Professional Documents
Culture Documents
Volume 3
Special Edition 1
The Six Sigma Supply Chain in Healthcare
2002
In This Issue...
By Don Redinius, Managing Partner, Six Sigma Qualtec
Six Sigma was born nearly twenty years ago and, like all new
The Promise of Six things, it has evolved and matured. Through its various
Sigma: “Getting experiences, Six Sigma has been shaped into one of the most
Better Faster” powerful problem solving, business and quality improvement
Page 3 methodologies available today.
Implementing Six The first businesses to experience Six Sigma were in the high-
Sigma to Achieve tech manufacturing industry. The industry’s complex product
“Breakthrough” problems provided a formidable testing ground for the new process.
Later it was applied with great success to administrative, or transactional, processes.
Results
Today, Six Sigma can be found in most fields of economic endeavor.
Page 7
Healthcare systems, in their drive to improve quality, reduce costs and enhance financial
Six Sigma Without
performance, have discovered Six Sigma and its long history of performance in other
Tears
U.S. industries. Healthcare is traditionally defined as the delivery of treatment and
Page 8
services to people in need of medical attention. Yet the industry’s performance is heavily
reliant on a vast and complex supply chain of companies working to design, produce,
Six Sigma: Using deliver, and manage a wealth of health and medical related products and services.
Statistics to Reduce Although doctors, nurses and hospitals are at the center of this massive and complex
Process Variability industry, they represent only a small portion of its influence.
and Costs in
Radiology A number of companies within the healthcare supply chain have already implemented
Page 11 Six Sigma and are discovering impressive results. Perhaps the most publicized company
is General Electric that adopted its Six Sigma agenda in 1995. Other notables include
North Shore - Long GlaxoSmithKline, McKesson and Johnson & Johnson. In addition, hospital systems
Island Jewish Health like Mount Carmel Health System, Commonwealth Health Corporation, Order of Saint
System Teams with Francis, Charleston Area Medical Center, Yale-New Haven, North Shore Long Island
GE & Harvard Jewish Health and Froedtert Memorial Lutheran (to name a few) have implemented, or
Page 19 are in the process of implementing, Six Sigma.
Commonwealth Mount Carmel Health System of Columbus, Ohio has successfully implemented Six
Health Corporation, Sigma after years of trying a variety of “more traditional” health care quality improvement
the Healthcare programs with varying degrees of success. Mount Carmel has produced positive margins
Pioneer of Six Sigma in recent years. But, like all hospitals, it faced declining reimbursements and rising
Page 22 expenses. Mount Carmel leaders sought an initiative that would significantly improve
its operational processes and enhance its financial performance, eventually settling on
Operational Six Sigma in July 2000.
Excellence- be the
benchmark Mount Carmel leaders don’t view Six Sigma as just another quality program. Rather,
Page 23 they consider it a business management system that not only improves quality, but
also improves employee morale and reduces expenses. Last year, the system
The health care industry has long been plagued by a wealth of obstacles. Few industries have Editor-in-Chief:
Heather Redinius
faced the sheer volume of challenges – both internal and external – that limit the ability to
Editor@isssp.com
evolve and improve. This dynamic has offered a formidable opportunity for healthcare industry
management and traditionally accepted quality initiatives alike. With it’s lengthy high technology President: Roxanne O’Brasky
and broad industry track record, Six Sigma has come to healthcare in recent years, bringing RoxanneO@isssp.com
with it limitless potential for improved efficiency, productivity and service delivery, not to mention Chief Technology Officer:
the great potential for cost savings passed to customers like you and I. Ken Kaplan
KenK@isssp.com
The challenges that healthcare represents for Six Sigma sets the stage for ISSSP’s newest Vice President Business Services:
educational and development campaign. This effort represents the first time our organization Robert Swagerty
has brought together players from all facets of the healthcare industry. Pharmaceutical BobS@isssp.com
companies, equipment manufacturers, suppliers, providers and practitioners alike will share
Information Management Director:
their experience, their concerns, and their ambitions in an exciting forum for the benefit of our Edna Cribb
collective membership. EdnaC@isssp.com
Membership Director:
While such opportunities will be exhibited through insight-filled programming — including Jeannette Kesmarki
roundtables and workshops like the upcoming Healthcare Symposium on April 29 — the overall JeannetteK@isssp.com
vision for this campaign is unveiled in the pages that follow. Special thanks to our corporate
Creative Director:
sponsors for the support they have shown for this new program. If your company represents
Heather Redinius
healthcare interests and you would like to get involved with this exciting new campaign, please HeatherR@isssp.com
don’t hesitate to contact ISSSP. We’d love to have you on board.
ΣXTRAOrdinary Sense is the official
publication of the International
This program is only a small taste of what is to come from ISSSP in the coming months. In Society of Six Sigma Professionals.
order for us to continue to provide this sort of best-in-class association content, ISSSP launched All rights reserved.
a formal membership campaign last month. We are confident that you will find the small
No part of this publication may be
investment well worth the benefit of being able to contribute to the continued growth and reproduced or transmitted in any form
enhancement of your own industry. For more information about your ISSSP membership, or by any means, electronic or
please contact us at 480-368-7083. mechanical, without written permis-
sion from the Editor.
Don’t forget to mark your calendar for the 3rd Annual Leadership Conference June 23—26 in Submissions
Chantilly, VA – we’ve just confirmed renowned Six Sigma advocate and business leader icon
Jack Welch. Please submit article, author
background and contact information
to Editor@isssp.com.
Since our inception in Jan 2000, we have been learning from more than 10,000 members about
the kind of programming and resources you would like to see made available through ISSSP. It ISSSP’s editorial staff will respond
within ten business days regarding
is this feedback that you have provided that allows us to continue to offer the cutting edge suitability for publication and other
content that Six Sigma professionals across the globe seek for their various endeavors. submission guidelines.
