《What+is+Six+SigmaA》由会员分享，可在线阅读，更多相关《What+is+Six+SigmaA（27页珍藏版）》请在金锄头文库上搜索。
1、DateSix Sigma as a Healthcare Quality InitiativeCarolyn Pexton, GE HealthcareBenjamin Williams, Harvard Health Policy ReviewTrack IC August 22, 1:45-6:15The Quality ColloquiumAugust 21-24, 2005Six Sigma BasicsBenjamin WilliamsFormer Editor-in-Chief, Harvard Health Policy Review;Former Administrative
2、 Resident & Six Sigma Green Belt, NewYork-Presbyterian HospitalThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeHistory & Early Pioneers“Six Sigma” coined at in the 1980sAdopted by Allied Signal (Honeywell) with great successLater adopted by Jack Welch (GE)
3、 and further developed into a true management systemThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeWhat is Six Sigma?A philosophy that underlies efforts to improve business performance and customer satisfactionUsing facts and data to eliminate waste (muda
4、) and variationEliminating activities that dont add value!The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeWhat is Six Sigma?1.The term “Sigma” is a measurementmeasurement of how far a given process deviates from perfection a measure of number of “defects”.
5、 “Six Sigma” implies near zero defects.2.“A quality improvement methodology that applies statistics to measure and reduce variation in processes.”3.A management system management system that is “comprehensive and flexible for achieving, sustaining, and maximizing business success.”The Quality Colloq
6、uiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeConceptual Framework Critical to Quality (CTQ)Critical to Quality (CTQ): : Attributes most important to the customer DefectDefect: : Failing to deliver what the customer wants Process CapabilityProcess Capability: : What your
7、process can deliver Stable OperationsStable Operations: : Ensuring consistent, predictable processes to improve what the customer perceivesThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeMeasurement: Variance is the EnemyTime IntervalsTime IntervalsMeanMea
8、nW I D E VariationSlim VariationEx: MRI TAT ProjectTime (Min.).TargetTargetCustomerUpper LimitCustomerUpper LimitDEFECTSZERODEFECTSTime (Min.).The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeMeasurement: Six Sigma as a Quality GoalThe higher the sigma, the
9、 fewer the defects. A increase from 3 to 6 Sigma represents a 20,000 fold improvement in quality.399% “Good” (3.8 Sigma)No electricity for 7 hours per month5,000 incorrect operations per week20,000 wrong prescriptions per year 99.99966% “Good” (6 Sigma)No electricity for 1 hour every 34 years1.7 inc
10、orrect operations per week68 wrong prescriptions per year The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeIRS - Tax Advice (phone-in)(140,000 PPM)7Sigma1,000,000100,00010,0001,000100101DPMORestaurant BillsDoctor Prescription WritingPayroll ProcessingOrder
11、Write-upJournal VouchersWire TransfersAirline Baggage HandlingPurchased Material Lot Reject RateDomestic Airline Flight Fatality Rate (0.43 PPM)Best-in-ClassAverage Company345621 1994 Dr. Mikel J. Harry - V4.0The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality Initiativ
12、eMeasurement: Comparative Analysis of Process CapabilityImprovement Methodology:Improvement Methodology: DMAIC “Backbone”the current process capability (get the data!)the problem in a measurable wayand validate root cause(s)Devise solution(s) and implementPerformanceImprovementBenchmarkingControl To
13、olsDEFINEMEASUREANALYZEIMPROVECONTROLSustain improvementProject TimelineReturn on Investment (ROI)The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeImprovement Methodology: Key PlayersTeam Members: Individuals who receive specific Six Sigma training and who
14、support projects in their areasChampions/Sponsors: Trained business leaders who lead the deployment of Six Sigma in a significant business areaBlack Belts: Fully-trained Six Sigma experts who lead improvement teams, work projects across the business and mentor Green BeltsGreen Belts: Fully-trained i
15、ndividuals who apply Six Sigma skills to projects in their job areasMaster Black Belts: Fully-trained quality leaders responsible for Six Sigma strategy, training, mentoring, deployment and resultsThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeManagement
16、System: ThemesCustomer FocusData- and Fact-Driven ManagementProcess is KeyProactive Management“Boundaryless” CollaborationDrive for Perfection; Tolerate FailureSource: Adopted from “The Six Sigma Way” by P. Pande, R. Neuman, and R. CavanaghThe Quality ColloquiumIntroduction to Track IC: Six Sigma as
17、 a Healthcare Quality InitiativeScalable ImplementationProblem SolvingStrategic ImprovementFull-Scale Business TransformationSource: Adopted from “The Six Sigma Way” by P. Pande, R. Neuman, and R. CavanaghThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeHow
18、 is Six Sigma Different?Six SigmaDriven by the customerTargets variationFocuses on processesProspective; prevents defectsFocuses on quality & ROI Attentive to total business Training is integral to management systemOther Quality ProgramsDriven internallyLooks at averagesFocuses on outcomesRetrospect
19、ive; fixes defectsFocuses on qualityAttentive to productionTraining is separate from management systemThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeIndustry $uccess!In a study of Motorola, Allied Signal, GE, and Honeywell - companies with mature Six Sigm
20、a deployments and associated culture changes - savings as a percentage of revenue were observed to vary savings as a percentage of revenue were observed to vary between 1.2% and 4.5%. between 1.2% and 4.5%. Charles Waxer (2003), “Six Sigma Costs And Savings”The Quality ColloquiumIntroduction to Trac
21、k IC: Six Sigma as a Healthcare Quality InitiativeIndustry Success - Quality & InnovationGeneral ElectricGeneral Electric-Reduced invoice defects and disputes with a key customer by 98%98%-Improved a key call center performance measure from 76% to 99%76% to 99%-Reduced vibrations in Power System rot
