Six Sigma/Lean in HealthCare and Medical Centers

Hey Guys:

Also new to healthcare (~2 years). I work at an 700-800 bed academic medical center. Our projects range from back office (billing, reimbursement, call center, etc.) to operational (bed assignment, service delivery, nutrition & food service, patient education) to clinical (improved outcomes in plastic reconstructive surgery, reduction of “never events” (nosocomial infections, adverse drug events, drug errors, identification errors, etc.)

A few points come to mind based on my limited experience:

1. You are VERY close to the customer. Few industries have so many folks in direct contact with the Big C.

2. LSS is new to most people in healthcare – you’ll spend a LOT of time explaining what you’re doing.

3. LSS is not a randomized, double-blind, placebo-controlled study. It is only slightly less powerful & rigorous, but it can be a hurdle for some nonetheless. Besides, we can’t hardly ask some nurses to wash their hands and others not to, can we?

4. Healthcare is a fee for service industry. Be aware that eliminating “unnecessary” tests and procedures can actually REDUCE revenue. It is still the right thing to do, but requires a STRONG case and lots of change management with stakeholders who will lose $.

5. Physicians and hospitals are not always reimbursed the same way (MD based on services provided regardless of the time required, hospitals are often capped by contracts or even flat rates based on diagnoses). This is not necessarily a bad thing as it encourages MDs to ensure that their patients are ready for discharge, and hopsitals are incentivized to be efficient with time and resources. However, it means that the two sides have a fundamentally different perspective.

I look forward to any discussion – as long as it does not include a decision tree for sitters :laugh:

Hi everyone!!

I have been deploying Six Sigma for a few years but new to the Healthcare arena.

I would like to discuss the projects I have worked on so far, and also would like to hear any ideas of projects others have worked on.

Thanks and welcome everyone to this new awesome forum!

Don Draper

Maybe I did miss the question in your post. By the way, questions are usually followed by this punctuation mark “?” I just thought we’d connect. Maybe not.
:S

Speaking of pompous….

“Don Draper, MBA, PMP, CMBB, BSIE “

Sorry, not impressed despite the array of acronyms and letters. Wow, listing your undergraduate degree….guess OK in healthcare but in reality, who cares.

Hi Don,

How you doing,

I was just browsing and saw ur message.

I am also a part of healthcare quality and new to healthcare as well.
It’s great that you want to share/discuss projects. Its a good approach
ok I am ready, so whats our 1st topic/project. and discussing with you will help me/us to get some new prespective and insight into the problems faced in ur area and the solution u come up with because at the end of the day we are doing for patients(customer).

Cheers
Quality Believer

Hey Don,

Thanks for the reply.

Wow. seems like you are sitting on a pile of projects (or big Y’s)… its great.. anyway I can see multiple projects here, and all these topics are very much a big improvment area in healthcare. In our area as well there are lot happening in all these areas, and will be good to know/share whats happening in your area and how u making a change.
Quality is my passion so I am very open for discussions.

So whats your Big Y & your project Y .

Anyway I am based in New Zealand. How bout u?
Hope to hear from you soon.Cheers

QB

Hey Don,

Thanks for the reply.

Wow. seems like you are sitting on a pile of projects (or big Y’s)… its great.. anyway I can see multiple projects here, and all these topics are very much a big improvment area in healthcare. In our area as well there are lot happening in all these areas, and will be good to know/share whats happening in your area and how u making a change.
Quality is my passion so I am very open for discussions.

So whats your Big Y & your project Y .

Anyway I am based in New Zealand. How bout u?
Hope to hear from you soon.Cheers

QB

Dear ,

I may suggest your looking into opportunities to reduce the costs of Energyin Healthcare .
Reduction in Total Energy required/patient could be One of the CTQ.
Probably sharing my experience in Utility /Infrastructure area may add some value to your initiative. Thanks.

Hi..

Just checking in..

I am a Pharma Hospital Account manager…i had responsibility for three 1A guideline recommended products critical to some of the first Quality and P4P driven protocols implemented in major academic centers in a major metropolitan market…I have seen version 1.0 fail due to lack of “Acceptance and Accountability” and version 2.0 of these protocols succeed due to EHR enforced “Acceptance and Accountability”. I am working now in a rare disease with high hospitalization rates and massive care gaps…calling it 0.5 sigma would be very generous..and looking to help hospitals improve..

Looking forward to networking with other Healthcare L6S types..
Steve Wild

I’m entirely sympathetic with the sentiment expressed by the previous poster. In many cases, nurses and junior doctors in the medical profession have been stretched beyond all reasonable limits! Perhaps the ‘nursing assistant’ mentioned had not received adequate training or had been recently abused by an overbearing, arrogant, abusive consultant. (I received regular reports about this through my wide network of contacts!)

If you were referring to me as the abusive consultant, that wasn’t the case at all. I was “Standing in the Circle” or simply observing. The process of setting up the patient in the recovery room was simply chaos. There was no standardized process for doing something that is repeated hundreds of times per week. Every time seems like a new process. The ER has one set of steps that they seem to follow (even these vary by shift and day) and the OR has another (again not standardized. The fact that these simple tasks are not standardized adds to the fact chaos, pressure, and the amount of work that has to be done.

I was replying to @Andy-U
Your post didn’t come up until I finished my comment.

@cseider Chris, I’m only reporting what many nurses and junior doctors claim. As I don’t work in the NHS, I can’t really give specific reasons, but if I was to hazard a guess it might have something to do with the government’s austerity measures. In other words, when are gross staff shortages and things go wrong some consultants blame staff instead of the hospital administrators/government. (By way of contrast, the real culprits – the casino bankers – only get a slap on the wrist!

Hola, Trabajo en servicios de Salud , y tengo formación en el tema, desde mi punto de vista lo más importante es entender los procesos para entender la variación de lo que ocurre en el día a día.

No se puede trabajar en servicios de salud como en Manufactura porque los problemas son multifactoriales, cada unidad (paciente) tiene características independientes y si a eso le suma la falta de estandarización en los procesos el tema se vuelve un caos y muy complicado para abordar por eso primero conocer el proceso y limpiarlo.

 Added by iSixSigma editor:

Via Google translate: Hello, I work in health services, and have training in the subject, from my point of view the most important thing is to understand the processes to understand the variation of what happens on a day to day.

You can not work in health care as in Manufacturing because the problems are multifactorial, each unit (patient) has independent characteristics and if we added the lack of standardization in processes theme becomes chaotic and very difficult to address by that first know the process and cleaning.