That Six Sigma has a home in healthcare has already been amply
Hospital
demonstrated by pioneering CEOs like John Desmarais from Goals
Commonwealth and Joe Calvaruso at Mount Carmel Medical Center Six Sigma applies customer-driven measures to process improvement;
in Columbus OH. The commitment of CEOs to the process also Customers can be patients, physicians, and employees.
CHC
sends an important message to future proponents: Six Sigma will Creative Healthcare USA
not work without a commitment from the top, and without it, there
is no point in ever getting started. Senior management commitment It’s hard to ignore the potential and broad appeal of Six Sigma
Cost
to Six Sigma is critical because the process will invariably cut when talking to its proponents. Dr. Glenn Crotty, MD and COO of
across department lines and change job functions. It will also the Charleston Area Medical Center insists that “Six Sigma quality
require that the organization take its best people out of comfortable is more than a goal. It is a commitment woven deeply into the
roles and into the front lines of new initiatives. fabric of everything we do.” The changes caused through Six Sigma
are “awesome and exciting” according to Lisa Thomerson, Six
The popularity of Six Sigma in healthcare was clearly evident at Sigma Corporate Champion at Commonwealth Health Corporation
the second annual Six Sigma Leadership Conference, held last in South Central Kentucky. “Our CEO as well as our senior leaders
October in Scottsdale AZ. Sponsored by the International Society
Promise continued on page 4
of Six Sigma Professionals, the conference featured six
3 ΣXTRAOrdinary Sense March 2002
Promise continued from page 3
CAMC. CAMC has moved forward on many additional Six Sigma
are fully behind it. John Desmarais is full of passion. His projects, with stunning results (see illustration).
commitment is tremendous.” To date, Commonwealth has invested
about $900,000 and has realized improvements well in excess of Out of control. In Six Sigma jargon, a process is said to be “in
$2.5 million. control” when it operates within acceptable specification limits.
At Scottsdale Healthcare (AZ), the process of “Bed Control” was
Spare parts. There are multiple day-to-day applications of Six decidedly “out of control.” The process of locating a bed and
Sigma in the healthcare and managed care setting. Typical projects transferring a patient from the Emergency Department to the
include billing office, supply chain management, emergency inpatient unit consumed fully 38% of the total time within the
department, operating room, high volume DRGs and analysis of department. Six Sigma consultants defined this problem as a
high cost admitters. Charleston Area Medical Center (CAMC), a “defect” and through additional analysis, found that the problem
919-bed three campus medical center in Charleston, West Virginia, was not locating a bed, but reducing the number of steps required
focused on supply chain management to test the potential of Six to make the transfer possible. The hospital employed the use of
Sigma methodologies. Upon reviewing and identifying this project an Administrative Nurse to perform “inspections” by locating beds
they found a $1.7 million opportunity within the inventory of surgical on different floors, and this process actually complicated the
equipment that remained in storage for over a year. Over 50% of process rather than expediting it.
this inventory were in orthopedic trays. Further analysis revealed
that old items were not being removed from shelves when new The process at Scottsdale Healthcare violated two arguments of
products replaced them. Once Six Sigma techniques were utilized Six Sigma: that inspection is fundamentally unproductive, and
to assess improvements from more rapid turnover of inventory, the more interim steps you add to a process, the more you reduce
specific team members were assigned to negotiate with each the potential yield on that process. As a result of eliminating the
principal vendor. Administrative Nurse position and through related streamlining
techniques, the hospital reduced the cycle time for bed control by
Requests for immediate refunds or “forward sales arrangements” 10%, increased ED throughput by an estimated 0.1 patients per
were made that included no future requirement for bulk purchases. hour, and produced nearly $600,000 in incremental profit. The
The medical center also initiated more rigorous inventory review hospital system is now considering the application of Six Sigma
procedures as part of Six Sigma’s “control process.” Today, there in improving the performance of specific DRGs.
are plans for a just-in-time inventory system with a centralized
Culture Shock. Beyond obvious financial measures, the most
procurement database for all 3 hospitals. Although the initial
savings in this project was merely $163,410 (from returned significant change across these profiled institutions has been the
merchandise), future cost avoidance is estimated to be $841,540,
development of performance improvement cultures. But what makes
Six Sigma different from previous quality management programs?
according to Beverly Begovich, a fulltime Six Sigma Black Belt at
Ms. Thomerson from Commonwealth suggests
“staff and involved physicians are buying it
Six Si Sigmgm
gma a Pr
Proo jec
ject t Po tential
Potential because it is data-driven, and is based on
statistical analysis. It points to specific
One Hospital’
Hospital’ss Experience problems. Physicians understand and support
this analytical approach to problem solving and
Project Validated Savings LT Cost Avoidance improvements. They practice it everyday.” “Six
Supply Chain Management $163,410 $841,540 Sigma gives practical applications to get
“Captain of the Ship” 519,000 790,000 projects started and to get them done quickly.
People are tired of forever committees,” adds
Denials 232,637 425,000
Ms. Begovich from CAMC.
Results Reporting 367,621 341,000
Medication Safety 31,774 242,777 Commonwealth Health Corporation’s, Six
Sigma vision (posted plainly on their website)
ED Wait Time 100,000 202,428
is that “by the year 2004, we will be proudly
HR Recruitment 32,000 124,430 recognized by our employees, patients, clients,
Physician Satisfaction 39,780 66,000 community, physicians and payors as the
unquestioned leader in care and service,
CHC
Creative Healthcare USA Promise continued on page 5
providing flawless quality never before achieved in the healthcare Black Belt Training
industry.” Their dependence on these techniques to deliver such March 25 - 29, 2002 (Measure Phase)
April 22 - 26, 2002 (Analyze Phase)
impressive results is a testament to The Promise of Six Sigma.
Minneapolis, Minnesota
Provided By: Breakthrough Management Group Inc.
