Lean Six Sigma Case Studies in the Healthcare Enterprise PDF
Preview Lean Six Sigma Case Studies in the Healthcare Enterprise
Sandra L. Furterer Lean Six Sigma Case Studies in the Healthcare Enterprise Lean Six Sigma Case Studies in the Healthcare Enterprise Sandra L. Furterer Lean Six Sigma Case Studies in the Healthcare Enterprise 1 3 Sandra L. Furterer Southern Polytechnic State University Marietta, GA USA ISBN 978-1-4471-5582-9 ISBN 978-1-4471-5583-6 (eBook) DOI 10.1007/978-1-4471-5583-6 Springer London Heidelberg New York Dordrecht Library of Congress Control Number: 2013950086 © Springer-Verlag London 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) I dedicate this book to my loving family, my husband Dan, and my children Kelly, Erik, and Zachary who provide constant support and the true purpose in my life. My children provide the incentive for me to strive for excellence to be a guiding example for their lives. I also dedicate this book to my parents, Joan, and the late Mel Brumback, who instilled in me the value of education and a lifelong love of books and learning, and also to my siblings, Dan, Neil, Tim, and Kathy, who encouraged the competitive spirit and being our best in all we do. Preface The purpose of this book is to provide an enterprise Lean Six Sigma methodology to enable alignment and optimization of processes across the entire organization. Healthcare has finally embraced Lean Six Sigma tools, even though it has been much later than many industries, there is great value and advantage for applying these tools and methods in healthcare. Healthcare is struggling with shrinking rev- enues and trying to control costs, what better environment could there be to apply Lean Six Sigma. In Chap. 1, we provide a description of the author’s Strategic Business Process Architecture methodology that can enable enterprise-wide improvement. In Chap. 2, we provide a description of the Lean Six Sigma methodology that can guide our process improvement projects. In Chap. 3, we provide an application of Lean Six Sigma that successfully reduced the patient Length of Stay and Door to Doctor time in a hospital’s Emergency Department. In Chaps. 4 and 5, we provide an application of Lean Six Sigma and 5S in an operating room. In Chap. 6, we provide an application of Lean tools applied for preparing patients for surgery. In Chap. 7, we provide an application of how Lean Six Sigma was used to reduce the number of CT scans in an Emergency Department. In Chap. 8, we describe how we reduced the linen loss throughout the hospital by applying Lean Six Sigma. In Chap. 9, we used Lean Six Sigma to design and implement sepsis protocols to reduce the mortality related to sepsis infections. In Chap. 10, we design women's services in an outpatient women’s center. In Chap. 11, we provide an innovative Patient Care Operating Model that can reduce delays in the inpatient value chain activities. In Chap. 12, we discuss labor management flaws and best practices in healthcare. In Chap. 13, we provide insights into several critical success factors that can enhance your organization’s Lean Six Sigma program. In Chap. 14, we provide a brief view into the future of Lean Six Sigma in healthcare. These case studies are representative of healthcare case studies, but generalized to protect the confidentiality of specific healthcare organizations. vii Acknowledgments My thanks and appreciation goes to all of the Lean Six Sigma team members, project champions, and Lean Six Sigma mentors that worked so diligently and courageously on the Lean Six Sigma projects that enabled us to enhance and improve the patients’ experience in the healthcare environments. As with any successful operational excel- lence program, there are so many wonderful participants that guide, mentor, cham- pion, encourage, and make change happen, I thank you for your dedication to helping make the patients’ experience in the hospitals one of healing, compassion, and care. Special thanks goes to several people for their contributions to development and production of the book at Springer UK. ix Contents 1 Enabling Enterprise Performance Excellence Through Strategic Business Process Architecture Modeling Techniques ............... 1 Introduction ................................................. 1 Underlying Concepts Evolving to Business Architecture .............. 2 Business Architecture ..................................... 3 Strategic Business Process Architecture Methodology ........... 4 Phase I: Enterprise Planning ............................... 5 Phase II: Strategic Business Process Architecture Modeling ....... 7 Lean Six Sigma ......................................... 9 Conclusions ................................................. 10 References .................................................. 10 2 Lean Six Sigma Roadmap .................................... 11 Lean Six Sigma Overview ...................................... 11 Lean Six Sigma Applications in Private Industry .................... 12 Define Phase ................................................ 14 Develop Project Charter ................................... 14 Perform Stakeholder Analysis .............................. 18 Perform Initial Voice of Customer (VOC) and Identify Critical to Satisfaction (CTS) ..................................... 19 Select Team and Launch the Project ......................... 20 Create Project Plan ....................................... 22 Measure Phase ............................................... 25 Define the Current Process ................................. 26 Define Detailed Voice of Customer (VOC) .................... 27 Define the Voice of the Process (VOP) and Current Performance ... 33 Validate the Measurement System ........................... 36 Define the Cost of Poor Quality (COPQ) ...................... 37 Analyze Phase ............................................... 38 Develop Cause and Effect Relationships ...................... 