six_sigma

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Six Sigma in Hospital Operations

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3 Quality – Six Sigma View Hospital Management – Key Challenges Six Sigma in Hospital Operations Overview

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4 Quality…a perspective 20,000 items rejections per months ~15 minutes each day of unsafe drinking water 5,000 incorrect surgical operations per week 2 short or long landings at most major airports daily 200,000 wrong drug prescriptions each year 7 hours without electricity each month The Classical View of Quality “99% Good” (3.8 s ) 7 items rejections per month 1 minute every 7 months of unsafe drinking water 1.7 incorrect surgical operations per week 1 short or long landing at most major airports every 5 years 68 wrong drug prescriptions each year 1 hour without electricity every 34 years The Six Sigma View of Quality “99.99966% Good” (6 s )

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5 Increasing Productivity Innovation Intersection Customer Insight Hospital Management: Key Challenges Low Cost High Quality

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6 Safe Environment Timely Services Efficient Services Effective Services Data Collection Hospital Operations: Key Challenges Patient Centric Care

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7 Six Sigma in Hospital Operations: Why? With the increased focus on customer requirements and pressure to deliver the best quality every time, cost of healthcare is escalating. It has become of equal importance, to optimize the performance with respect to quality and to optimize cost of care. Six Sigma addresses both these concerns

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8 What is Six Sigma? Six Sigma is a “data driven” problem solving methodology. … how you utilize and implement that methodology depends on you. A highly Structured and Data Driven Approach for Improved Customer Quality. A Measurement of Our Process and our Capability to deliver services. Goal of Six Sigma – Attain Less Than 3.4 Defects per Million Opportunities Six Sigma?

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9 Six Sigma Vs Traditional Approach Statistical Problem Statistical Solution Traditional Approach Practical Problem Practical Solution Six Sigma Approach Customer Focused . . .Bottom Line “cost” Driven

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10 What’s Six Sigma . . . Generally “Sigma” is used to designate the distribution or spread (standard deviation) about the mean (average) of any process or procedure. For a business, the Sigma Capability (Z-value) is a metric that indicates how well the process is performing. D As Defects Go Down . . . Z . . . Sigma Capability Goes Up s 308,537 66,807 6,210 233 3.4 PPM* Defects per Million Opportunities *PPM: Parts Per Million 2 s 3 s 4 s 5 s 6 s Process Capability Z

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11 Measure Define Improve Analyze Control what is important to the customer: Project Selection Team Formation Establish Goal how well we are doing: Collect Data Construct Process Flow Validate Measurement System the process: Analyze Data Identify Root Causes the process gains: Ensure Solution is Sustained the process performance measures: Prioritize root causes Innovate pilot solutions Validate the improvement DMAIC: Basics

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12 Once the process is measurable, outcomes becomes measurable. Right from patient’s admission to treatment to discharge, it is all measurable As a result, the patient’s confidence and level of satisfaction increases. Six Sigma is Data Driven Six Sigma- Application

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13 Six Sigma Projects Cost Services Process Some Six Sigma Projects at MHC… Reducing Discharge Time Discharge Time Before: 282 mins - After: 135 mins Increase Dispatch Capacity-CPS Process Sigma improved by 1.22 Optimizing Diagnostics Pricing Avg realization – 1.78 Sigma increased Optimization of Dialysis Process Process Sigma Increased by 1 Improving Lift Efficiency 50% Improvement in Customer Satisfaction 50% Process Capability increased Standardization of Consumable Process Sigma improved by 3.4 Reducing Cathlab Waiting Time 30% improvement in waiting time Reduction in CRBSI Rate Infection reduction - 3.66 to 6 Sigma

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14 High rate of Catheter Related Blood Stream Infections (CRBSI) in ICUs Increased Length Of Stay (LOS) for patients, due to CRBSI Patient Dissatisfaction Revenue loss due to increased LOS To Standardized process & eliminate CRBSI from MHC Problem Goal CRBSI – Six Sigma approach

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15 People Material HIGH ICU CRBSI RATES Process Culture process TNA data available BSI Confirmation Patient Immunity Dressing Technique Environment Contaminated Lines Periodic dressing Sterilized material Patient Behavior Wire Control Insertion Site Causes for High CRBSI Patient Movement Emergency /code Multiple Pricks Supervision Assistance TAT for information Criteria for CRBSI Sterile technique Guidelines for catheter insertion Universal Precaution C/L protocol

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16 Pt. in MICU Patient consent & procedure explanation Procedure preparation Doctor's decision for C/L Site –Subclavian /Femoral/Jugular Site dressing Suturing Patient preparation & C/L insertion Key Improvements Monitoring Site Drying Hand Wash & Dr. Assistant Drying time for site, increased to 3-5 mins., as per WHO standards Established measurements system Revised Standard procedures - Hand Wash

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17 CRBSI Rate in MICU – 4 The Classical View of Quality “98.45% Good” (3.66 s ) The Six Sigma View of Quality “99.99966% Good” (6 s ) Achievement… CRBSI Rate in MICU – 1 The Classical View of Quality “99.61% Good” (4.16 s ) CRBSI Rate in MICU – 0

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18 Bed related Inpatient Functions Out patients related Functions Diagnostics and Treatment Functions Administrative Functions Research and Teaching Functions Supply Chain Medical Operations Administrative Operations Six Sigma Scope in Hospital Services Focus on Process Capability , Utilization , Cycle Time , Cost Optimization

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19 Six Sigma Infrastructure The actual infrastructure and number of roles will be dependent on the size and complexity of an Organization &maturity stage of deployment of Six Sigma. Six Sigma Champion Master Black Belt Black Belt Green Belt Yellow Belt Resources Primary Role Role Duration 24 Months 18 Months 12 Months 6 Months Culture change agent Mentor Project Identify opportunity & Execute Project Execute Project

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20 LEADERSHIP COMMITMENT Time Effort Resources MANAGING WITH DATA Design-measure-analyze-improve-control TRAINING AND CULTURAL CHANGES Integrated business strategy Impact on career paths Essential of for Six Sigma

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21 Our focus... “ Providing highest quality at lowest cost”

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22 Thank You