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Lean Six SigmaThe UMC Journey
LISA BARRINGTON, PROCESS EXCELLENCE MANAGER
MARK FUNDERBURK, EXECUTIVE VICE PRESIDENT AND COO
Objectives• Review why UMC has chosen Lean and Six Sigma as a
Performance Improvement methodology.
• Review our organizational approach to a Lean and Six Sigma implementation strategy.
• Explore the 2015 Waste Walk including examples of ideas submitted and Lessons Learned.
• Identify our future trajectory for sustaining the methodology within our organizational culture.
Lean and Six Sigma
Lean and Six SigmaHistorical Foundation• Henry Ford Assembly Lines• Pioneers of Statistical Quality Control • Toyota Production System
Objective• Elimination of waste
o Over productiono Waiting or queuingo Transporto Over processingo Inventory (or storage)o Unnecessary motiono Defectso Underutilized employees
Six Sigma - 6σHistorical Foundation• Motorola introduced these principals in 1986• Motorola employee, Mikel Harry, develops the belt
naming convention• General Electric CEO Jack Welch made the method
popular
Objective• Reduce variation in processes• Achieve a Six Sigma level of perfection• Graphic display of data• Statistical analysis
Quality, Speed, and CostCreate process speed if you want to achieve high quality• A process that creates errors cannot maintain speed• A slow process is prone to errors
Low quality and slow speed are what make processes expensive
IHI Triple Aim• Patient experience• Population health• Reduce cost
Teams and ToolsTeams• Executive Sponsor• Physician Sponsor• Team Lead/Process
Owner• Team Members• Subject Matter
Experts• Data Manager• Facilitator
Tools• Project Charters• GOYA• Process Maps• Value Stream Maps• 5 Whys• HFMEA• Visual Controls• Error Proofing
MethodologyDMAIC
Define the problem and what the customers require
Measure the defects and process operation
Analyze the data and discover causes of the problem
Improve the process to remove causes of defects
Control the process to make sure defects don’t recur
Organizational ImplementationFoundation - 2013• Hired a dedicated person to manage the program• Invested in training for the new individual• Engaged a consultant• Selected the first 5 projects
First Five Projects – 2014• B Nursing Non-Value Added Time• B+ Professionals for the Effective Timing of Antibiotics• C OR Efficiency Improving Close to Cut Time• A Decreasing Lab Tests in the Emergency Center• A Discharge Planning: The Voice of the Customer
Organizational ImplementationCurrent Initiatives - 2015• Lean Forward Training• Sustaining the First Five Projects• Waste Walk• 2015 Projects• Lean Daily Management
Lean Forward TrainingLeadership Training
• A component of strategic plan• Focused on key elements of Lean and Six Sigma• Initial focus on hospital leadership (open to everyone)• Six hours of training• Began in January 2015 – 157 individuals trained to date• Leadership Development • 2014 – Pathways to Leadership training event• 2015 – Leadership Council monthly updates
Waste Walk - 2015Ideas will generate• $1,000,000 in savings • Lean and Six Sigma projects
Waste Walk - 2015Learning the Concept• Catholic Health Partners – Ohio• Lifespan Health System – Rhode Island• Floyd Medical Center – Georgia
UMC Plan• Leadership focused• All Directors submit two ideas• Learn to see Waste
Waste Walk - 2015179 Total Ideas• Wide variety• Some Directors submitted multiple ideas• Ideas focused on another department
Classification System DevelopmentComplexity • Just Do It• Moderate Complexity• High ComplexityValue • Non-Value Added Time• Direct Savings• Patient Wait Time Saved
Waste Walk - 2015Just Do It – 95 Ideas
• Focused and tangible• Within the control of a single Director• May not be easy
Resource Assistance• Saved 62 hours of non-value added time by changing how
documents are scanned.• $33,735 in employee time savings.
Food and Nutrition• Purchased a new meat slicer and reduced the amount of ham
and turkey used per week.• $10,601 in cost savings.
Waste Walk - 2015Moderate Complexity – 10 Ideas• Can be completed within 6 months• Require more than one department to implement• Additional review by Administrative staff required
Infection Prevention and Control and Environmental Services• Frost glass in patient rooms and eliminate privacy
curtains. • $29,631 in cost savings.
Waste Walk - 2015High Complexity – 17 Ideas (11 Ideas Considered for Projects)• Uncertain of timeline required to complete• Requires multiple departments• Possible capital request or multiple FTEs• Additional review by Administrative Staff required
Revenue Integrity• Minimize printing costs by duplexing copies• A 17% reduction = $61,250
Waste Walk - 2015The Value of an Idea
• Goal $1,000,000
• Value Categories• Non-Value Added Time• Direct Savings• Patient Wait Time Saved
Waste Walk - 2015Non-Value Added Time Savings = $453,979 • Non-Value added activities are inefficiencies within a process• Customers are not willing/should not pay for inefficiency
Laboratory• Leveraged available technology to auto-verify results• $19,198 time saved annually
Trauma Services • Identified unnecessary data abstraction• $6,261 time saved annually
Waste Walk - 2015Direct Savings = $1,408,514 • Evaluate current work from the perspective of Waste results
in cost savings
Trauma/Surgical ICU and Burn • Burn step down staff now manage all burn wound care
independent of Physical Therapy• $75,697 in annual savings
Nursing Education• Nursing departments will no longer pay administrative
time for nurses attending class that is not required• $6,205 in annual savings
Waste Walk - 2015Patient Wait Time Savings = $243,365• Waiting is considered Waste and impacts customer satisfaction
3 West• Patients are discharged home after their final physical
therapy session rather than returning to their room for nursing to complete the discharge process
• Patient Flow improvements worth $5,100
Heart Center• Increased Cardiology coverage minimizes diagnostic study
turn-around times• $132,000 in savings
Waste Walk - 2015Benefits and Lessons Learned
• Effective method to influence the development of a Lean culture
• Identifying Waste is not as easy as it seems• Ideas crossing departmental lines require management• Identify Waste in your own department is difficult and
requires transparency• Executive Leadership had to make decisions on some ideas.• Administrative Leadership assisted with idea valuation • Administrative Leadership has to ensure ideas are
implemented and budget changes made
2015 Projects• Idea themes generated by Administrative Staff • Physician Leadership Retreat ideas included in review• Themes refined and scoped for team development
Projects• Patient Flow - Discharge Process• Follow-Up Appointments• Supply Chain• Physician Handoff• Physician Call Schedules
Lean Daily ManagementLearning the Concept• North Mississippi Medical Center• Baylor• Zale Lipshy• Advocate, Chicago• University of Utah• Baltimore Medical Center• Virginia Mason
Goal• Turn our staff into accountable, focused problem solvers every shift• Visual transparency of patient outcomes at the point of care in real time• Use a standard, low tech method of data collection • Administrative staff rounding at boards for analysis and issue resolution• Begin 4th Quarter 2015
SummaryUMC Journey• Selecting the Methodology• Lead Forward Training• Waste Walk• 2014 Projects• 2015 Projects• Lean Daily Management
Questions?