Lean Six Sigma was initially developed to reduce waste and improve quality in the manufacturing world, but the methodology has now been successfully applied across a wide variety of industries, including healthcare, the service sector, and now the federal government. The Army executes Lean Six Sigma through its Office of Business of Transformation and that culture of continuous improvement has recently spread to the United States Military Academy, West Point.
In early February, West Point hosted a day-long Lean Six Sigma Yellow Belt certification course. The session resulted in 33 new Yellow Belt practitioners from 10 organizations across the academy. A similar training day in September 2016 resulted in 34 trainees, so West Point now boasts 67 Yellow Belt holders.
Bolstered by the support of local military and civilian leaders who support Lean Six Sigma training, West Point is eager to continue to train cadets, faculty, and staff in an effort to do more with less. Col. Doug McInvale, Math Professor and Master Black Belt, reflected on the recent training session, noting, “We’re just building on years of success by local operations researchers and responding to positive feedback from our recent events.” He also reported that dozens more people are on waiting lists for future training events!
The Army has been reporting cost savings and improved quality for several years as a result of Lean Six Sigma implementation, and West Point hopes to build on that success. The goal is to select a number of the new Yellow Belt holders to continue their training and become Green and Black Belt certified so more advanced problem solving principles can be introduced across the organization. In fact, plans are underway to hold a two-week Green Belt training program on campus during Summer 2017.
McInvale is optimistic about the future of Lean Six Sigma training at West Point. He explained, “Lean Six Sigma is not magic, but the philosophy and tools promote quality across many areas.” He is particularly excited about benefiting the community as a whole by connecting quality people with quality improvement achievements using local processes.
Lean Six Sigma is making a difference in the Army and at West Point and it can dramatically impact your company, too. Interested in bringing Lean Six Sigma Training to your business? Contact us today to learn more about the Lean Six Sigma method and find a training program that fits your needs!
A Boston hospital has decreased its cesarean delivery rate by 13 percent through a quality improvement initiative.
A Boston hospital has decreased its cesarean delivery rate by 13 percent through a quality improvement initiative. According to a press release from The Joint Commission Journal on Quality and Patient Safety, a clinical instructor at Harvard School of Medicine teamed up with a maternal fetal medicine doctor from Beth Israel Deaconess Medical Center for a seven year study that produced five factors that may impact the cesarean delivery rate in women who are carrying one fetus, presenting in the head down position.
Women in this category are at lower risk for a cesarean than those carrying multiple fetuses or a fetus in the breach position, the release stated. The factors that cause cesareans in single, head-down presentations include the interpretation of fetal heart rate findings; the provider’s tolerance for labor, the induction of labor, the provider’s awareness of the cesarean rate for this category of patients; and environmental stress. After identifying these factors, the team spent seven years — from 2008-2015 — developing a multi-strategy approach that involved provider education as well as new policy that would reduce the number of cesarean deliveries.
Data was then collected regarding fetal, maternal, and neonatal outcomes from the births that were impacted by this new approach. Analysis was considered on more than 20,000 deliveries during the initiative, and the cesarean delivery rate for women in this category was reduced from 34.8 to 21.2 percent of the births. The total cesarean delivery rate for women at the hospital was reduced from 40 to 29.1 percent.
The study stressed the need for a cultural change in maternity units across the country to mitigate the recent rise in cesarean deliveries. It’s a change, the press release noted, that requires commitment and the willingness of hospitals to use multiple approaches in their quality improvement projects.
Six Sigma provides the skills to look at quality improvement from a number of angles in order to produce the best outcome. Want to know more about how Six Sigma can help you improve the way your business operates? Contact us.
Embarking upon improving quality within large companies is an overwhelming task. While turning to consultants, implementing support software programs, or looking to management may be the initial impulse, recent efforts have shown that turning to staff for leadership in quality improvement endeavors may be the better option.
Letting Hospital Staff Lead Quality Improvement Efforts
One of the most influential reviews of this type of quality improvement effort is explained in an article by Health Leaders Media. Hospitals are employing a “high reliability” technique. Per Health Leaders Media, “high reliability is the technique of standardizing high-risk processes.” In short, this technique helps to create an internal learning system where staff members are able to provide real-time feedback on processes.
