iSixSigma

GeJay BB

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  • #61621

    GeJay BB
    Participant

    Good information Lean MBB Trainer. Even with the information you provided some still need to try and make their points heard. Your posting re-inforces there is no one standard methodology regardless of how you look at LSS, SS, or Lean. Different companies use different tools and call it one of the 3. It is obvious my comments have been and continue to be taken out of context people who feel validated as an expert. When in fact we are all experts, that is why we all are certified in SS and Lean.  Either way all tools can be used in all environments. Some are more difficult to transition into healthcare that are easy to use manufacturing. That doesn’t mean you should not actively assess to see if you should use the tool. To me it means you shouldn’t force the tool just because you have it in your box. I have vice-scrips in my tool box. Should I use them on every bolt that I run across or should I use my socket wrench. I should attempt to use the wrench and come back with the vice scrips if the bolt the wrench doesn’t work. As a certified BB you need to recognize when you should use one tool as opposed to others. Its hard to recreate the same conditions on patients when trying to take things from an art to a science. You have the physician variation that you deal with. Doctors (at least the ones I have worked with) are reluctant to use their patients and their practice for these changes. You need the literature reviews to support the changes that you want to make.

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    #61611

    GeJay BB
    Participant

    I never said you could not use a DOE in healthcare. My statement was that some tools are harder fits than others. The main point of my posting is if it is why call it Lean Six Sigma when you are using all the tools of the six sigma methodology. To me that is Six Sigma. Maybe its a difference in location, but from the companies that we researched for Lean six sigma methodologies They had Lean tool under the DMAIC frame work. The course work had some 6 sigma tools but not a lot. The focus was about eliminating waste Value added vs Non value added. Some statistics but not a lot measures of central tendacy and histograms and box plots…..

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    #61603

    GeJay BB
    Participant

    I did not say there were tools that could not be used in healthcare. People tend to struggle to make them fit in a healthcare setting. All the tools can be used, but depending on the type of project it can be a difficult to make it fit.
    Britw you are saying lean six sigma I would agree there is not a tool in the lean six sigma tool box that can’t be used. Correct me if I am wrong but DOE is not a lean six sigma tool. Its a six sigma tool.
    Lean six sigma is lean tools used under the DMAIC frame work  (5S, Waste, Setup reduction, pull vs push, Kanbans etc). DOE is not one of those tools. As a matter of fact the Lean Six sigma toolbox uses basic statistics

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    #61601

    GeJay BB
    Participant

    I completed my training with BMG and I have beeen in healthcare for 15 + yrs. Our Healthcare company built a GB and BB methodology specifically for heaalthcare that we currently teach. I don’t think there is any quick answer. I found a lot of value in learning the tools with various different industries. It gave me a broader perspective in undestanding all the tools. Some tools fit into healthcare perfectly and others you have to struggle to make it fit. When we provided all healthcare examples in the methodologies it did not help with the understanding of the tools in all cases. Which makes me wonder if it really makes a difference. It seems to me it might be better to have a balance of HC and other industry examples. So when you actually start using the tools you can get “out of the box” with your thinking in using them for your own projects within HC.
    My thoughts for what they are worth

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    #61530

    GeJay BB
    Participant

    We rolled out GB and BB training and I was one of the trainers. We went as far as doing some training in excel to get people familiar with using spreadsheets. I am like BritW in that you can not change the stat piece of it. You have to let the clas know that they may not understand it until they come back to the next phase of training at times. Every student that came through training felt overwhelmed.. We use Monday of each week to reveiw what was taught the previous week. Are you using MT? The good thing is they don’t have to learn how to do calculations by hand they just need to understand the results of the calculations. I tell my students that you may not get it today sometimes you have to sleep on it before it sink in because they are receiving so much info.

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    #61519

    GeJay BB
    Participant

    Thanks Bob
    Statistics is not a strong point fo rme. Do you have any suggestion for how I can go about running the anlaysis to determine how processes and severity affect LOS? What type of test.

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    #61517

    GeJay BB
    Participant

    I am working on that project as we speak. The methodology that I am using is a Kaizen. I have noticed that there is a lot of wast inthe entire process. Our process doesn’t require a lot of statistics for imrpovement. Just an elemanation of waste. Goal door to balloon 90min. The interaction between the ED and Cath Lab has been crucial on this team. Our cath lab is on call in the evening time. So we were losing 30 min just because of the time it takes them to get in when they are paged. We have wait time built into the process that needed to be compensated for.

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    #155982

    GeJay BB
    Participant

    All of this is very good commentary Ricky in flipping through the the messages. It appears as if you are giving a lot of information for 1 day sessions.  I think someone mentioned before that if they know all the tools then why is the company STILL creating defects through the process?
    Point being SS is a structured approach to improvement. The tools may be the same, but what you get through the process is structure and not a shot in the dark on improvement. All changes are validated through data. So ask the class what types of improvement have they done in the past and what were the results? Why did the process slip backwards. I knew a lot of the tools prior to training, but I did not know all the tools. What I got out fo SS was structure to my imrpovement.
    The buy in for this methodology starts at the top and you need the executive champion to provide some re-enforcement on how he supports the methdology and to also set the expectation for what is to happen after the training.
    You should really think about the curriculm that you have laid out. Not being familar with stats prior to training. I can just imagine the anxiety in the analyze phase when you start to think about the types of test that should be run on data.
    Good Luck

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    #155841

    GeJay BB
    Participant

    The data was originally put into excel format
    MM/DD/YYYY HH:MM.
    What I have been doing is subtracting various colums from each other in order to calculate LOS and other turn around times.
    The issue is that I keep adding data to the spreadsheet and I have to run these calculations all over again. The last time that I performed the calculations I copied the formula strings from the history folder
    (Let ‘ED-Reg’ = (‘Registration Admit Date Time’ – ‘ED Admit Date Time’) * 24) and placed them in a cell within the spreadsheet to use later as I added data. Well MT is giving me an error message when I try to perform the task using it as a Macro value string via Edit >> Command Line editor I get an error message.
    Am I doing this correctly?

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    #155836

    GeJay BB
    Participant

    I would like to send you the information, but it has patient specific info that could be detrimental to my job.  I need to work on declassifying the information before I can forward it to anyone outside of the organization.

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    #61499

    GeJay BB
    Participant

    Great suggestion Bob I never thought about it that way. I am pulling information out fo the chart that is telling me about how aggressive we our with medications and treatments (ABX, Diuretic, Resp Tx, ABG, PT OT, MRI, CT, Cardiac Test) How aggressive we are with consultations (pulmonary, cardiology). I have data on co-morbidities, age. To do a multi variate analysis the Y would be LOS. I can capture all these other variable as X’s (inputs). Do you think it would be wise to severity of Illness and Processes seperate or together or does it even make a difference- GJ

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    #61498

    GeJay BB
    Participant

    Thanks Brit I will do a t test on the two populations that is a good starting point to validating if the populations really are different.

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Viewing 12 posts - 1 through 12 (of 12 total)