“Shaken, not stirred.” If the culture of an organization can be Visit www.bmgi.com for more information!
described as a product of its “corporate DNA,” then Six Sigma
aims to reshape the DNA of the organization, and to create a Lean Six Sigma Executive Roundtable
highly effective organism in the process. Its promise of “disruptive March 14, 2002
Atlanta, Georgia
innovation” is cause for optimism and hope in an environment of
Provided By: George Group
regulatory and market constraints that are stifling in its effects. Visit http://www.georgegroup.com/events/events.asp
But CEOs considering Six Sigma must be careful not to push too
hard or too fast. As with any cultural change, the process of ToolMaster
introducing Six Sigma must be approached with patience and March 18 - 21, 2002
leadership. Minneapolis, Minnesota
Provided By: Breakthrough Management Group Inc.
Visit www.bmgi.com for more information!
Although the development of knowledge workers has been
recognized as one of the most impactful competitive strategies Lean Six Sigma Executive Roundtable
available to service industries, implementing such a strategy in a March 19, 2002
healthcare enterprise can feel like trying to boil the ocean. Houston, Texas
Because change is uncomfortable, CEOs can expect initial Provided By: George Group
Visit http://www.georgegroup.com/events/events.asp
resistance and anxiety in connection with these efforts. If not
addressed early on, any of the following conditions can ultimately Lean Six Sigma Executive Roundtable
lead to a failed attempt at implementing Six Sigma methodologies: March 22, 2002
Dallas, Texas
Lack of understanding of Six Sigma principles Provided By: George Group
Ambivalent involvement of senior management Visit http://www.georgegroup.com/events/events.asp
Lack of broad participation and involvement
Lean Six Sigma Executive Roundtable
Dependence on consensus-based decisions April 4, 2002
Initiatives too broad or too narrow in scope Chicago, Illinois
Failure to attack cultural impediments Provided By: George Group
Visit http://www.georgegroup.com/events/events.asp
Ultimately, the CEOs job in implementing Six Sigma is to engineer
Champion Training
a cultural change first that recognizes the moral imperative of the
April 9 -11, 2002
organization to forge new ground in performance improvement. Buffalo, New York
Attitudes that suggest “we are the best we can be” must be Provided By: Breakthrough Management Group Inc.
replaced with “we must get even better.” Constant monitoring to Visit www.bmgi.com for more information!
ensure quality must be replaced by systems and controls that
make defects nearly impossible. On one hand, it may seem that Lean Six Sigma Executive Roundtable
April 18, 2002
Six Sigma demands as much from the organization as it delivers
Detroit, Michigan
in return. This may be a valid observation, but you do not hear Provided By: George Group
any of its proponents expressing anything but enthusiasm and Visit http://www.georgegroup.com/events/events.asp
anticipation from the promise that Six Sigma can offer them.
ISSSP Six Sigma in Healthcare Symposium
Reprinted with permission from the January 2002 issue of Managed April 29 - May 1, 2002
Healthcare Executive. No reproduction permitted without express St. Louis, Missouri
written consent of authors and publisher. All rights reserved. Provided By: ISSSP
Visit www.isssp.com/symposium01.htm for more details!
Ian R. Lazarus, FACHE and Beatriz Stamps, MD MBA are principals
with Creative Healthcare USA (www.creative-healthcare.com) a ISSSP 3rd Annual Six Sigma Leadership Conference
consulting firm providing strategic advisory services, including Six June 23 - 26, 2002
Sigma consulting, to healthcare providers and suppliers. You may Chantilly, Virginia
contact either Mr. Lazarus or Dr. Stamps at 1.888.376.8652.
Provided By: ISSSP
5 ΣXTRAOrdinary Sense March 2002
13th Annual National Forum on Quality Improvement in Health Care
By Bob Swagerty, VP Business Services, ISSSP
Our ISSSP team returned in December from the Institute for
Healthcare Improvement Conference in Orlando, Florida and
quickly assessed the impact that Six Sigma can have on the
healthcare industry in the coming months and years. We
presented our sponsoring Affiliates and spoke with hundreds
of attending physicians, executives and quality leaders from
all across the world. Our learnings were significant.
First, there is a real and verified interest in Six Sigma methodology, within the Healthcare industry, to provide industry wide solutions
and help solve the mounting problems of inefficiency and patient dissatisfaction. This was expressed in the Six Sigma session, “Six
Sigma: Is it for Us? From Experiment to Strategy”, presented by Randal Linton, MD, President and CEO Elect, Luther Midelfort - Mayo
Health System, and later reiterated by the many attendees that visited our booth over the two days.
Secondly, Healthcare groups seem to be in an exploratory phase and need answers to questions concerning the Six Sigma methods
and best practices. How can it help them? Who can they go to for answers? At what level are they able to enter and reap the benefits
of process thinking across their operation.
As a result of our learnings derived from our conference presence, we have developed our Six Sigma in Healthcare Campaign that will
help organizations throughout the Healthcare supply chain investigate the power of the Six Sigma solution. This campaign will provide
the many healthcare providers interested in Six Sigma a platform to acquire answers to their questions. All of this leading up to our Six
Sigma Healthcare Symposium - “Six Sigma in Healthcare: Exploring the Opportunities”, scheduled for St Louis, April 29 - May 1,
2002.
CHC
Creative Healthcare USA
Creative Healthcare brings
Six Sigma performance to the healthcare industry.
Call today for our Free Guide...A Primer on Six Sigma for Healthcare Providers
Creative Healthcare USA
www.creative-healthcare.com
info@creative-healthcare.com
1.888.376.8652
Ian R. Lazarus, FACHE Daniel Gee, MD, MBA Beatriz Stamps, MD, MBA
6 ΣXTRAOrdinary Sense March 2002
Implementing Six Sigma to Achieve “Breakthrough” Results
By Jeffrey Burnich, M.D., and Tammy Weidner, R.N., MBA, Mount Carmel Health System
In the spring of 2000, Mount Carmel Health stages of deployment, with additional committee work as needed.