Per Jay Bhatt, D.O, chief medical officer and president of the Health Research and Educational Trust of the American Hospital Association, high-reliability hospitals push staff to enter leadership roles as they are acutely “aware of how different processes and systems effect the organization … Each member of the staff is really thinking about those operations.”
Outside of the high reliability setting, an internal learning system aids companies to meet the learning or training needs of staff, primarily field staff, participants, as well as larger groups. This type of quality improvement effort is designed for success.
The Pyzdek Institute is a high-quality, easy access online resource for Six Sigma training and certification. Founded by Thomas Pyzdek, author of the Six Sigma Handbook, The Pyzdek Institute offers the ease of either a self-study or guided program using Pyzdek‘s knowledge and extensive network. For more information regarding or to speak with a representative directly, please feel free to contact us.
There seems to be a lot of mystery associated with how companies that make continuous quality improvement work actually do it. In his article Ten Common Misconceptions About Toyota Stewart Anderson sets the record straight about how Toyota actually works its magic. The gist of the article is that Toyota doesn’t follow some rigid set of rules mindlessly. They have a small number of guiding principles to guide them, and they apply them as consistently as is practical to do so
Toyota’s basic pattern for improving a process is based on a simple three-part model:
Understanding the current condition.
Developing and defining a target condition.
Understanding and tackling problems which need to be overcome to move from the current condition to the target condition.
In other words, go from the staus-quo to a new state that is better. All of the hubub about Six Sigma, Lean, or any of the other approaches advanced during the past three-quarters of a century or so is nothing more than the attempt of managers who don’t really understand that this is all there is to it. The reason, I believe, is that our managers are taught by business school professors who are, philosophically, pragmatists. And pragmatism is all about eschewing guiding principles. In fact, they don’t even think there is such a thing as a principle. Pragmatists just want to know what works, not why it works.
This may sound like a good approach at first glance, but it’s a blind alley in the long run. For pragmatists — knowledge of the world is impossible to separate from actions upon it. There is no reality out there — both facts and values are products of men interacting with an environment and shaping it to their wills. If there are no facts per se, then what is the use of principles which are intended to guide action long-term? The goal of thought is merely to reconstruct the situation in order to solve the problem. If the proposal, when implemented, resolves the issue, then the idea is pragmatically true. Truth cannot be known in advance of action. One must first act and then think. Only then can reality be determined.
But there is a reality, and there are principles. Engineers and scientists — and Toyota — know that discovering what makes things tick is the only way to truly know how to make them better. This is the way to continuously improve.
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Click here to go to the Amazon.com page for the Six Sigma Handbook. #1 Best Seller in Industrial Quality Control on Amazon.com.
Publication Date: May 13, 2014
The most complete, current guide to Six Sigma
“Best practices in Six Sigma are continuously evolving, just as Six Sigma itself evolved from earlier best practices in quality improvement. …This fourth edition…(features) expanded materials on innovation, strategic development, Lean, and constraint management. …You’ll notice many references to free online materials within the text, such as Excel file templates that can be used for analyzing projects, or videos that provide an in-depth narrative on specific topics. Additional links will be added over time to further extend the learning potential offered by the text, so be sure to regularly check back into the online site at www.mhprofessional.com/SSH4.” —From the Preface by Paul Keller
The Six Sigma approach is being used to vastly improve processes, profitability, sustainability, and long-term growth at global organizations of all sizes. Fully revised for the latest developments in the field, The Six Sigma Handbook, Fourth Edition, reveals how to successfully implement this improvement strategy in your company.
The book explains how to define and deploy Six Sigma projects focused on key stakeholder requirements and carry out data-driven management. This comprehensive resource walks you through the phases of DMAIC and DMADV and demonstrates how to use the statistical tools and problem-solving techniques of Six Sigma with screenshots of Minitab and Excel applications.
The new edition has been updated to include:
Two online quizzes for Six Sigma certification, one for Green Belt candidates and one for Black Belt candidates
Links to five videos that walk you through specific processes, such as Minitab functions, statistical process control, and how to read a Pareto chart
Fully incorporated coverage of Lean methodologies
Find out how to select the right personnel to train, achieve technical proficiency, build the best teams, and foster effective leadership. Improve the quality of processes and products in your organization, increase customer satisfaction, and boost profits with help from this definitive guide to Six Sigma.
