2. Learning Objectives
• Why Six Sigma in Healthcare
• How to apply Lean Six Sigma in a hospital
setting.
• How to get doctors to lead the Lean Six Sigma
implementation.
• How to link training and process improvement
activities.
Dr Amel Farrag LSSMBB 2
3. How Senior Management Describes Six Sigma?
" One of the greatest management innovations of the
past quarter-century and an extremely powerful way
to boost a company’s competitiveness…Nothing
compares to the effectiveness of Six Sigma when it
comes to improving a company’s operational
efficiency, raising its productivity, and lowering its
costs.”
Jack Welch WINING )
Dr Amel Farrag LSSMBB 3
4. Why Hospital Strive for Process
Excellence ?
Increase Improve Empower Fix Broken
Process Customer Employees processes
Efficiency Experiences
Errors will Customers People There are
slow only allow continuously costs
hospital one bad think of associated
growth and experience better ways with the bad
increase to do their quality
liability jobs
Dr Amel Farrag LSSMBB 4
5. History of Six Sigma
Six Sigma was launched by Motorola in late 80s and
early 90s As Quality program
Mid 90 implemented in GE .CO by Jack Welsh then to
other companies like U.S. Government American
Express o Hercules Allied Signal Microsoft,
Johnson & Johnson
Since then many companies have embraced Six Sigma
it is transmitted for healthcare industry like United
Health Group , NHS , The Joint Commission .
Dr Amel Farrag LSSMBB 5
6. What is Six Sigma (6 σ)?
Sigma is a Greek alphabet letter (σ)
Used to describe variability .
Sigma level
Indicator of how often a process is likely to meet objectives
Often expressed as 2 σ , 3 σ , 4 σ , A 6 σ process will perform to
specifications 99.9999998% of the time (2 in a billion defect
rate)
Philosophy of Six Sigma
All processes vary over time
Six Sigma is a process for controlling that variation and
continuously improving the product or service produced
Dr Amel Farrag LSSMBB 6
7. What is Lean
“To get the right things to the right place at the right
time, the first time, while minimizing waste and
being open to change”
— Taiichi Ohno,
Lean is an approach that seeks to improve flow in
the value stream and eliminate waste .
Dr Amel Farrag LSSMBB 7
8. Lean and Six Sigma
Use Six Sigma to Use Lean to
-Improve process -Improve process efficiency
effectiveness
- Reduce number of steps in
- Reduce variability the process
-Ensure hitting the target -Reduce waste with Less
ALL the time effort
- Accuracy , Reduce -Timeliness , Reduce NVA
Defects Steps .
Dr Amel Farrag LSSMBB
8
10. Customer Requirements in
Healthcare
• Patient Safety Goals .
•Improve Clinical Outcomes.
• Increase Compliance Rates
• Operational efficiency.
• Improve Supply chain Labs , pharmacy.
• Discharge Rates at Clinics ER / OR / ICU .
• Financial Impact / Service Cost.
•Increase quality Service Levels / Patient Care .
• Stakeholder satisfaction Patients, Employees, Physicians
10 Dr Amel Farrag LSSMBB
11. Joint Commission and Six Sigma
Six Sigma was adopted by The Joint Commission Center for
Transforming Healthcare
Initiating Seven large Projects :
1. The Hand Hygiene Project 2008
2. Improve the safeguards to prevent patients from wrong site,
wrong side and wrong patient surgical procedures 2009
3. Improving the quality of hand-off communications 2010
4. Reduce surgical site infections (SSI) 2010
5. Prevent avoidable hospitalizations 2011
6. Prevent falls that occur in health care facilities 2011
7. Improve Safety Culture 2011
Dr Amel Farrag LSSMBB 11
12. Six Sigma In Healthcare
• ICU hours of Care Per Patient day:
Dropped from a starting point of 29.6 hours in the 1980s to 20.5
hours by 1995 and 19 hours by 2001
• The Mortality Rate from Acute Myocardial Infarction
declined from 9.68 percent in 1999 to 6.3 percent in 2002
• Shortened LOS of patients with Chronic Obstructive
Pulmonary Disease. This resulted in more possible patient
admissions and an annual savings of $40,000 in one hospital.
• Cardiac Surgery Cost Savings: $1.1 to $2.6 million saved / year
Dr Amel Farrag LSSMBB 12
13. Which areas are Six Sigma
Companies Focus?
Dr Amel Farrag LSSMBB 13
15. Where do Healthcare Focus?
Reduced medical Errors
Accurate, repeated, processes
Just in time and every time
Meet customer and patients needs
Reduce hospital cost without
affecting quality of care
This why we are thinking for six sigma in Healthcare
Dr Amel Farrag LSSMBB 15
17. Six Sigma Implementation Strategy
Sell top management on the benefits of Six Sigma.
Have top management communicate the hospital
strategy to all staff members .
Emphasize a quality culture through communications.
Change mentality to patient center organization .
Establish data-driven improvement measurements .
Dr Amel Farrag LSSMBB 17
18. Six Sigma Training Strategy
• Teach Executive Staff "Sponsors" on how to drive the hospital
strategy .
• Choose and train hospital Champion ,leaders will set process
measurements ,review results and be accountable .
• Choose and train Master Black Belt - A core team of experts
embedded in key business areas to lead, teach and audit.
• Choose and train project managers black Belt - Business team
members will deploy, collect and measure data, analyze results and
make improvements.
• Provide general overview & emphasize tools to "Green Belts"
Dr Amel Farrag LSSMBB 18
19. Six Sigma Training Strategy
• Continue Six Sigma competency training across the
hospital
• Establish a Quality Committee - to choose most
important projects to the hospital .
• Assign Black Belts to projects based on their expertise
and background .
• Create a Black Belt community across the hospital .
• Establish best practice "Centers of Excellence"
Dr Amel Farrag LSSMBB 19
20. Examples of Six Sigma Projects in
Hospitals
Process Clinical out come Administrative
Efficiency
Reducing waiting Reducing redo after Increase quality rate
time in Radiology Lasik Operation in medical transcript
Department
Decrease discharge Door to treatment Decrease Rat of
TAT TAT in acute chest invoice errors
pain with STEMI
Decrease rate of Decrease Bed Sore Decrease Nursing
operation Rat in hospitalized Turnover
cancelation patient
Dr Amel Farrag LSSMBB 20