System -- a three-hospital system in Colum-
bus, Ohio with 7,300 employees and a medi- The responsibilities of the core team included developing job de-
cal staff of 1,200 physicians -- was experi- scriptions and a compensation program for Six Sigma black belts
encing severe financial challenges like many (which the organization prefers to call Six Sigma Guides); prepar-
healthcare systems nationally. ing the strategy for training black belts; ensuring the information
technology resources necessary to track Six Sigma projects; de-
The senior management team realized that veloping the tools and metrics for measuring and validating the
we needed to drastically improve our finan- financial returns of Six Sigma projects; and preparing a strategy for
cial performance, and that incremental im- communicating Six Sigma to Mount Carmel's internal stakehold-
provement wasn't going to be sufficient -- we ers -- especially managers, employees, and physicians -- as an
needed a breakthrough level of improvement. important new strategic initiative the organization was undertaking
as an investment in its future.
At about that time, Mount Carmel's CEO and
its Chief Quality Officer each began reading Black Belt/Brown Belt Strategy And Training
about Six Sigma without the other's knowl-
edge. They both came to the conclusion that We selected a total of 44 employees from among the organization's
Six Sigma had the potential to help the orga- best staff in two training waves to serve as black belts, and an
nization achieve breakthrough results. additional four employees to serve as brown belts (which Mount
Carmel prefers to call Six Sigma Scouts). While black belts as-
Mount Carmel selected Breakthrough Management Group (BMG), sume their positions on a full-time basis in working on Six Sigma
Scottsdale, Ariz., to help facilitate our deployment of Six Sigma projects, brown belts retain their functional responsibilities and ful-
throughout the organization, a process that began in the summer fill their brown belt responsibilities part-time in helping scope projects.
of 2000. We are now in the process of implementing a green belt strategy to
train select employees in the Six Sigma methodology so that they
Leadership Buy-In And Infrastructure Development can pursue less complex Six Sigma projects in their functional
areas of responsibility and/or assist black belts on their projects
Our deployment began with a two-day broad overview of Six Sigma on a part-time basis.
system for the senior management team, ensuring buy-in and sup-
port for the implementation. The Chief Quality Officer was se- To avoid adding unnecessary labor expense, only a few of the black
lected to provide executive oversight of the deployment, and a vice belts' previous positions were back-filled. We knew that this ap-
president's position was converted into the dedicated role of Vice proach would cause some consternation in affected departments
President of Six Sigma to direct the day-to-day implementation since we were taking one of their best employees our of their role -
activities. - and asking the remaining employees to absorb the workload among
themselves. We acknowledged the sacrifice we were asking them
Next, an in-depth, week-long training session was held for those to make, and promised them that they eventually would begin to
within the organization who would likely become Six Sigma Cham- see positive benefits as these black belts helped fix problems in
pions responsible for identifying and overseeing Six Sigma projects. work processes that were a source of frustration and dissatisfac-
This group mostly included the senior management team as well tion for them.
as vice presidents (we currently have 16 active Six Sigma Champi-
ons). The black belts and brown belts received four weeks of intensive
training, one week each month for four months, while spending the
Then, a Six Sigma core team was formed with the responsibility of other three weeks applying what they were learning by working on
developing the infrastructure necessary for the successful deploy- an actual Six Sigma project during the training period. The first
ment of Six Sigma at Mount Carmel. The core team was cross- wave of black belts graduated in March 2001, and the second wave
departmental, including representatives from finance, human re- in July 2001
sources, information technology, communications, as well as learn-
ing and education. The core team received a full week of training Organization-Wide Deployment
and met for two-day working sessions every month during the early
Rather than limiting the implementation of Six Sigma to one de-
Breakthrough continued on page 9
9
isssp Visit www.isssp.com or call 480-368-7083 for more information!
Six Sigma Qualtec continues to expand its client base, worldwide involvement, portfolio of Rath & Strong
service offerings, and client services delivery capacity while exceeding our client’s expectations. Sigma Breakthrough Technologies Inc.
Our company works with leaders in both the public and private sectors throughout North America,
Asia, and Europe, and across all industry and government segments, leading them to increased Six Sigma Qualtec
profitability. Six Sigma Qualtec world headquarters is located in Tempe, Arizona with offices in Smarter Solutions
Tokyo, Japan and Oxfordshire, UK.
StatSoft
Y-change
Y-change offers an internet-based, enterprise-wide strategy and project
management application that ensures strategic initiatives are efficiently
deployed down to the individual project level. Y-change’s unique Project/
ISSSP thanks you for your continued
Portfolio Management allows managers to track the progress of multiple
support! For more information on the
Six Sigma projects in real-time. With y-change, Six Sigma initiatives Six Sigma Affiliates Program, please
can now be centrally coordinated and monitored leading to faster, more visit www.isssp.org.
efficient deployments.
CHC
In 1984, Commonwealth Health Corporation CHC) was formed as a
not-for-profit holding company for The Medical Center and other health
related businesses.
CommoNWeAlTH By the year 2004, CHC will be proudly recognized by its employees,
HeAlTH patients, clients, community, physicians and payors as the
CoRpoRATIoN unquestioned leader in care and service, providing flawless quality never
before achieved in the healthcare industry.
Mount Carmel has been caring for residents of central Ohio for
over 113 years.
Its core values, which underlies everything that it does, are: dignity
of persons, service to others and social justice for all. Mount
Carmel is committed to treat all people with fairness, respect
and compassion and to ensure that everyone has access to quality
healthcare services. Each year, Mount Carmel provides millions
of dollars in free care and benefits to the community.
Six Sigma was seen as having the potential to drive quality to new
heights and sharpen the competitive edge for both the radiology Six Sigma training involves several phases, reaches various levels
department and the system as a whole. Like most providers, CHC of expertise, and can extend anywhere from one to 14 days.
has had some form of quality initiative in place for years. The differ- Training is always linked to particular projects impacting
ence is that Six Sigma actually becomes ingrained in work and operations, giving participants a chance to learn the methodology
while at the same time achieving results within their own work
environment.
