Six Sigma Method for QI

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Six Sigma Method for QI PI

• MHS 665
• William C. Brannan, MD

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Classic Componentsof Quality
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Institute of Medicines New Components of QI
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Relationship of Classic New Components of
Quality

• Not one or the other
• Not competitive
• They are to complement each other
• They form the matrix or fabric for Quality
  Management (QM) in either Quality Assessment (QA)
  or Quality Improvement (QI)

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The Fabric of QI

• Safety
• Effective
• Pt. Centered
• Timeliness
• Efficiency
• Equity
• Outcomes Customer Cost Process
• Satisfaction Improve

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History of Six Sigma

• Developed by Motorola General Motors in
  mid-1980s
• Data-driven quality methodology
• Seeks to eliminate variation (and its associated
  costs) from a process

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Sigma Levels

• Sigma Defects Per Million
• Opportunities (DPMO)
• 1 690,000
• 2 308,537
• 3 66,807
• 4 6,210
• 5 233
• 6 3.4

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Sigma Comparisonof Industries
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What is Six Sigma?

• A process must not produce more than 3.4 defects
  per million opportunities.
• In Healthcare it means not more than 3.4
  medication errors in 1 million doses.
• Not more than 3.4 foreign bodies left in patient
  during 1 million surgeries.
• Not more than 3.4 no shows per 1
  million appointments.

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The Six Sigma Cycle

• Define Training Implementation
• objectives, Designate Black Belts. Develop
• set goals Train SS methodology. Projects
• Involve organization-
• wide projects. Define
• Staff advancement Measure
• in SS Analyze
• Continue training Improve
• new staff Control
• Continue identifying
• new projects

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Key Six Sigma Roles

• CEO
• Champion
• Master Black Belts
• Black Belts Experts Guides
• Green Belts

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Central Components - Existing

• Define
• Measure
• Analyze
• Improve
• Control

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Central Components - New

• Define
• Measure
• Analyze
• Design
• Verify

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Define

• What is the business case for this project?
• Current state map vs future state map.
• What is the projects scope?
• Due date determined.

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Measure

• What are the metrics for this process?
• Are they valid and reliable?
• How will I measure progress?
• How will I measure success?

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Analyze

• Can the process be improved?
• Who will help make the changes?
• What resources are required?
• What could cause this change effort to fail?

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Improve

• What is the work breakdown structure?
• What specific activities are necessary to meet
  project goals?
• How will I reintegrate various subprojects?

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Control

• How will I control quality, cost, schedule, scope
  and changes to the plan?
• How will I ensure that the business goals of the
  project were accomplished?
• How will I keep the gains I made?

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Implementation Step 1

• Begin with senior leaders.
• Train them in the principles and tools.
• Direct the management infrastructure.
• Cultivate the environment for innovation and
  creativity.
• Reduce organizational hierarchy.
• Remove barriers to experimentation and change.

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Implementation Step 2

• Develop external quality measures.
• Communicate with patients, employees,
  stakeholders and suppliers.
• Develop rigorous methods to obtain input
• Conduct baseline studies of starting point.
• Identify cultural, policy and procedural
  obstacles to change.

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Implementation Step 3

• Rigorously assess and conduct top-to-bottom
  training in systems-improvement tools, techniques
  and philosophies.

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Implementation Step 4

• Develop a framework for continuous process
  improvement.
• Monitor progress and success.
• Metrics should focus on strategic goals, drivers
  and key business processes.

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Implementation Step 5

• Managers staff with intimate process knowledge
  at all levels of the organization choose
  processes for improvement.
• Improve business performance linked to measurable
  financial results.

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Implementation Step 6

• Individual employees and teams, led by Green
  Belts, conduct Six Sigma projects.

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Medical Error Reductions

• Reducing patient falls
• Reducing ADEs from medications
• Reducing ordering administration errors
• Improving turnaround time for pharmacy orders

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Business Operations

• Improving revenue cycle
• Improving nurse or pharmacy technician
  recruitment
• Improving employee retention
• Increasing OR throughput

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Patient Case Management

• Decreasing stroke patient LOS
• Decreasing CHF LOS
• Reducing lost MRI films
• Improving MRI exam scheduling
• Reducing emergency department diversions

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Patient Satisfaction

• Reducing ED wait times
• Improving patient satisfaction in ED

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WEB SITE

• www.isixsigma.com

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Six Sigma _at_ Mission

• CEO
• Champion
• Master Black Belt
• Black Belts
• Green Belts
• DMAIC

• Bob Burgin
• Bill Brannan
• Tom Knoebber
• PI Consultants
• Collaborative Practice Team
• FOCUS-PDCA

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QI Process _at_ Mission