Lean Six Sigma DMAIC Project (Example) - ets

1 Lean Six Sigma DMAIC Project (Example)Last Updated: 1 15 14Te a m : The SpeedersTo m Jones (Team Leader)Steve MartinArt FranklinMary Jefferson Amy KiddBob VillaJimmy SmitsGreen BeltProject Objective:To Reduce Clinic Cycle Time (Intake & Service Delivery)Linda Hill (Sponsor)0120171 Copyright 2017 ets, inc. - (321) 636-2212yThe Community Health Organization (CHO) Leadership Team determined that Clinic Cycle Time (Intake & Service Delivery) needed objective was driven by patient satisfaction survey results from throughout the service Executive Director assigned Tom Jones as the Team Leader, and requested Mr. Jones to assemble a cross-functional company-wide team to develop a Project Charter and confirm the need for team decided to use the DMAIC methodology and Lean Six Sigma tools to address this 2017 ets, inc. - (321) 636-2212 Theme Selection MatrixThe team selected Reduce Clinic Cycle Time as its theme because cycle time was a driver of patient satisfaction, retention, and referral.

2 Cycle Time was also a strategic objective and Key Performance Indicator on the Senior Leadership : June, 2013 The team evaluated cycle time in the context of the 5 greatest issues identified in the strategic planning SWOT Selection MatrixPotential ThemesImportanceNeed to ImproveOverall ScoreFacility Cleanliness34 Employee Lost Time Incidents 5 Employee Absenteeism3 Clinic Cycle Time (Check-in to Check-out)5525 Customer Service Responsiveness52101512933 Scale: 1= Negligible 2= Somewhat 3= Moderate 4= Very 5= Extreme3 Copyright 2017 ets, inc. - (321) 636-2212 Green Belt Team Project CharterBusiness CaseProject Name (Theme):To Reduce Clinic Cycle Time (Current Actual = 70 Minutes)Problem / Impact:Clients expect to be treated within a reasonable time. Longer than necessary Length of Stays (LOSs) cause Client dissatisfaction and loss of trust in the clinic s ability to meet their health care Benefits:Reduce Arrival to Checkout (Intake & Service Delivery) Times: Reduced # of Client Complaints; Increase Client SatisfactionObjectivesOutcome Indicators:Q2 - Average # of Minutes to Serve Clients (from Arrival to Checkout)Proposed Target(s):Target = 39 minutesTimeframe:July 2013 through December 2013 Strategic Alignment:Supports CHO Strategic PlanScopeIn Scope:Clients within CHO AreaAuthorized By:Linda HillTeamSponsor(s):Linda HillTeam Leader:Tom JonesTeam Members:Steve Martin, Art Franklin, Mary Jefferson, Amy Kidd, Jimmy SmitsProcess Owner(s):Linda HillMgmt.

3 Review Team:Dr. Kildare and Linda HillScheduleCompletion Date:December 31, 2013 Review Dates:Monthly and Final Review in November Milestone Dates:See Action PlanProject Charter4 Copyright 2017 ets, inc. - (321) 636-2212 Project Planning WorksheetThemeProblem Statement(Summarize)Team Work LocationTeam NameDuration(mm/yy) through(mm/yy)Sponsor:Team Info2nd Team LeaderTeam Members#1N/A6/3 Subject matter experts from various disciplines invited throughout meeting :00a726/1010:00a736/173:00p546/242:00p65 7/21:00p567/99:00a777/1611:00a787/23 Noon697/306:00p41710/122:00p725108/104:0 0p41810/319:00a726118/173:00p51911/159:0 0a427128/247:00a32012/310:00a528138/318: 00a72112/194:00p729149/49:00a72230159/11 4:00p62331169/185:00p52432 Project Planning Worksheet Page 1 of 2 Reduce Clinic Cycle Time 31 minutes by 12/31/13 ( of Gap) of Clients served that were taking longer than 30 minutes required CBC Lab WorkMiami, FLThe Speeders6/13/1312/13/13 Tom JonesTeam LeaderTeam Member 1 Team Member 2 Team Member 3 Team Member 4 Team Member 5 Team Member 6 Amy KiddSteve MartinArt FranklinBob VillaMary JeffersonJimmy SmitsTeam Member 7 Linda HillTeam MembersMeetings#DateTimeAtt.