Commonwealth Health Corporation
• A not-for-profit integrated delivery network located in Bowling Through these educational sessions, leaders learn to better manage
Green, KY. strategic change, cultivate support, mobilize constituencies, and
establish systems for long-term results. Employees also learn to
• The Medical Center in Bowling Green: 487 beds use a problem-solving approach designed to reduce organizational
redundancies. Participants successfully planning and completing
• The Medical Center in Scottsville: 157 beds (includes 105
extended care beds at Cal Turner Extended Care Pavilion) two Six Sigma projects attain what is commonly known as Green
Belt status. The completion of additional projects and achieving
• The Medical Center at Franklin: 50 beds higher levels of accomplishment lead to the attainment of Black
Belt and Master Black Belt status.
• Employees: Over 2,000
• Radiology diagnostic technology includes state-of-the-art MRI, CHC’s radiology department was chosen as the launching pad
Cat Scan, CT-3D treatment planning and Angiography. for Six Sigma. Twelve participants within Radiology used the various
training processes to focus on learning team dynamics, identifying
Modalities: specific areas of opportunity within the department, and putting
• MRI • Radiology improvement and control mechanisms in place. Making sure that
• Mammography • CT
process changes are built-in and remain as guidance systems for
•Nuclear Medicine • Ultrasound
the long haul differentiates Six Sigma from previous quality initiatives
• Number of procedures per year: at CHC.
FY’99: 91,055 This radiology-focused phase significantly reduced wait times for
FY’00: 104,036 patients, generated faster turnaround times for radiology reports
FY’01: 108,780* and increased productivity. In fact, CHC’s team managed to boost
*estimate based on available ‘01 data
Radiology continued on page 28
ΣXTRAOrdinary Sense March 2002
13
Six sigma in Healthcare educational program
Educational Program
isssp
As a leading source of credible information regarding Six Sigma, ISSSP has decided to provide a platform for those who are learning
how Six Sigma can be the best improvement solution for an organization’s need to improve quality, reduce costs, eliminate defects and
enhance financial performance.
To this end, ISSSP, in conjunction with its Affiliates and Corporate Sponsors, is offering a program of educational, one-hour, interactive
webcasts that will take you through the elements of Six Sigma from A to Z. As a registrant of this program, you will have the option to
attend (12) different one-hour sessions. The schedule of sessions currently available represent many different topics within Six Sigma
and will be updated to ensure that participants have the greatest opportunity to learn and the availability to attend a variety of topics
that may meet their individual scheduling needs.
In the event you've already missed a few sessions, rest assured. ISSSP will continually add new modules and repeat modules to ensure
participants receive the full value of this program. As a registrant, you will receive email notices of any enhancements to the schedule.
Sessions are also recorded and archived. If you miss a session or if there is a particular session that provides you great insight, you
have the opportunity to re-visit those topics that benefited you most.
March 14, 2002 What is a Six Sigma Project? Breakthrough Management Group Inc.
April 4, 2002
P
Using Action Workout™ as the "on ramp" to Six Sigma in Healthcare Leap Technologies
isssp
M
April 11, 2002 Statistical Analysis for the Healthcare Industry Minitab
April 18, 2002 Six Sigma, The Medical Staff and You Creative Healthcare USA
May 9, 2002
TBD
A
Engaging Your Partners: Including Your Customers and Suppliers PwC Consulting
Smarter Solutions
Pivotal Resources
For a more detailed description of each session, please visit our website at www.isssp.com.
CQI managers and quality professionals are often threatened by The decision was made to introduce a complementary improvement
Six Sigma. They know that in some Six Sigma companies, the process called Action Workout to work in parallel and in support of
internal quality staff ends up marginalized and reduced to a the Six Sigma DMAIC process.
paperwork compliance office.
Action Workout is the latest generation of the fast change process
Of course, some CQI managers persist in spinning the broken first used by Jack Welch at General Electric to “break down
record of “no management commitment” as the cause of failed bureaucracy”. Action Workout has evolved over the last decade
CQI efforts in the past and use this as an excuse to block Six into a system for converting employee know-how and creativity
Sigma introduction. into focused results.
The truth is that CQI efforts in many healthcare provider Action Workout is a natural complement to Six Sigma. It uses
organizations have yielded significant benefits by identifying patient the same rigor of business case-based project selection, a
expectations, educating the workforce on quality values and structured improvement process and expert guidance.
concepts, and establishing process documentation systems.
What’s different is the nature of the problems Action Workout
The COO of the healthcare provider in our case example made the attacks and hence, the level of expertise and time required to
wise choice of holding his CQI manager accountable for the success succeed. Action Workout fills the gap between the “no-brainer”
of Six Sigma. In addition, the COO used the introduction of Six fixes made with decisive management action and problems that
Sigma to conduct a complete audit of the CQI effort, “sunsetting” can’t be reliably fixed without detailed analysis.
unproductive Quality Action Teams and refocusing the CQI staff
on improving the CQI infrastructure – from satisfaction At our regional healthcare provider, Action Workout was used to
measurement to best practices. attack problems like these:
Lesson Three: Get More Employees and Managers “Into the • Reducing the use of contract nurses through more
Right CQI Game” effective scheduling and management
• Improving the accuracy of patient treatment records to
One of the biggest concerns about Six Sigma is captured in a smooth claims processing
water cooler exchange making the rounds. • Reducing materials and energy waste
• Shortening hiring cycle time and improving employee
Question: “How many Black Belts do you need to achieve Six retention
Sigma performance?”
Answer: “A few good ones to do the work and an army of certificate These problems were attacked using frontline employees,
holders to impress Wall Street.” supervisors and managers organized into small (five to seven people)
action teams and equipped with an Action Workout Team Kit – an
Sarcasm aside, the point worth noting is that Six Sigma is not a expert improvement process literally packaged in a box.
backyard sport. Black Belt training is rigorous and not for the
masses because everyone can’t be an expert. Furthermore, there Action Workout was chosen over DMAIC or the in-place Quality
typically aren’t enough problems worth the dedication of Black Action Team process for two reasons: Speed and simplicity.
