Increase Quality, Decrease Waste, Decrease Errors, Decrease Cost, “Sounds Wonderful, but Not Possible !” any CEO or Board of Directors would say, but, we are telling you not only is it possible………..we can do it.
The health care system must work toward optimizing its services to the public, this will be the difference between sustainable profitability and failure.
Joseph Juran linked manufacturing and healthcare directly. In his forward to Curing Health Care, Juran wrote, “As the health industry undertakes …..change, it is well advised to take into account the experience of other industries in order to understand what has worked and what has not. Of course, in the minds of many, the health industry is different. This is certainly true as to its history, technology and culture. However, the decisive factors in what works and what does not are the managerial processes, which are alike for all industries.”
Manufacturing and Healthcare are both multi-functioning bodies which require team work. Although similar, Healthcare systems can be more varied and have many different multi-functioning bodies providing more types of services under one umbrella than the typical manufacture who focuses on one type or group of products. At times the healthcare system is a short and long term “hotel” admitting and discharging people, providing all the amenities required by the vast array of different people of different cultures, ages and socioeconomic levels. In addition to basic “room and board”, healthcare systems must offer routine “maintenance”, manage emergencies, provide testing and in depth treatments all in a smooth seamless manner with the sometimes almost impossible goal of restoring or maintaining the individual and families’ health. Perhaps one if not the most difficult task for the healthcare system is when it must manage, support and work with individuals and families who will not survive or will not survive in a lifestyle as they once previously were able to function and survive.
There is the added complication of the hierarchy of a health system. Doctors in a healthcare system are not employees, but contractors, hospitals are typically “not-for-profit”, the main goal is prevention, cure or ongoing care, which is unique to every individual and situation.
Healthcare has no identified methodology or strategy to identify and improve processes, eliminate ineffective actions or results and waste. Manufacturing, with its’ “for profit” orientation, will not tolerate inefficiency, waste and error. Manufacturing has developed two major processes with the goal of identifying a problem and eliminating waste. They are “Lean” and “Six Sigma”.
Lean is a structured process which looks for and eliminates waste, its’ goal is “Performance Enhancement”. Lean identifies eight (8) types of waste: 1) Inventory, stagnant money; 2) Defects, errors; 3) Motion, poor facility layout; 4) Transportation, moving; 5) Overprocessing, more than is needed; 6) Waiting, idle people or facilities; 7) Underutilization, of staff, professionals; 8) Overproduction, yields inventory or waiting.
Six Sigma is a business management strategy, for “Error Identification and Error Correction”. Six Sigma was originally developed as a set of practices designed to improve processes and eliminate defects, but, as a result of its’ significant success in those areas, the application of this process has grown to include many other types of business processes. In Health care, where the stakes can be: Life versus Death; Healthcare Treatment versus No Treatment or the “Wrong” Treatment, Six Sigma’s business management strategy is gaining new levels of recognition.
Six Sigma directs you to: “Define the Problem”; Collect data pertaining to the output and variables or essentially “Measure” the defined problem. You then “Analyze” this problem area looking for correlations in other areas. Alterations or “changes” are put in place to alter or “improve” the problem you defined. Controls are used to monitor and collect additional information which will provide data demonstrating the success or failure of the alterations/changes upon the identified problem.
Six Sigma uses a set of quality management methods which are then molded to specifically meet the needs of the health care provider. Individuals already working within that health care system, are trained to implement the specific quality management tools for that health care system. This is a “key” to the success of these processes, they are directed at teaching and using the people within the system. When these individuals are trained and able to work within the health care system, this provides for continuous evaluation and improvement within the system.
The goals of each of these management tools are:
1) Increase the quality of the product, in this case the treatment which the individual receives;
2) Decrease the defects or errors which occur in the process of providing this care or treatment to the individual;
3) Decrease the cost of the care and treatment once the defects of errors have been identified and eliminated.
The utilization of these two processes together “Lean Six Sigma” identifies, solves problems through a disciplined methodology which results in sustainable improvements.