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Beds per Black Belt

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  • #25777

    leo
    Participant

    Folks,
    for those of you who are applying Lean Six Sigma at hospitals, I´d like to get an idea of the ratio of beds per Black Belt you currently have.
    Here at Albert Einstein hospital we´re staffing our team to work around 90 beds per fulltime black belt.
    Thanks in advance for your contribution.
    Best regards,
    Leo

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    #62424

    Don Bass
    Participant

    Leo:
    There have been a lot of attempts to create a “magic” ratio of Belts to some basis unit. 
    When I was at George Group, we used a ratio of 1% of the workforce should be BBs and 2.5% should be GBs. 
    While this worked great with Industrial clients, it was rejected out of hand by large Government entities that had hundreds of thousands of people.
    However, I fail to see the applicability of “Beds” as a basis unit at all. 
    I do see that there is a relationship between overall Workload and Beds…but the analogy would be that in a non-medical setting that one would use the number of Machines in one’s factory as a basis unit which doesn’t work so well.
    It really comes down to how many Processes you have and an attempt to establish an “A-B-C” inventory for your Hospital.  For a Hospital, “A-B-C” inventory and Processes are functions of Prevalent Treatment Pathways and your principle services (e.g. trauma care, burn unit, ambulatory care, oncology, etc.).
    It seems to me that correlating the strategic goals of the Hospital Senior Administration, its mission, etc. is a necessary first step, followed by an alignment of LSS Practitioners to the Processes that rank high in drilling down those strategic goals to LSS deployment tactics.
    A LSS Deployment Kaizan would answer those questions. 
    With a specific Army Command, we did this by starting with their Mission Essential Task List (there were 10), breaking it down into Supporting Tasks (there were 99) and then into Staff Tasks (over 600). 
    We then used Balanced Scorecard to rank and align Potential LSS Projects according to Value Levers (Voice of Command, Voice of the Army, Voice of Customer, Voice of the Process) and Percieved Effort (Do we own the process entirely, Number of internal silos the process comprises, etc.). 
    The output of this Balanced Scorecard was a Benefit-Effort Matrix that divided projects into Kaizans, Green Belt and Black Belt projects.
    From this initial ranking, one can then establish how many GBs, BBs and MBBs one needs.
    If you feel that there is a direct correlation between the number of Beds you have and the number of Processes that are critical to achieving the Strategic Goals of the Senior Administration, then maybe the number of Beds apply.
    But from where I sit that correlation has little to do with the Value Levers involved in delivering LSS.

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    #62425

    Angel
    Participant

    I recently read a publication by The Advisory Board.  They completed their own survey of hospitals in conjunction with a survey completed by Health Leaders Media.  Based on the survey results, the industry benchmark is 100 individuals per bed.  This was not specifically “Lean Six Sigma” but rather encompassed all improvement methodologies.  The question specifically stated “How may individuals per bed are deeply trained in process redesign methods such as Lean, PDCA, CQI, Six Sigma?” 
    Angel

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    #62426

    Robert S
    Member

    Don, I agree with your conclusion and to further support them I would argue the number of processes does not increase on a “per bed” basis. That is, there are a rather fixed number of discrete processes a hospital conducts. The number of beds simply impacts the number of times they do those processes.
    There may well be more opportunities for defects with more beds however if each process is fixed and implemented across the hospital, then the BB moves on to the next process. BB work load does not necessarily correlate to number of beds.

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    #62437

    Perryman
    Participant

    Leo,
    I have to agree with Don on this but I would go even further.  The number of project resources you need is a function of the number of projects you are planning to do in a given year.  And I might add that realistically, since we are resource dependant, the logic usually goes the other way around such as; we have x number of belts, therefore we can only do y number of projects this year. I never found any use for the number of belts per department/proces/whatever type of measure.
    On the other hand, one metric that did become very important as our deployment matured had to do with the ratio of BB to MBB and GB to BB.  Since all our belts had teaching and coaching responsibilities we had to maintain adequate span of control ratios.
    Hope this helps,
    Patch

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