been able to understand what it means, except to see that accounts receivable sometimes go up and sometimes go down. At…
Today’s industrial black belt typically trains for six months. Seventy-five percent of this training time is spent learning theory, and the balance is spent in practice. Often when the black belt returns to the real world to tackle inefficiencies, he finds that there are no takers for his logic and passion – his Six Sigma entreaties fall on…
Six Sigma, 6s, is nothing more, and nothing less, than the use of science to solve problems. Scientific evidence that a breakthrough medical solution is genuine is statistical evidence. Though altruism and evidence influence medical treatments, economic pressure drives improvement. Multi-million dollar savings created by “beating heart” or “off-pump” coronary artery bypass outcomes are a…
GE employees see Six Sigma as “the way we work.” A key component of Six Sigma is the use of Work-out to move from a statistical delineation of a process or quality improvement to a practical solution. Work-out is a tightly designed problem-solving process involving facilitation tools and techniques. Use of this highly structured process…
Six Sigma is not for the faint-hearted. It is a challenging strategy to master and execute in for-profit businesses, but even more difficult in the healthcare industry with constraints such as high barriers between the different professional groups, the lack of funds, understaffed and overworked employees, and individualized work procedures that are rarely managed or…
Business Issue All medications are not created equally. Reopro (generic name: abciximab), Integrilin (generic name: eptifibatide) and Aggrastat (generic name: tirofiban) are all platelet-inhibiting drugs used in cardiac care. Each is priced differently. They act on patients in slightly different but clinically significant ways. The key critical to quality issue in healthcare is patient safety….
Appropriately implemented, Six Sigma clearly produces benefits in terms of better operational efficiency, cost effectiveness and higher process quality. Perhaps less obvious – and until recently less documented – is the impact it can make in clinical areas such as infection control and medication delivery. Clinicians are often receptive to Six Sigma given its familiar scientific and…
Like a detective, Pam Thomson probed the mysteries of CPT coding errors in the pulmonary medicine department at University of Virginia (UVA) Medical Center, looking for hard evidence of what went wrong and why. Were coding errors correlated with the time of day, day of the week, or workload? Was something amiss in the physician/coder…
Before exploring the various ways Six Sigma is currently being used, we should set the stage and understand the challenging environment where this methodology is being put to the test, a relatively small, but growing segment of the healthcare industry. Healthcare today is a vast web of complexity and contradiction. It offers astounding advances in…
Evidence pointing to the applicability of Six Sigma and related best practices within healthcare has been steadily mounting over the past few years. Primarily based on the implementation of the DMAIC process (Define, Measure, Analyze, Improve and Control), we’re seeing an ever-widening array of documented and publicized results… from improving turnaround time for patients to…
Ashley Sedorovich
Niraj Goyal
Wayne Westgaard
Gregory Nardin
Sue Gillman
Hobart Swan
Paul Arnold
Chuck Gaster
Elizabeth Cuevas, FNP
David D. Jones
Robert Hijazi
Jill Koroseta
Kirsten Terry
Kate Burrows
Rajiv Panigrahi
Stephen Turgeon
Ray Ernst
Patricia O'Rourke
Stephen E. Clarke, Ph.D.
Joann Moon
Carolyn Pexton
Bradley Schultz
Ann Loree
Tom Long
Rick Tucci
Rosalie Sager
iSixSigma-Editorial
Blake Hubbard
Dr. Deborah L. Smith
Jean Cherry
Walter Ettinger
Michael J. Cleary, Ph.D.
Daniel Sloan
Donna Seecof
Thomas Bertels
Mark Van Kooy, M.D.
Richard Stahl