Lean Six Sigma in Healthcare. Lynne Hall RN, BSN October 17, 2012

Transcription

1 Lean Six Sigma in Healthcare Lynne Hall RN, BSN October 17, 2012

2 Objectives Name several tools used in Lean Six Sigma Define the DMAIIC process Understand a real world example of simple LSS project 2 Keep the 2 Drum Beat Going.

3 Introduction Lean/Six Sigma is relatively new to Healthcare Healthcare provides an excellent venue for Lean/Six Sigma Opportunities to improve processes Financial aspects bottom line Able to sustain the gain Works well with other process improvement cycles Includes frontline staff input and help with data collection 3 Keep the 3 Drum Beat Going.

4 Lean Six Sigma Overview GHA has adapted a Lean Six Sigma approach for Healthcare Not just a new way to look at process improvement Incorporates PDSA Cycle Uses DMAIIC process improvement Looks at Customer Requirements (could be department, units, floors) Organizational Culture Implementation Strategy Rewards and Recognition 4 Keep the 4 Drum Beat Going.

5 Daily control plan Statistical process control Simulation techniques Control Improve Implement Improve Lean process design FMEA Correlation studies Statistical process control Design of experiments Simulation techniques Lean Six Sigma Process Continuous Improvement improvement Ensure Permanence permanence Evaluate Solution solution Lean Six Sigma Select and Implement implement Solution solution Recognize the problem exists PDCA PDSA Determine Root root cause Cause 1-5 Form Quality quality Improvement improvement Teams teams Define the Problem problem Develop Performance performance Measures measures Analyze problem/ process Define Analyze SIPOC Project charter Voice of the Patient Process map Measure Measurement plan FMEA Ishikawa diagram Statistical process control Capacity analysis Pareto analysis Correlation of variables Confidence intervals Hypothesis testing Regression analysis 2012 Institute of Industrial Engineers Keep ANOVA the Drum Beat Going.

6 Lean Six Sigma Overview Recognize That Variation Exists Identify What the Customer Wants and Needs Use a Problem-Solving Methodology Follow the DMAIC Model Monitor the Process Update Best Practices and Lessons Learned Celebrate Success Sustain the gain!! 6 Keep the 1-6 Drum Beat Going.

7 Lean Six Sigma Overview Six Sigma incorporates more tools that help define and improve the process Spaghetti Diagrams DMAIC Process Statistical Tools Value Stream Mapping Waste, Non-Value Added Speed, Cycle Time Standardization And so much more!! 7 Keep the 7 Drum Beat Going.

8 Six Sigma Project CMS charged Hospital Engagement Networks (HEN) with reducing Early Elective Deliveries (EED) Using a Lean Six Sigma Approach the GA HEN Decreased EED by 90% Saved over 1 million dollars!! 8 Keep the 8 Drum Beat Going.

9 Six Sigma Project (DMAIIC) Define CMS defined the problem to be addressed Decrease Early Elective Deliveries High risk for infant born between 37 and 39 weeks Action Group developed with partners to discuss plan of action to decrease the overall rate of EED s and charter developed Looked at baseline data 2009 and 2010 (65% and 57% respectively) Held an in-person meeting with hospitals to be engaged in reducing EED s 9 Keep the 9 Drum Beat Going.

10 10 Keep the Drum Beat Going.

11 Six Sigma Project (DMAIIC) Measure Looked at possible measures to help reduce EED Meeting with small group of hospitals and measures were decided on using JC-PC-01 (process) and 5 minute Apgar Scores (outcome) Starting in May 2012 telnet meetings were held every 3 weeks Education included Hard stops Bundles Physician and staff buy-in Community education Staff empowerment Hospital highlights 11 Keep the 11 Drum Beat Going.

12 Six Sigma Project (DMAIIC) Analyze Initial data collection revealed a correlation between physician buy-in, staff empowerment, and success in decrease of EED Hospitals who were successful in reducing EED s had hard stops in place Physicians who wanted to induce or schedule a cesarean section and did not have a pre-determined medical condition for the patient were sent to peer review or the staff had the power to say no Data also revealed a need for community education as well By decreasing EED s waste is cut out 12 Keep the 12 Drum Beat Going.

13 Six Sigma Project (DMAIIC) Improve/Implement hard stops, induction bundles, and policies and procedures were put into place Improvement in reduction of EED s was noticed Education continued on Physician Buy-in, staff empowerment, and community education Hospitals continued to submit data Resource page was developed on the GA HEN website with best practice policies and procedures to share from hospital to hospital 13 Keep the 13 Drum Beat Going.

14 Six Sigma Project (DMAIIC) Control we are currently in the control phase in sustaining the gain the hospitals have made Continued with data submissions Encouraged hospitals to submit data to monitor continued progress Hospitals shared their journey to zero Run charts developed globally and hospital specific 14 Keep the 14 Drum Beat Going.

15 Six Sigma Project (Data Results) 15 Keep the 15 Drum Beat Going.

16 Six Sigma Project (Data Results) 16 Keep the 16 Drum Beat Going.

17 The Results 3 According to Managed Care Magazine it costs around $41,000 for a late preterm NICU visit The incidents went from 147 incidents in March 2012 to just 34 in August 2012 That s a decrease of 113 incidents If even a ¼ of the babies went to NICU, we saved Georgia Healthcare $1,158,250 OVER 1 MILLION Dollars!! 17 Keep the Drum Beat Going.

18 Conclusion This was a simple six sigma design Defined the process Measured baseline data Analyzed the data Implemented and Improved the new process Now sustaining the gain Six Sigma in Healthcare does not have to be complicated AND the financial and practical gains are well worth it 18 Keep the 18 Drum Beat Going.

19 Questions?? 19