Belts to justify “excess inventory”. Black Belt certification as a
career or stock price booster becomes very expensive. Action Workout allowed this particular healthcare provider to
mobilize more than 50 employees to make performance
When Black Belts become a substitute management team for improvements without classroom training or overtime. Then, they
solving problems that don’t require rigorous statistical analysis, were turned loose to achieve major financial gains in a 60-day
Six Sigma initiatives spiral down into a game for the elite only. “sprint” timeframe.
isssp
Program Highlights
The Symposium is a 2 1/2 day program designed for Healthcare executives and
April 29- May 1, 2002 practitioners. One full day is focused on lessons learned and deployment case
St. Louis, Missouri studies targeted to Healthcare leadership. One and a half days are focused on
best practices, advanced educational sessions and project case studies demon-
strated by Six Sigma Experts, Practitioners and Deployment Leaders.
If you are interested in Speaking Opportunities at this Symposium, please contact Edna Cribb at 480-368-7083 or EdnaC@isssp.com.
If you are interested in Sponsorship Opportunities, please contact Roxanne O’Brasky at 480-368-7083 or RoxanneO@isssp.com.
* All cancelations/substitutions must be received in writing. All cancelations will be subjected to a $150 administrative fee. No refunds will be given after April 12, 2002.
Making the Transition Without Tears experienced a 23 percent turnover rate. After seven months of
applying Six Sigma, that rate dropped to only 11 percent. The
The introduction of Six Sigma into healthcare provider organizations realized cost savings are also impressive. Since beginning the
can be made smoother with attention to three key questions: implementation of Six Sigma, the organization has seen a financial
return of $2.4 million through the end of 2001. And those returns
• Where are the opportunities for the Six Sigma DMAIC are expected to grow as they tackle more Six Sigma projects.
process and Black Belts to achieve a return that
justifies the investment? The International Society of Six Sigma Professionals (ISSSP), in
conjunction with its Affiliates and Corporate Sponsors, has begun
• How to reliably and cost-effectively get more managers a campaign to help tell the story of health care entities that have
and frontline employees into the CQI game to quickly experienced great success with Six Sigma. ISSSP’s objective for
solve problems outside the DMAIC domain? this campaign is to provide credible information and expertise in
Six Sigma to quality-minded practitioners in healthcare and its
• How to refocus existing CQI activities and redirect allied fields. The source of this information comes from the
the CQI staff to hold gains from all improvement healthcare industry itself, from outside the industry and from the
projects? healthcare supply chain.
Healthcare provider leadership teams who fully answer these Programs have been developed to equip healthcare professionals
questions will get “on the Six Sigma bandwagon” at a ticket price with the knowledge to make informed decisions about the
they can afford and experience a smooth ride. application of Six Sigma. One specific forum brings together
organizational leaders from the healthcare supply chain and
hospitals to examine a variety of issues facing healthcare.
Programs like this and others have been developed to provide
healthcare professionals with a keen understanding of Six Sigma
and the potential it represents.
Specific Topics:
• Creating a Six Sigma Culture in Healthcare
• Clinical & Operational Six Sigma Projects
• Six Sigma in Pharmaceutical Manufacturing
• Open Discussion on Six Sigma Related Healthcare Issues
• Reducing Cycle Time and Improving Productivity in Hospital ER’s
Featured Speakers:
Larry Bossidy,
Chairman & CEO
Some of What You Will Hear:
Honeywell
“I have not seen anything that can deliver the sustainable results like Six Sigma.”
John Desmarais,
President & CEO “You have to get the best people you can.”
Commonwealth Health “Leadership is the most critical aspect of any successful program.”
Corporation
“You have to dedicate yourself to a life of learning.”
Tim Tyson, “There's plenty of data that indicates you will get twice your money back in the
Pres. World Wide Mfg. &
Supply Operations first year (of Six Sigma).”
GlaxoSmithKline “Six Sigma takes an organization and shakes it up.”
Jeff Burnich, “Six Sigma has the ability to change an organization...as if by magic.”
CQO & Senior VP. “Six Sigma creates a restlessness within an organization.”
Mount Carmel Health System
“Give Six Sigma constant care, until it becomes part of the culture.”
CHC
Creative Healthcare USA
www.creative-healthcare.com
isssp
480-473-2525
www.BMGI.com www.actionworkout.com
1-800-46-SIGMA 800-254-6805
Leaders of Change
As part of the Center for Learning and Innovation, GE Medical
Over the past three years, Michael Dowling has been
Systems Healthcare Services will lead a 36-month initiative to bring
conceptualizing ways of transforming North Shore – LIJ into a
GE’s approach to leadership development and change management
“learning organization.” The GE Leadership Institute in Crotonville,
to LIJ. Specifically, GE will provide courses on “fast track decision
NY where Dowling attended several leadership programs served
making” for solving organizational problems, “change acceleration”
as a basis for a number of initiatives envisioned for the North Shore
processes for breaking down barriers to change and helping
– LIJ. In March of 2001, Dowling wrote his initial plans for a broad
employees embrace new concepts, and “Six Sigma” management
based learning center at North Shore – LIJ. By June 2001, strategy
processes that have been widely recognized in the corporate sector
committees were established between the health system, GE and
for more than two decades.
Harvard to begin planning and implementation of the Center.
Presently, CHC’s Six Sigma team develops training materials, teaches the Six Sigma methodology, and mentors Green Belts and
Black Belts as they progress through the various levels of projects. These projects represent a variety of processes within the organization,
both operational and clinical service lines. Projects are selected based on a variety of considerations: benchmarking, peer group data,
and/or invaluable suggestions or ideas from employees, patients, and physicians. Although there are many challenges inherent in
applying the Six Sigma methodology in a healthcare setting, CHC has seen many positive results in these ongoing Six Sigma projects.
