Recently I have been working
on a new account for a healthcare organization in the Chicago area. My company, NOVACES, performed what we refer
to as a JumptStart initiative which is a full-blown needs assessment. Needless to say this assessment uncovered
many, many opportunities for improvement.
Our next step was to interview the organization’s leadership team and
begin the selection of the most impactful opportunities that can help them
become a more successful world class organization. I might add that this healthcare group had
just undergone a significant reduction in force in an attempt to save their way
to profitability. Since this had just
taken place prior to my arrival, it was clear that many of the employees were
kind of frightened for their jobs. And
then here comes Bob Sproull with a message of how to do much more in terms of
process throughput without adding additional labor! You can imagine how that reception was……
One of the first orders of
business was to select potential Green Belt candidates for training in what we
refer to as SystemCPI® which is an integrated Lean, Six Sigma and
Constraints Management improvement methodology. Our contract
called for Green Belt and Champion training followed by at least three Value Stream Analysis (VSA) initiatives and up to
three Rapid Improvement Workshops (RIW) or additional VSAs instead of RIW's. The VSAs would be selected and scheduled
after the Green Belt and Champion training was complete.
The selection process would be based upon individual interviews with the
Project Champions and then presented to the leadership team for final approval. The selection criteria would be a combination
of potential financial payback and which problems were most pressing for the
organization. With the new Affordable
Care Act looming, things like hospital re-admissions, patient satisfaction,
infection rates, and other criteria had to be in the mix for project selection.
The first project selected
was in the Radiology Department and it was a flow issue which is perfect for a
VSA initiative. In fact several of the
projects selected were intended to improve the flow of the processes which is a
great place for both Lean and Constraints Management. The second project, for example, was in the
Emergency Department with the objective being to reduce the “Door to Doc” time. As these projects are initiated, I’ll try to post
the progress made here in my blog.
With the Green Belt
candidates selected and a significant list of improvement projects in our
portfolio, we were now ready to deliver our week-long training. The Green Belt training went off as planned
for twenty-four students as they learned a variety of tools and techniques
during the week. Of particular interest
was a simulation that we include in our training that involves simulated
physicians, patients, pharmacy technicians, a pharmacist, nurses, etc. intended
to demonstrate how a process full of waste and error prevents the distribution
of needed medication to patients. There
were two teams competing against each other with the winner being declared
based upon the number of patients receiving their medication. The simulation has three rounds with the
first round requiring the teams to run their operation based upon predetermined
guidelines with no changes permitted. At
the end of Round 1 of this simulation, neither team had distributed a single
medication to any of their patients.
The Green Belt training
included a variety of tools like Process Mapping and Value Analysis to
determine whether each process step was value added, non-value added or
non-value added but necessary. They also
learned the true meaning of a value added
activity, the seven Lean deadly wastes and various other Lean tools like SIPOC
diagrams, Spaghetti Diagrams, and others.
They also learned various Six Sigma tools and techniques, but the most
useful piece of the training was how Constraints Management (CM) works in this
integration. I say CM is the most useful
simply because, as I’ve written about many times on this blog, it provides the
focusing mechanism needed for application of Lean and Six Sigma at the right
location within the process being improved.
This part of the training included a discussion of Goldratt’s Five
Focusing Steps and it was very well received by all of the students. As a side note, I’m happy to report that all twenty-four
of the students passed the exam at the end of the training.
Armed with their new
training, round two of the simulation progressed with the students being
required to perform a Value Stream Analysis of the process used to distribute medication
to patients. In this round the students
were only permitted to remove the non-value-added steps in the medication
distribution process. The teams were
amazed by the number of steps that added no value and as a result of this
exercise, both teams improved their results significantly over the first round
of the simulation. One team distributed meds to 24 patients and
the other distributed meds to 26 patients.
Both teams were amazed with the significant improvements they had
achieved by simply removing the apparent waste.
In the third round of the
simulation both teams created both an Ideal State and a Future State map of the
meds distribution process. Using
Constraints Management, both teams were able to identify the system constraint
and focus their improvement efforts on that constraint. I told them in this round they could use
their creative juices to produce a streamlined process. For example, one part of the process was the
notification to the pharmacy of the need for meds and both teams established an
on-line notification process. Both teams
established their new processes and the results even astonished me. In this third round, I cut the Rounds 1 and 2
time from 20 minutes to only 10 minutes which both teams thought was unfair
until they ran their new processes and saw their results. Team 1 led the way by
distributing meds to 41 patients while Team 2 was able to distribute meds to 36
patients! Think about that…..they had
significantly exceeded the results of simulation Round 2 in only half the
time!!
In my next posting I’ll
discuss a couple of breakthroughs achieved by several Green Belt students just after
receiving this initial training and some follow-up training on a Constraints
Management case study that I gave them a couple of weeks later.
Bob Sproull
2 comments:
To all of my readers, I sincerely apologize for the links put on this posting!! In the end, this anonymous person obviously has no respect for blog postings and in the end, I may have to delete this posting. Again, please accept my apologies.
Bob Sproull
Six Sigma is tools are used for process improvement. Six Sigma is the system preferred by businesses around the world to streamline, improve, and optimize any and every aspect of their organization. You can find the best Six Sigma tools to use and its applications to practice Six Sigma.
Post a Comment