iSixSigma

Six Sigma and OT

Six Sigma – iSixSigma Forums Old Forums Healthcare Six Sigma and OT

Viewing 9 posts - 1 through 9 (of 9 total)
  • Author
    Posts
  • #25558

    BillT
    Participant

    Is there anyone that can share with me how can I use 6-Sigma to correctly schedule employees, monitor OT and time off pay?  I know that there has to be something that I can use.
    Thanks,
    Bill
     

    0
    #61728

    RDogg
    Participant

    I’m not convinced that you require 6-sigma or any specific 6-sigma related tools to optimize scheduling for OTs.  I’ve used other techniques that have proven effective with just basic resource planning, i.e. understanding demand and capacity. 
    Do some web research on “Advanced Access ” and you’ll find some information on scheduling health professionals in clinic settings that proves useful.  You may find that Advanced Access itself is not what you seek, but the approach to measuring demand and capacity will lead you to better resource utilization and scheduling practices.
    It also depends on what your goal is.  For example, if your goal is to reduce wait times for OT appointments, then your problem is to match demand and capacity on a daily basis.  If your goal is to maximize resource utilization then your problem may be workload reduction/streamlining or standard risk analysis.
    Ultimately its about matching demand and capacity.  A profound understanding of your demand and capacity for OTs is the key (it’s best to define demand and capacity in terms of units of the scarce resource, in this case hours of OT time).  For example, understanding differences between demand for assessments and demand for follow-up appointments (by type, by day of the week, by provider) will provide direction (shape demand, match capacity to demand, offload unused capacity, balance capacity).  Be careful not to mistake block scheduling practices for accurate measures of demand.  For example, if a patient requires 0.5 hours of follw-up time with an OT on Monday but is slotted into the next available 1 hour slot next Wednesday, the demand is 0.5 hours on Monday and not 1 hour on next Wednesday.
    My $0.02

    0
    #61729

    BillT
    Participant

    Thanks for the information.  But what I am trying to do is find some way to reduce employee OT (overtime).  It seems like here it is a two-way sword.  It is not so much reduce wait times, but trying to find the exact cause of the OT is not an easy answer from some of my managers.   With that in mind, I am looking for a way to reduce OT, increase productivity and revenue.  It looks like that I will be digging tonight.  Does this make sense?
    Here is my $0.02!
     

    0
    #61731

    RDogg
    Participant

    My mistake.  I thought you meant Occupational Therapists (OT) but upon re-reading your post I was way out to lunch, however, matching demand and capacity still applies.
    Here’s how I might approach the situation:
    First you need to baseline your staffing requirements. Workload measurement tools (industrial engineering techniques) may be useful for estimating your staffing requirements for clinical and administrative processes, or using any established industry standards available.  Allow for a target utilization rate for staff.  Again it’s a matter of understanding demand. If no standard measurement tool is available, work with staff to develop the simplest workload measurement tool possible.
    Then you want to create what an ideal schedule would look like, where your staffing available meets your staffing requirements at all times.  From here, you introduce any constraints (i.e. fixed amount of resources, seniority limitations, shift work limitations, worker shift preferences, quality of care, provider-patient ratios) and start to create a schedule that minimizes OT.  This can be done on something as rudimentary as Excel by trial and error, or if you have access to the expertise, an optimization model or a scheduling software suite.
    If a target OT level is not attainable at all, then you need to consider other strategies such as workload reduction (offloading or streamlining administrative tasks), resource sharing (share or use floats from other areas if there are non-coincidental peaks in demand), greater reliance on part-time staff, increasing your staffing complement, increasing ratios, without compormising the constraints identified previously.
    My $0.02.

    0
    #61732

    BritW
    Participant

    With staffing, you will also want to consider flexing, which can be a littel more tricky.  Simulation is a good tool for this, slthough underused.  Flexing up or down with Census, if possible, is a great cost saver.  We have been able to find over $90,000 last FY in simple flexing opportunities and are looking for more.  Utilization of per diems, pools, and adjusting resources are a key, as is a focused reduction of agency staff.

    0
    #61733

    BillT
    Participant

    Interesting concept.  Can you give me an example of how this works?  If you could email it to me, that would be better. 
    BillT

    0
    #61734

    BritW
    Participant

    It can be very large or unit based. I did mine by connected units – for instance surgery and pacu.  You model your processes using computer simulation.  This isn’t as hard as it sounds.  You vary entry levels into the system, mimiking your census expectations.  You adjust staffing levels to reduce wait times/LOS throughout.  It will give you a good idea how many staff you will need given the different areas of the hospital and different acuities at different census levels.  2 problems with this approach – you need to have a commitment to staff up and down based on census and you need the staffing levels to do it.
    Unfortunately – the data contained in the files I have are proprietary because I am using actual numbers and patient case mix.  And our desired nurse/patient ratio might be different than yours.  I’m sure there are simulation consultants out there who would be glad to offer their services – beware that you need to satisfy the 2 problems I mentioned before you go this route.  It’s not a very popular method with nursing, especially. 

    0
    #61745

    Roger Noble
    Member

    I can’t believe I’ve never really done a project on this in healthcare. Oh yea, the clinical staff resistance to it, that must be it. It’s a no-brainer in service and manufacturing sectors, but healthcare, it’s a new breed all to itself. I’m working on an outpatient capacity and wait time master blackbelt study to highlight all our potential blackbelt projects for our 22 hospital system. I am sure employee staffing will be a highlighted factor and I’m scared, I don’t care what Deming says!

    0
    #61748

    Perryman
    Participant

    Hi Bill,
    you may want to consider looking at this problem differently.  The most common reason for overtime, when department heads are asked, is that they don’t have sufficient staff to accomplish all that they have to do.  Then the question becomes – what are they doing that is so time consuming?  Look at what your people are working on.  How much of what they do in a day or shift is adding value? Then take steps to remove waste from their processes. 
    With this approach, overtime is a symptom of ineficiency and waste.  Reduce these and overtime goes down.
    Hope this helps,
    Patch

    0
Viewing 9 posts - 1 through 9 (of 9 total)

The forum ‘Healthcare’ is closed to new topics and replies.