22、ors by 300%300%-Developed breakthrough technology that reduced medical scan times from 3 from 3 minutes to 30 seconds minutes to 30 seconds Allied Signal (Honeywell)Allied Signal (Honeywell)-Reduced defects by 68% in 4 months68% in 4 monthsTexas Instruments-Improved yield from 84.3% to 99.8%84.3% to
23、 99.8% since 1998The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeIndustry Pursuing Six SigmauFedEx uSonyuToshibauNokiauAmerican ExpressuOracleuAuTexas InstrumentsuHitachiuHondauRaytheonuLockheed MartinuSiemensuHoneywell uKodakuDupontuBank of AmericauIBMuBo
24、mbardieruMaytaguCanonThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeApplying Six Sigma and Related Methods in HealthcareCarolyn PlextonGE HealthcareDirector of Communications, Performance SolutionsThe Quality ColloquiumIntroduction to Track IC: Six Sigma
25、as a Healthcare Quality Initiative44,000 to 98,000 Preventable Hospital Deaths(IOM study, 1999)In-Hospital Deaths from Medical Errors at 195,000 per Year. Patient Safety Incidents In Hospitals Account for $6 Billion per Year in Extra Costs (HealthGrades - July, 2004) How Safe is Healthcare?Defects i
26、n healthcare are costly - unlike manufacturing, you cant simply shut down the line until you find and fix the problem.The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality Initiative210,000580,000790,0000100000200000300000400000500000600000700000800000Defects per Million
27、Opportunities6 6 6 Sigma Sigma SigmaHospitalized Patients Injured by NegligenceTreatment of Ambulatory Patients with Antibiotics for Viral Respiratory ConditionsAppropriate Identification & Treatment of Patients with Clinical DepressionAdministration of Beta Blockers to Elderly Patients Following He
28、art AttackSource: Chassin, Milbank Quarterly, 11/4/98.Healthcare Fails to Deliver Six Sigma2 Sigma2 Sigma1 Sigma1 Sigma3 Sigma3 Sigma3.410,0005 Sigma5 SigmaThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeImproving process/safety for medication administrati
29、onReduction in Blood Stream Infections in ICUReducing ventilator acquired pneumoniaStroke Patient Length of StayReduced Number of Inpatient TransfersEmergency Department Patient Wait TimeImproved Patient Throughput in RadiologyReduction in Lost FilmsMR Exam Scheduling ImprovementStaff Recruitment an
30、d RetentionOperating Room Case Cart Accuracy Physician (Professional Fee) Billing Accuracy Appointment Backlog for Hospital-Based Orthopedic ClinicQuality of Care and Satisfaction of Families in Newborn ICUHealthcare Project ExamplesThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Heal
31、thcare Quality InitiativeMitigating risk in clinical careIncrease compliance with care protocolsImprove medication administration Remove conflict in coordinating careReduce post-surgical infectionsFocus areas include: Clinical outcomesInfection controlCase managementPatient safetyThe Quality Colloqu
32、iumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeBetter patient safety with 91% improvement in post-surgery antibiotic use, delivering annual savings over $1 million at Charleston Area Medical Center, WV.Achieving 35% higher “take home baby” rate with increase in successful i
33、mplantation at Women & Infants Hospital, RI.The Big “Why”Shorter ED wait times allow 28 more patients per day to be seen, with potential financial impact over $13 million annually at Verdugo Hills Hospital, CA.The Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality Initiati
34、veSupporting Major InitiativesIHIs 100k CampaignBaldrige AwardProjects to improve patient safety in key areas:Deployment of Rapid Response TeamsDelivery of Reliable, Evidence-Based Care for Acute Myocardial InfarctionPrevention of Adverse Drug EventsPrevention of Central Line InfectionsPrevention of
35、 Surgical Site InfectionsPrevention of Ventilator-Associated PneumoniaSix Sigma helps to identify the right opportunities, target critical underlying factors and maintain measurable improvementThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeKey Success Fac
36、torsCEO must own it and must have a clear vision for the initiativeInvest in resources and make a long term commitmentDedicate “best and brightest”Measure and hold people accountableChange the systems and structures to support the effortEstablish early, ongoing and clear communicationsBe flexible an
37、d patientSelect and scope projects carefully: Focus on critical issues tied to business priorities, with measurable and manageable parametersUse change management tools to identify cultural barriers, gain acceptance and build momentumEstablish shared need, values and visionRecognize, reward and cele
38、brate successesThe Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality InitiativeA journey rather than a destinationSix Sigma is a solid approach, but not a “magic bullet” - Transforming healthcare will also likely require changes in technology, legislation/regulation, tran
39、sparency and culture.Over 60% of quality efforts fail. To be among the successful 40%, pay attention to the people side of change.The Effectiveness (E) of the result is equal to the Quality (Q) of the solution times the Acceptance (A) of the idea.The Quality ColloquiumIntroduction to Track IC: Six S
40、igma as a Healthcare Quality InitiativeExpectations and Questions?Additional ResourcesEckes, G. (2001) The Six Sigma Revolution. John Wiley and Sons, NY.Pande, P., R. Neuman, and R. Cavanagh. (2000) The Six Sigma Way. McGraw-Hill, NYPande, P., Holpp, L. (2002) What is Six Sigma? McGraw-Hill, NYSnee, R., Hoerl, R. (2003) Leading Six Sigma. FT Prentice Hall, NY.iSixSigma Healthcare Portal International Society of Six Sigma Professionals Inside Quality GE Healthcares Performance Solutions Quality ColloquiumIntroduction to Track IC: Six Sigma as a Healthcare Quality Initiative