All projects must impact at least one of the following Critical-to-Quality factors (CTQs): Customer Satisfaction, Timeliness/Speed/
Convenience, Quality of Care/Service, or Cost. A typical CHC Six Sigma project takes four to seven months to complete. Every project
is an intense objective study of a particular process that is driven by data. Neither subjective assertions nor random recommendations
for improvements are tolerated in the DMAIC process (Define, Measure, Analyze, Improve, Control). Black Belts and Green Belts must
prove statistically that a problem exists and the improvements made within the process have been improved using objective data. One
of the innumerable strengths of Six Sigma is that all projects are approached the same, utilizing each of the five phases in DMAIC.
Commonwealth continued on page 24
communicates the organization’s Six Sigma successes internally cumulative savings have exceeded $7 million. CHC boasts that all
and externally as well as manages the strategy’s acceptance. existing employees have received Six Sigma training – from a
primer in Orientation to Master Black Belt level training. Toward
Six Sigma’s Triumph that end, this includes over 120 trained Green Belts, six Black
Belts, three Master Black Belts, a Corporate Champion, three
Tangible benefits of process improvements utilizing Six Sigma Corporate Sponsors, and a CEO who continuously drives the
methodology projects are being experienced throughout the fabric challenge of becoming a Six Sigma organization. It is evident
of our organization. The first Green Belt class focused on processes through continued process improvements that CHC will realize
in Radiology, engaging a cross-functional group of employees to escalated savings, increased morale and customer satisfaction.
enhance the corporate-wide implementation. As a result of these As the pioneer for Six Sigma in healthcare, CHC’s leadership
projects, costs per procedure have been significantly reduced. changed the organization’s approach to problem solving utilizing
Exam results are distributed to ordering physicians faster, patients Six Sigma methodology to deliver absolutely the premium service
receive treatments more timely, and physical workspace has been to customers.
re-designed to increase employees’ efficiency. Other Green Belt
classes have focused on other areas of the organization: Maternal The Way We Work at CHC
care, specific Pulmonary DRGs, Admissions, Billing processes,
Documentation/Charge Entry, Human Resources, Staffing, In addition to CHC leadership’s commitment to Six Sigma quality,
Managed Care, and Surgery processes. Each project represents organizational buy-in is one of the most vital elements of its success.
a significant opportunity to improve aspects of the services provided Part of the Champion’s responsibility is to gauge the progression
by CHC, and Green Belts are beginning to realize the extent to of Six Sigma and determine its effectiveness from a corporate-
which they can positively impact the way CHC does business. As wide perspective. Perhaps the greatest measure of this success
training objectives are met, processes throughout CHC will continue is to hear from those closest to the pulse of Six Sigma methodology
to improve as the organization continues its journey to become a – CHC’s Six Sigma Green Belts. A few of CHC’s over 120 Green
Six Sigma organization. Belts were asked to share their perspective of Six Sigma. This is
what they said:
Along this journey, the American Productivity and Quality Center
(APQC) named CHC a Six Sigma “Best Practice Partner”. CHC “Six Sigma has been a true learning experience for me. I am
was among only a few others in the nation to receive this award: working on my third Green Belt project currently. I am finding this
American Express, Iomega, DuPont and Raytheon. CHC project particularly interesting since it involves our Corporate
executives have also had many opportunities to share this approach Wellness program and the results from the Health Risk
to quality improvement with several organizations. In March 2001, Assessments. The tools of Six Sigma are proving very beneficial
CHC was profiled at the Association for Quality and Participation’s in analyzing the aggregate data from the assessments with the
23rd annual spring conference in Chicago. In May 2001, CHC hosted end result being an even stronger, more effective wellness program
healthcare executives from Japan. Additionally, CHC executives for our employees.”
have delivered presentations to the American Society for Quality’s Linda Rush, Director of Community Wellness; Green Belt;
Annual Quality Congress; Healthcare Financial Management led project for Health Risk Assessments
Association’s conferences; International Quality and Productivity
Center’s Six Sigma Conference; International Society for Six Sigma “I have found Six Sigma methodology very beneficial. At one time
Professionals’ Leadership Conferences; numerous Healthcare during my project, I considered the possibility that there was no
Symposiums; and, a Six Sigma Conference hosted by Marcus reason to proceed to the next phase. I felt there was no way I
Evans. Along with numerous other presentations, CHC’s could improve the process after analyzing my data. We proceeded,
experience with Six Sigma has been featured in various publications and on my 2nd measurement, I had only one defect. I was able to
including Strategic Finance, Radiology Management, Modern make a positive change for all involved and addressed all CTQs
Physician, Managed Healthcare Executive, Hospitals and Health (critical-to-quality).”
Networks, and Diagnostic Imaging. Gary Sullivan, Director of Security; Green Belt; studied the
process of direct admits from EMS
Since beginning in 1998, CHC invested approximately $900,000
through the course of this implementation. Improvements have “I know that Six Sigma methodology can and is making a difference
resulted in savings well over $3 million in 2001 alone. To date, the in our organization. It allows us to continually ask ourselves how
Commonwealth continued on page 27
we can improve processes as we go about our regular duties. The best part is the ability to hold improved processes in place so we can
strive for further improvement in that process and move toward improving other processes. I’m just glad I’ve been able to be such an
active part of the Six Sigma initiative because I’ve learned so much. It is so valuable in my new position as we look at process
improvement - it’s just such a different way of looking at things.”
Lorraine Bormann, Director of Corporate Clinical Facilities; Green Belt; currently leading a project in the process of
medication charge audits
“The Six Sigma training has spawned a “new and improved” way of thinking not only for myself but for staff within my department. It has
expanded our thought processes to continually question “why” is a task performed in such a way and question “Is this the best way?”
