Six Sigma Process ItI mprovement Methodology

1 Six Sigma P. Process Improvement I t Methodology Presented by Content Expert: Beth Lanham, RN, BSN, MBA. Director Six Sigma Director, Six Sigma Froedtert Hospital, Milwaukee, WI. This presentation is part of an on line series, brought to you through a collaboration between the Wisconsin Office of Rural Health and the Wisconsin Hospital Association. Property of the Wisconsin Office of Rural Health. What is Six Sigma ? What is Six Sigma ? Six Sigma is a customer focused customer focused project focused results driven app oac to Qua ty approach to Quality This presentation is part of an on line series, brought to you through a collaboration between the Wisconsin Office of Rural Health and the Wisconsin Hospital Association.

2 Property of the Wisconsin Office of Rural Health. Six Sigma Overview Six Sigma Overview A rigorous Methodology A rigorous Methodology Originated by Motorola (1986). A. A statistically based method to reduce variation in statistically based method to reduce variation in electronic manufacturing processes Heavily inspired by Previous quality improvement methodologies Quality Control Management, CQI, TQM Based on the work of quality pioneers q yp Deming, Juran, Ishikawa, Taquchi and others This presentation is part of an on line series, brought to you through a collaboration between the Wisconsin Office of Rural Health and the Wisconsin Hospital Association.

3 Property of the Wisconsin Office of Rural Health. Six Sigma Overview Six Sigma Overview By late 1990s y 2/3 Fortune 500 companies Aimed at reducing costs and improving quality Today T d Utilized all over the world Local governments, prisons, hospitals, the armed forces, banks, g ,p , p , , , manufacturing, etc. In recent years Si Six Sigma often combined with Lean Manufacturing to Sigma often combined ith Lean Man fact ring to yield a Methodology called Lean Six Sigma . This presentation is part of an on line series, brought to you through a collaboration between the Wisconsin Office of Rural Health and the Wisconsin Hospital Association.

4 Property of the Wisconsin Office of Rural Health. Why Six Sigma ? Why Six Sigma ? What we were doing wasn't working well enough! Wh d i ' ki ll h! Incremental improvements not good enough . Need to /Desire to: Need to /Desire to: Focus on customer requirements Base decision on data, not anecdotal information Be Proactive vs. Reactive Establish a culture of ownership vs. culpability It's the processes, not the people Effect rapid and effective change Improvement efforts were fragmented Large system wide processes broken L id b k Not holding the gains . What does Six Sigma offer? What does Six Sigma offer? Augments traditional quality tools Augments traditional quality tools Organizational g Benefits.

5 Data driven decision making Competitive edge Focuses on customer requirements Service Excellence A focused/organized approach Empowered staff Empowered staff Redefines processes for long term results Leadership Becomes ingrained in work and thought Development processes Quality/Safety Relies on evidence based solutions Healthcare Costs Rapid/effective change Six Sigma Six Sigma Methodology aimed at Error reduction Eliminating variation Eliminating variation Goal Design/improve processes so it is impossible to make an error Reliance on performance measurements and statistical analysis statistical analysis This presentation is part of an on line series, brought to you through a collaboration between the Wisconsin Office of Rural Health and the Wisconsin Hospital Association.

6 Property of the Wisconsin Office of Rural Health. Traditionally .. Traditionally Businesses Businesses have described their products or have described their products or services in terms of averages: Average cost g Average time to delivery Average number infections A. Average usage Average wait time This presentation is part of an on line series, brought to you through a collaboration between the Wisconsin Office of Rural Health and the Wisconsin Hospital Association. Property of the Wisconsin Office of Rural Health. Are These Processes the Same? Process 1 Process 2. Are they performing well? 20 9. 5 11 Goal = less than 10. 17 8.

7 5 10 Process 1 Process 2. 15 10. 5 9 Mean Mean 5 11. 5 10. Are all the customers happy? ppy 5 8. 12 8. Variation = Opportunities for Errors pp Process 1 Process 2. Average Minimum 5 8. Maximum 20 11. Median Median 5 5 Standard deviation Customers feel the variation, not the average!!!!!! Variation in the Process Variation in the Process Process 1 Process 2. Histogram of Process 1 Histogram of Process 2. Normal Normal Mean 80 Mean 100 StDev StDev N 1000 70 N 1000. 80 60. 50. Frequency Frequency 60. 40. 40 30. 20. 20. 10. 0 0. -12 -6 0 6 12 18 24 -12 -6 0 6 12 18 24. Process 1 Process 2. Many Fewer Defects Defects Process 1 is less capable of meeting our customer Process 1 is less capable of meeting our customer'ss expectations!

8 Exact capability can be measured! Six Sigma Central Concepts Six Sigma Central Concepts Critical to Quality (CTQ) Critical to Quality (CTQ). How the customer judges our products/services Y = The outcome measure of the Process X's = Inputs or variables that affect the Y. Defect Failure to deliver what the customer expects DPMO Defects per million opportunities DPMO Defects per million opportunities Variation The enemy of predictable output and customer satisfaction Sigma An expression of Process yield, based on the number of defects per million opportunities (DPMO). defects per million opportunities (DPMO). Six Sigma g A Philosophy p y of f Operational Excellence A set of Problem A Metric A Metric Solving Solving Tools/Tactics A Measure of Process Capability Definitions of Six Sigma ?

9 Definitions of Six Sigma ? A metric A metric Greek letter A measure of Process capability How capable is our Process of meeting our customer's '. expectations? A rigorous, structured approach to problem solving g pp p g Includes a defined Methodology with specific tools and tactics A management philosophy Operational excellence and continuous improvement Operational excellence and continuous improvement Definitions complimentary, not contradictory! p y y Six Sigma as a Metric A statistical concept Represents the variation that exists in a Process Relative to the customer requirements l h A Process operating at a 6 Sigma level SSo little variation, that the Process outcomes are li l i i h h defect free Six Sigma = 6 , 6 Sigma , or 6s.

10 Six Sigma = 6 6 Sigma or 6s Process Sigma Process Sigma DPMO = Defects per Million Opportunities DPMO = Defects per Million Opportunities A more sensitive indicator than % yield or % good Sigma Defects Yield DPMO. 1 691,462. 2 308,538. 3 66,807. 4 6,210. 5 233. 6 When Compared to Best in Class (N i (National Data). lD ). Beta Blocker Use Beta Blocker Use Antibiotic Post MI Overuse Inpatient Medication Accuracy 1000000. 000000. 44,000 98,000. 100000 Preventable Hospital Defects / Miillion Deaths (IOM Report). 10000. 1000. 100 Anesthesia During Surgery 10. 1. 1 2 3 4 5 6. Sigma Domestic Airline Fatality Rate Traditional Process Improvement Traditional Process Improvement 5 & 6 1 Sigma g Sigma 2 Sigma 2 Sigma 3 Sigma 3 Sigma 4 Sigma 4 to 5 Sigma 27 fold Performance Improvement 5 to 6 Sigma Another 69.