4 ##DateTimeAtt.#DateTimeAtt.# : In some cases a team may choose to use a Project Charter and a separate Project Planning Worksheet with DMAIC schedule as 2017 ets, inc. - (321) 636-2212 Outline of ActivitiesProject Planning WorksheetNote: In some cases a team may choose to use a Project Charter and a separate Project Planning Worksheet with DMAIC schedule as 2017 ets, inc. - (321) 636-2212yProject Name:Reduce Clinic Cycle Time (Intake & Service Delivery)ySituation: 11 Clinics in Service Area Average Cycle time = 70 minutes Industry Best = 30 minutes Customer Satisfaction = 68% Customer Complaints = encounters Strategic Issue related to patient satisfaction, revenue, and Federal funding 20% of patients leave before being seenReason for Improvement7 Copyright 2017 ets, inc. - (321) 636-2212 Stakeholders and NeedsReason for ImprovementStakeholdersNeedsCustomer / PatientQuality Medical ServicesTimely Medical ServicesAccurate Billing for ServicesCompany / Senior Leadership TeamRetain Existing Patients (Maximize Revenue)Add New Patients (Revenue Growth)Maximize Funding Potential (No Penalties)EmployeesMeaningful WorkCareer OpportunitiesFair Pay and 2017 ets, inc.

5 - (321) 636-2212 Costs of Poor QualityStakeholderPainAnnualized Costs Customer / PatientLow Satisfaction68% SatisfactionCustomer / EncountersCustomer / PatientLeaves Without Being Seen (LWOBS)20% LWOBSC ompanyLost Patients$ Million RevenueCompanyFinancial Penalties from Funders$900,000 in PenaltiesEmployeesRework10% Rework = $ Million per Year in Wasted Labor Expense9 Copyright 2017 ets, inc. - (321) 636-2212 Theme: Reduce Clinic Cycle Time 31 minutes by 12/31/13 ( of Gap). Term Target39 Minutes2013 GOODGapASOND7030 FMAM JASONDJJI ndustry Best2014010 Copyright 2017 ets, inc. - (321) 636-2212A schedule for completing the five DMAIC steps was of ActivitiesThe Sponsor signed off on the Project s purpose, scope, and 2017 ets, inc. - (321) 636-2212yThe team developed a flow Chart12 Copyright 2017 ets, inc. - (321) 636-2212yDefective parts, services & reworkyOver-productionyWaitingyNon-utili zed talent & wasted knowledgeyTransporting yInventoryyMotionyExcess processingEight (8) Categories of Waste (Muda)The team applied the 8 Wastes to the process with an emphasis on cycle 2017 ets, inc.

6 - (321) 636-22128 Wastes8 WastesPotential Causes of Waste1. Defects & ReworkyPatients show up late for are accepted and worked into the patient call-back patients many times to reach patients to change gown when not WaitingyPatient waits for blood draw and lab without appointments are mixed with those that have rooms are not must wait for not informed immediately when nurse completes must wait to be checked must wait in line at Non-Utilized Talent & Wasted KnowledgeyOnly clinicians are allowed to order lab required to complete routine move equipment between exam and equipment are ordered based on the calendar rather than top computers not positioned in exam rooms to provide convenient access by physician or Excess ProcessingUnnecessary tests may be performed on the 2017 ets, inc. - (321) 636-2212 Clinic Services SummaryChecksheet (Used to collect & analyze data)A checksheet was developed to collect data on patient flow through the clinic for 100 : Checksheets may be used in all DMAIC 2017 ets, inc.

