2 we provide a description of the Lean Six Sigma methodology that can guide our process improvement projects. 13 we provide insight into several critical success factors that can improve your organization's Lean Six Sigma program.
Introduction
Abstract We begin this book with a description of an Enterprise Performance Excellence (EPE) methodology that links the Lean Six Sigma methodology discussed in the chapter. EPE helps to understand the organization from a cross-functional enterprise perspective, so that the Lean Six Sigma program can be aligned with strategic and operational plans, as well as focus on key narrow processes within the healthcare organization.
Enabling Enterprise Performance Excellence Through Strategic Business
This method starts with understanding the organization's value chains and functionally breaking down the business functions that provide services to the customers or patients.
Techniques
This can ensure alignment between business strategies and goals and the organization's improvement plans. We will then discuss activities that can be used to integrate Business Architecture methods and models to achieve alignment between an enterprise's Six Sigma improvement efforts, key processes, and strategic business goals.
Underlying Concepts Evolving to Business Architecture
Business Architecture helps us understand the business processes and the company's three- to five-year strategies. The relationship between the business goals and the capabilities that support the goals should be understood.
Enterprise Planning
Purpose The purpose of this step is to plan SBPA engagements based on business strategies and critical business processes. In the SBPA Plan activities, we first develop the value chains for the enterprise so that these can be used to prioritize business processes according to the model, based on business strategies.
Strategic Business Process Architecture Modeling
This phase can also be performed when a picture of the current state of affairs is needed for business planning activities. This phase can also be performed when a picture of the future situation is needed for business planning activities.
Conclusions
Summary The purpose of this chapter is to provide a roadmap for applying the Lean Six Sigma (LSS) methodology and the key tools that can be applied when implementing LSS in healthcare processes. Healthcare processes include both clinical and non-clinical processes, and both types can be improved using LSS methodologies and tools.
Lean Six Sigma Overview
Lean Six Sigma Roadmap
Now Lean and Six Sigma are merging to leverage the best of both improvement philosophies and methods. Six Sigma uses the DMAIC (Define, Measure, Analyze, Improve, and Control) problem-solving approach and a wide range of quality problem-solving tools.
Lean Six Sigma Applications in Private Industry
As part of the Six Sigma program, they implemented statistical methods and team leadership using Black Belts. They had separate Lean and Six Sigma projects depending on the objective of the project and the problem to be solved (Kandebo 1999).
Define Phase
The CTS should be specific to the scope of the project and the process to be improved. The status of the item should be identified, open (newly opened), closed (resolved), pending (pending-not actively being worked on).
Measure Phase
Quality Function Deployment (QFD) can be used to organize the voice of customer information. You would not use the data collected during the pilot in the actual results of the studies.
Analyze Phase
The correlation coefficient (r) is a measure that measures the strength of the relationship between the two variables. We use the coefficient of determination, R2, which allows us to identify the fit of the prediction equation.
Improve Phase
The Six Sigma team should use the data collected in the first three phases of DMAIC to identify recommendations for improvement. During the formulation of recommendations, input from process owners should be obtained to assess the feasibility of solutions. A future state process map is simply a process map of a new process that includes recommendations for improvement.
The team should develop detailed procedures as needed to ensure consistency of the new process.
Control Phase
They should assess the effectiveness of the training as part of the control plan in the next phase. The team must keep all stakeholders in the loop by developing and implementing a communications plan. In this step, the team must demonstrate the impact of the project's metrics and create or revise the process control plan.
Defects are unintended, unintentional, random mistakes made by humans due to the human sensibilities built into our products and processes.
Summary
In this step, it is important to identify opportunities where you can repeat the same process in the organization. Dashboards and scorecards can be used to determine where you should focus improvement efforts in the future. The cause-and-effect analysis can also be used to identify the next root cause on which improvements should be focused.
The Six Sigma Handbook: A Complete Guide for Green Belts, Black Belts, and Managers at All Levels.
Bibliography
In this case study, a multifunctional team representing emergency departments, inpatient departments and units, including clinical, ancillary support staff and non-clinical members, applied Lean Six Sigma methodologies and tools to dramatically reduce patient length of stay (LOS). and the percentage of patients left without being seen. There are many reasons for this emergency department crowding, including increased patient acuity, lengthy emergency department evaluations, insufficient bed capacity, a severe nursing shortage, problems with access to on-call specialists, and the use of emergency care by people who have no other help. alternative to medical care, such as the uninsured. Even people with health insurance need access to emergency care because primary care networks are unable to meet the demands of unplanned health care (American College of Emergency Physicians 2002).
Our cross-functional team across the hospital worked together to apply Lean Six Sigma tools and methods to significantly improve patient performance and time spent in the ED when they seek emergency medical care.
Hospital and Emergency Department Throughput Improvement
Bed-to-physician time The time from when the patient is placed in the ED bed to when the physician sees him for the first time. ED Discharge Disposition The time from when the EDP provides the patient with disposition (discharge or admission) to when they leave the ED. Assign bed to discharge from ED The time from hospital bed assignment to when the patient leaves the ED.
Disposition to discharge The time from when the patient receives the admission orders until the patient leaves the emergency department. ED admissions The number of patients who were admitted to the hospital from the ED. Twenty-two percent of patients are self-pay (do not have insurance) who come through the ED.
The value chain for providing surgical services is one of the most complex for the hospital because it touches almost all functions of the hospital. One project focused on improving the turnaround in the outer periphery and preparing the outer periphery for the first case of the day. The second project focused on the location and organization of equipment, furniture, supplies and instruments in the OR area.
The remainder of this chapter will focus on the first project improving the OR turnaround and preparing the OR for the first cases of the day.
Operating Room Turnaround and On Time Starts Improvement
Lean, Six Sigma, Theory of Constraints and Supply Chain Management tools and methods were applied to improve the OR processes. This begins with identifying the supplies, equipment and instruments required for the surgeries, tailored to each procedure and surgeon. The operating rooms are prepared, including moving and setting up the equipment, furniture, supplies and instruments.
Two projects were conducted focusing on key elements of the surgical services value chain.
Lean Six Sigma Project for OR Turnaround and On Time Starts of Cases
On Time Start measures the timeliness of operating cases that start when they are scheduled. The employee satisfaction survey assesses the job satisfaction of the staff working in the operating room. We rated the significance of the effects of OR turnaround as high (10), and the start time as medium (5).
The team brought together some of the staff who perform the operating room to develop the new process.
Summary and Project Critical Success Factors
Summary This chapter describes the project started with the OR Turnaround and On-time Case Starts project from Ch. The need for this project became painfully clear early in the OR turnaround project. These challenges led to the need to improve OR location and organization of equipment, furniture, instruments, and supplies.
Pictures of the operating room before the start of the project are shown in fig.
Applying 5S to Improve OR Organization
Problem Statement: There is currently no standard organization in use in the OR areas for the storage of equipment, furniture, supplies and instruments. The current lack of organization in the OR areas causes inefficiencies within the OR processes. The team members used one of the OR rooms that was not in use for the two-day sorting event.
The operation is now easier to clean and keep clean, which is crucial in an operation.
Leaning the Surgical Outpatient Screening Process in an Acute Care Hospital
We also provided a rough estimate of in-process flow time versus value-added processing time. Process maps illustrate that the process is time-consuming, with a lot of redundancy, and that many people "touch" the chart multiple times during the process. The head of the pre-screening department expressed frustration at not being able to obtain medical orders, medical certificates and other patient information in a timely manner without having to call and "harass" surgeries.
This would be a collection of the number of cancellations on the day of surgery due to incomplete preliminary examination.