As the Six Sigma approach is expanded throughout our department, we desire to realize and improve upon our weaknesses and
celebrate our strengths.” Cristi Pruitt, Director of Corporate Accounting; Green Belt; member of the Green Belt class studying
process of documenting charges
“For me, Six Sigma changes the way that I look at my department, the daily activities of the hospital, and how I do my job. Using the
Six Sigma methodologies, each process can be studied and evaluated. Not all projects will reach a “Six” Sigma, but any increase in
sigma levels can be considered a success. When a project has an increase in the sigma level or improvement noted, then our patients
and the facility will ultimately benefit. Having the tools, such as this methodology, that allow me to look at my processes and improve
patient care, makes my job and career much more rewarding.” Melinda Joyce, Director of Pharmacy; Green Belt; currently
leading a project studying the crediting process for medication
As you can see by these testimonials, Six Sigma has proven to be not only a way of improving processes but also a method for
employees to achieve stretch goals. These Green Belts are living proof of CHC’s ability to continually seek greater and greater levels
of quality.
Lisa Thomerson became the first Six Sigma Corporate Champion at Commonwealth Health Corporation (CHC) in January 2000. Ms
Thomerson received CAP & WorkOut training from General Electric Medical Systems following CHC’s kick-off of Six Sigma in March
1998. In early 2000, she was GreenBelt trained by CHC’s Six Sigma training staff of Black Belts and received Champion training
through Juran Institute. CHC is the first healthcare organization to partner with General Electric, fully integrating Six Sigma into its
culture.
raise the satisfaction level for employees, reducing burnout and radiology throughput by 25% using fewer resources, while
unwanted attrition. Well-developed, highly satisfied employees simultaneously decreasing cost per radiology procedure by 21.5%.
translate into higher patient satisfaction and improved healthcare
delivery. Keys to Making It Work
Dowling is optimistic about his expectations for the Center, saying, One of the primary keys to unlocking Six Sigma success is solid
“We are doing this because I believe it will enhance the product we commitment from leadership. Since this initiative will invariably
are delivering, as well as the business we are running… When we
talk about this with our department heads and employees, you
Applying Six Sigma to Radiology:
can absolutely observe the excitement. There is an excitement Snapshot of Success
that people will improve themselves. Excited about the relationship
with outside partners.”
• Decreased the time between reports dictation and
report signature
Changing Health Care and Beyond • Reduced patient wait time from arrival in radiology to
Although North Shore – LIJ is not the first healthcare organization time of exam
to apply Six Sigma methodologies, this project is the largest • Reduced time between patient dismissal and dicta
endeavor to date, according to GE. Currently, it is estimated that tion completion
there are more than 3,000 Six Sigma healthcare projects worldwide, • Decreased patient wait time for radiology registration
including such organizations as Commonwealth Health Corporation process
in Bowling Green, KY, Charleston Area Medical Center in
• Enhanced radiology scheduling process
Charleston, WV, Virtua Health in Marlton, NJ and Northwestern
Memorial Hospital in Chicago, IL. • Reduced time from radiologist signature to report
distribution
The impact that the simple principles of Six Sigma are going to •Increased efficiency in the MRI ordering process
have on North Shore-LIJ and subsequently the collective health
• Optimized the content quality and delivery of pre-
care may not be immediate. However, the path of this troubled
exam patient education
industry toward improved process management is something that
all of as practitioners of quality will anxiously follow in the months • Reduced time for dismissal of radiology patients
to come. • Enhanced film jacket retrieval process
• Decreased MRI report turnaround time
Breakthrough continued from page 9
• Improved general radiology staff scheduling
To date, Mount Carmel's Six Sigma projects have included:
• Increased efficiency of Ultrasound exam scheduling
and reduced overtime
• Several claims-processing projects in the organization's Medi-
care HMO, employed primary care physician practices, and be- • Utilized special procedures inventory more efficiently
havioral health business
• Processing time in central scheduling • Augment radiology exam scheduling and pre-
• Claims denials due to patient type changes and long-stay obser- registration process
vations • Reduce CT order to taken time
• Discharging throughput to decrease bottlenecks in the emergency
department • Decreased IVP exam time
• Implementing of a procedure-based delivery system in the sur-
• Improve utilization of Nuclear Medicine radio-pharma
gery area to help ensure supplies are present when needed during
an operation ceuticals
• Enhancing clinical documentation to ensure it matches the ser-
vices rendered Measurable improvements in radiology added up to greater
• Making clinical laboratory results available according to the re- efficiency and better quality. Staffing was reduced by 14 full-
questing physician's needs, enabling the physician to make timely time equivalents, entirely through attrition; identification errors
decisions for patient discharge or continued treatment were reduced through bar coding, and processes were
• Reducing cycle time in various inpatient and outpatient diagnos- improved.
tic areas
Breakthrough continued on page 29 Radiology continued on page 29
Onward and Upward Pande, P.; Neuman, R.; and Cavanagh R. 2000. The Six Sigma
Way: How GE, Motorola and other top companies are honing
As it has had an impact on other industries, Six Sigma could their performance. New York, NY: McGraw-Hill Professional
Publishing.
positively affect public perception of healthcare delivery. Society
has struggled to find a workable methodology to measure Rath & Strong’s Six Sigma Pocket Guide. 2000. Lexington, MA:
quality. Looking beyond the obvious indicators of mortality and Rath & Strong, Inc.
morbidity, it’s tough to gauge. Using the methodology to
Slater, Robert. 1999. Jack Welch and the GE Way: Management
carefully gather and analyze data can help providers accurately Insights and Leadership Secrets of the Legendary CEO. New
identify where problems exist and how best to correct them. Six York, NY: McGraw-Hill Professional Publishing.
Sigma provides a roadmap for process improvement,
dashboards to let you know how well you’re doing, and process Slater, Robert. 1999. The GE Way Fieldbook: Jack Welch’s Battle
Plan for Corporate Revolution. New York, NY: McGraw-Hill
“cruise control” to keep the improvements on track.
Professional Publishing.