7 - (321) 636-2212 The team collected a random sample of 100 clinic clients served during July 2013. The team analyzed the data many ways and - StratificationThe team looked closer at these 91 clients Flow ReportWhen: June 2013 Where:Miami, FLWho: J. Smits x 313# of Clients16 Copyright 2017 ets, inc. - (321) 636-2212 The team stratified the 91 clients which took longer than 30 minutes many ways and Clients Served During July 2013 taking longer than 30 minutes from Check-into Check-out and involving Lab Chart Stratification ContinuesTarget: 75% Reduction in CBC Lab Work DelaysWe set a target to reduce the percentage of CBC Lab clients taking longer than 30 minutes from check-in to check-out by 75%. of Lab Work25%50%75%100%CBC LabUA (w/o Microscopic)Quantitative Bhcg (Pregnancy)GC/Chlamydia DNA ProfileCk-Mb Profilen = 91671453291756030450%67 ( ) Clients had Complete Blood Count (CBC) Lab Work 2017 ets, inc.

8 - (321) 636-2212yProblem Statement: of clients served that were taking longer than 30 minutes from Check-in to Check-out required CBC Lab work. yTarget: We will reduce the percentage of CBC Lab clients taking longer than 30 minutes from Check-in to Check-out by 75%.yIf the target is achieved, the team determined that it could achieve the short term target of 39 minutes Average Cycle Time on the Theme Indicator in the Define team looked closer at these 67 Sponsor signed off on the Project s focus and Statement and 2017 ets, inc. - (321) 636-2212 The team completed Cause and Effect Analysis and team next looked to verify the 4 identified Potential Root # of people trained and/or authorized to draw bloodPolicy on who is allowed to draw blood out of dateLab Work ordered by Clinician after ExamExisting Policy only allows Clinician to order Lab WorkClinician is planned to see Client after Vitals and RN AssessmentEnvironmentEquipment / MaterialsRN and Clinician available staff often less than needed to meet demandPolicy for securing temporary back-up staff not clearACDS upplies for drawing blood are limited and not easily accessible to allBProcedures for stocking supplies and equipment needed for drawing blood not well definedCBC Lab clients served during July 2013 taking longer than 30 minutes from Check-in to Statement= Potential Root CauseCause and Effect (Fishbone) Diagram19 Copyright 2017 ets, inc.

9 - (321) 636-2212 The team collected data to verify causes and summarized its findings on a Verification Root CauseHow Verified?Root Cause or SymptomA. Existing Policy only allows Clinician to order Lab WorkTeam reviewed current Policy and guidelines and verified Policy only allows Clinician to order Lab CauseB. Procedures for stocking supplies and equipment needed for drawing blood not well definedTeam reviewed current guidelines and verified that no clear Policy CauseC. Policy on who is allowed to draw blood out of dateTeam reviewed current guidelines and found Policy is current and matches company standardsSymptomD. Policy for securing temporary back up staff not clearTeam reviewed current guidelines and found there is no written Policy on when to secure back up staff to meet staffing CauseABDP robable Cause Verification MatrixC20 Copyright 2017 ets, inc. - (321) Cause Verification MatrixyA checksheet was developed and 100 samples were taken to determine the frequency of occurrence of each selected cause.

10 This enabled the team to estimate the impact of each root cause on the gap. Three (3) primary causes were verified by the Cause A = present 35% of the time = 23 patients;yRoot Cause B = present 22% of the time = 15 patients;yRoot Cause D = present 19% of the time = 13patients;Total = 51 patientsEstimate: 51 67 = 76% which approximates the target in the Measure step of a 75% sponsor signed off on the verified root causes and impact on the 2017 ets, inc. - (321) 636-2212 The team developed and evaluated countermeasures and many potential practical methods and narrowed them down to 6 team next looked closer at implementing the 6 practical methods Legend: 1 = None 2 = Some 3 = Substantial 4 = High 5 = ExtremeRatingsProblem StatementVerified Root CausesCounter-measuresPractical MethodsEffectivenessFeasibilityOverallTa ke Action? Yes / NoClinic Clients served during July 2013 taking greater than 30minutes from Arrival to Checkout and involved CBC Lab WorkA.