March 2006
So Many Tools So Many ProjectsSo Many Tools
So Many Projects
Susan McGann RN, BSN, MBB
Virtua Health
4th Annual Conference on Successfully Implementing
Six Sigma In Healthcare
WCBF – Las Vegas
March 30, 2006
March 2006
Virtua Facilities
March 2006
Virtua Health….Today Four hospital system in Southern New Jersey Two Long Term Care Facilities Two Home Health Agencies Two Free Standing Surgical Centers (JVs) Two Medical Staffs (currently merging) Ambulatory Care - Camden Fitness Center 8000 employees + 2000 physicians 7,752 deliveries 8% Operating Margin - #1 in the state of NJ STAR Culture
March 2006
Virtua Locations
March 2006
The Virtua STAR
CaringCulture
ExcellentService
Clinical Quality
& Safety
ResourceStewardship
BestPeople
Outstanding Patient
Experience
March 2006
S1&S2Business Acumen
LeanSpeed & Efficiency
DFSSNew Product/Service
OE ToolsAssessment, Recognition
BP ReviewPerformance & Values
Virtua U.Skills & Knowledge
Leadership andManagement Development
Process Improvement
Six SigmaEliminate Errors
Change Acceleration ProcessManaged Change
WorkOutEmployee Engagement
L&M SystemsStrategy & Operations
ME ToolsOptimization &
Quantitative Methods
STAR PERFORMANCE
Coaching Performance and Development
President’s SeriesLeadership Enhancement
March 2006
The Problems
ED Cash Collections Process
Emergency Department Discharge Process
Patient Access Create a Vision for Breast
Cancer Care Determine whether or not
to add O.R.s Buy in for the New Salad
Bar
Six Sigma
Lean
DFSS Work Out
M.E. Optimization
CAP
The Tool Solutions
March 2006
Six Sigma
Defect Reduction or Elimination Move a mean Reduce Variation Xs or drivers are not clear Process requires rigorous measurement and
evidence of improvement 4-6-8 months DMAIC training
March 2006
Optimization/M.E. Tools
Process is known Xs are known Want to know the impact of change on a current
process No Teams No Training Skill set required Software required
March 2006
DFSS (Design for Six Sigma)
Process is so broken might need to start over Focus on Voice of the Customer Design Defects out of the process Data oriented 6-8 months DMADV Training
March 2006
CAP: Change Acceleration Process Change is inevitable - how do you ease the
blow? Is its own tool set Used when a decision has been made Garners buy-in Can be used with all other tools Common sense just not common practice Tools that all management can use – should be
ingrained in the organization 3 days of training – constantly practicing
March 2006
Work Out
Process problems Need the “wisdom of the group” Frequently “cross silo” issues Not heavily data oriented Might be data supported 1-3 days Facilitator needed Training just in time with the tools
March 2006
LEAN
Need for Velocity (in process and results) Reduce waste and non value added steps Xs are pretty clear Use of Value Stream Mapping Kaizen Event Done live Event takes a week – total up to a month Training is JIT
March 2006
How do you do it
Culture of the organization CEO ownership and leadership Data heavy organization? Commitment One tool at a time Go for the quick wins Value Stream Mapping – funnel creation Not mutually exclusive
Annual STAR Launch
G&O review & signoffPOE report & Final S1
G&O Review #1 QMM
QMM & celebration POE S2 review
G&O Review #3QMMEOS
Best PeopleUpdateBudget Process
Best People Review
G&O Review #2QMM
January
February
April
May
June
September
August
July
November
December
October
Outstanding Patient Experience
Stewardshi
pPatient Safety
Best People
Caring CultureClinical
March
Virtua Values
1st Quarter
2nd Quarter
3rd Quarter4th Quarter
Virtua Health STAR Management System 2006
Resource
Service Excellence
Quality &
January
4Q G&O Report Out
Strategic Imperatives for 2007 for goals & budget planning
POE S2 review
POE S2 review & S1 draft
March 2006
Value Proposition: Quantitative ValueSix Sigma Benefit
12 Waves 60 Six Sigma Projects $14,339,245 Gross $ 9,839,245 Net Does not include
financial benefit from WorkOut
Oct 2000-Sept 2005Yellow Belts: 271Green Belts: 56Black Belts: 22Master Black Belts: 5Star Coaches 170
March 2006
The Problems
ED Cash Collections Process
Emergency Department Discharge Process
Patient Access Create a Vision for Breast
Cancer Care Determine whether or not
to add O.R.s Buy in for the New Salad
Bar
Six Sigma
Lean
DFSS Work Out
M.E. Optimization
CAP
The Tool Solutions
March 2006
CAP WorkOut Lean Six Sigma DFSS
ProblemI know the answer but I’m going to meet a lot of resistance
I have a rough idea of where we need to go. I want my team to work together to improve the process quickly.
I have to do more, faster with less. I want to be sure my team is as productive as possible
The process is important and it isn’t working. I’m not sure why. I need to understand my process better and pick the right solutions.
The process is so broken in so many places I’m not sure where to start. We might as well blow it up and start over.
Deliverable
- Change management- Dealing with resistance- Maintaining the gains
- Helping those who do the work come up with and own great solutions
- Speed - Efficiency- Productivity- Removing waste
- Meeting customer expectations- Eliminating defects
-A new process- Defects designed out of the process- Exceeding customer expectations
Catch phrase“Why are we
always surprised by resistance”
“The people who do the work know
it best”
“We need to do more with less…. and faster too!”
“We need to get it really right for our
customers!”
“Now that we have a blank sheet of paper, lets get it right”
Turnaround < 1 day 1 – 2 days 3.5 - 5 days 6 – 9 months 6 – 9 monthes
Facilitator CAP/WorkOut Coach
CAP/WorkOut Coach
Lean leader Black Belt Black Belt
At a Glance