38 Determine and Validate Root Causes ......................... 41 Develop Process Capability ................................ 49 Improve Phase ............................................... 52 Identify Improvement Recommendations ..................... 53 xi xii Contents Perform Cost/Benefit Analysis .............................. 54 Design Future State ...................................... 55 Establish Performance Targets and Project Scorecard ............ 56 Gain Approval to Implement, Then Implement ................. 56 Train and Execute ........................................ 57 Control Phase ............................................... 57 Measure Results and Manage Change ........................ 57 Report Scorecard Data and Create Process Control Plan. . . . . . . . . . 58 Apply P-D-C-A Process ................................... 60 Identify Replication Opportunities ........................... 61 Develop Future Plans ..................................... 61 Summary ................................................... 61 References .................................................. 61 3 Hospital and Emergency Department Throughput Improvement ............................................... 63 Introduction ................................................. 63 Define Phase ................................................ 64 Develop Project Charter ................................... 65 Perform Stakeholder Analysis .............................. 66 Perform Initial Voice of Customer and Identify Critical to Satisfaction .......................................... 69 Select Team and Launch the Project ......................... 69 Create Project Plan ....................................... 70 Measure Phase ............................................... 70 Define the Current Process ................................. 71 Define Detailed Voice of Customer .......................... 71 Define the Voice of Process and Current Performance ........... 72 Validate Measurement System .............................. 74 Analyze Phase ............................................... 77 Develop Cause and Effect Relationships and to Determine and Validate Root Causes ................................. 77 Develop Process Capability ................................ 83 Improve Phase ............................................... 91 Identify Improvement Opportunities and Plans ................. 91 Perform Cost/Benefit Analysis .............................. 94 Design Future State ...................................... 95 Establish Performance Targets and Project Scorecard ............ 95 Pilot Improvements ...................................... 95 Train and Execute ........................................ 97 Control Phase ............................................... 101 Measure Results and Manage Change ........................ 101 Report Scorecard Data and Create Process Control Plan. . . . . . . . . . 102 Identify Replication Opportunities ........................... 102 Develop Future Plans ..................................... 103 Contents xiii Conclusions ................................................. 103 Project Critical Success Factors ............................. 103 Reference ................................................... 104 4 Operating Room Turnaround and On Time Starts Improvement .... 105 Lean Six Sigma Project for OR Turnaround and On Time Starts of Cases .................................................... 106 Define Phase ................................................ 106 Develop Project Charter ................................... 106 Perform Stakeholder Analysis .............................. 108 Identify Critical to Satisfaction ............................. 110 Select Team and Launch the Project ......................... 111 Create Project Plan ....................................... 112 Measure Phase ............................................... 113 Define the Current Process ................................. 113 Define Detailed Voice of Customer .......................... 116 Define the Voice of Process and Current Performance ........... 117 Validate Measurement System .............................. 123 Analyze Phase ............................................... 123 Develop Cause and Effect Relationships ...................... 123 Determine and Validate Root Causes ......................... 126 Develop Process Capability ................................ 126 Improve Phase ............................................... 128 Identify Improvement Opportunities and Plans ................. 128 Perform Cost/Benefit Analysis .............................. 129 Design Future State ...................................... 129 Establish Performance Targets and Project Scorecard ............ 129 Pilot Improvements ...................................... 130 Control Phase ............................................... 136 Measure Results and Manage Change ........................ 136 Report Scorecard Data and Create Process Control Plan. . . . . . . . . . 140 Identify Replication Opportunities ........................... 140 Develop Future Plans ..................................... 140 Summary and Project Critical Success Factors ...................... 143 Reference ................................................... 143 5 Applying 5S to Improve OR Organization ....................... 145 Define Phase ................................................ 147 Project Charter .......................................... 147 Stakeholder Analysis ..................................... 147 Suppliers-Inputs-Processes-Outputs-Customers ................ 148 Project Kick off ......................................... 149 Measure Phase ............................................... 150 Analyze Phase ............................................... 152 Improve Phase ............................................... 154
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