Written by two of the foremost authorities on the subject, this authoritative resource delivers all of the guidance you need to successfully implement Six Sigma. Comprehensive coverage includes:
With the arrival of the Accountable Care Organization and the Patient-Centered Medical Home, physicians face a new challenge. They must assess how they provide healthcare in such a way that they become more valuable to patients, efficient in their clinical practices, and effective to their bottom line.
Enter Lean Six Sigma, which has gotten some notice in the medical field recently.
ACO and PC Medical Home
An Accountable Care Organization, according to this article from Kaiser Health News, is a local healthcare organization and a related group of providers(such as primary care physicians, specialists, and hospitals) that are held accountablefor the cost and quality of care delivered to a specific patient population.
According to the U.S. Department of Health and Human Services, a Patient-Centered Medical Home provides relationship-based healthcare focused on providing care to the whole person by connecting with “patients and their families to understand and respect each patient’s unique needs, culture, values, and preferences.”
Both ideas revolve around the concepts of improving outcomes and quality while lowering costs – “producing results not volume.”
ACO, PCMH, and LSS
According to the October 2012 American Hospital Association Trendwatchreport, regardless of whether you use Lean, Six Sigma or another model, there are important steps to improve quality:
Identify target areas for quality improvement efforts. To ensure a higher likelihood of success, first determine where you will get the most for your efforts. For example, the Joint Commission developed protocols to prevent wrong-site surgery. “In 2011, organizations following the protocol reported reductions in the proportion of surgical cases in which there was a process-related defect that could result in a wrong procedure.”
Determine what processes to adjust to improve outcomes. According to the report, despite safety protocols, there is room for improvement. Point in fact, hand hygiene compliance, thought to be at 70% or higher, was actually less than 50%.
Develop and implement effective improvement strategies. Quality gains and cost savings come from well-designed, well-executed strategies.
Track and share results. To further quality improvements, track and disseminate successful quality strategies to maximize future success throughout the organization.
Ultimately, healthcare must be about improving and maintaining the health of patients as well as controlling costs through proactive and preventative care, not reactive care.
Donald Berwick, a Harvard University professor and leading advocate for improving health-care quality and efficiency, has been named by President Obama as his choice to head the Centers for Medicare and Medicaid Services (CMS.)
Donald Berwick, a Harvard University professor and leading advocate for improving health-care quality and efficiency, has been named by President Obama as his choice to head the Centers for Medicare and Medicaid Services (CMS.) Berwick is well-known in Quality circles for aggressively advocating quality improvement in healthcare. Berwick, who specializes in health-care policy and pediatrics, has never led such a large organization. As head of the Boston-based Institute for Healthcare Improvement, however, he is known for persuading doctors and hospitals to adopt innovative methods for reducing medical errors. Dr. Berwick is author of numerous articles and books, including the classic work demonstrating the application of quality technology to health care issues, Curing Health Care. He is one of the nation’s leading authorities on health care quality and improvement. He is also Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School, and Professor in the Department of Health Policy and Management at the Harvard School of Public Health.
If confirmed by the Senate, Berwick will face a number of daunting challenges. One is the sheer size of the CMS, which is about to become even larger. The agency, which is part of the Department of Health and Human Services, must oversee a massive expansion of Medicaid, the federal-state insurance program for the poor, with an estimated 16 million people expected to join its rolls by 2020. At the same time, Medicare, the insurance program for the elderly, will need to reduce payments to health-care providers by about $400 billion over 10 years without impacting the quality of coverage. Lean Six Sigma and Quality technologies provide an approach for doing this while minimizing the impact on value-added health care processes, operations and activities. Berwick’s familiarity with these areas provides reason for optimism or, at least, hope. This blog has frequently posted examples of poor quality in health care. Let’s hope that Dr. Berwick will have a positive impact at CMS.
However, nearly all of you have a big advantage: you have a lot of job experience. And much of your experience is closely related to Six Sigma.
Since I started teaching students online a year ago I’ve encountered something new: students trying to get into Six Sigma for the first time. This obviously wasn’t a problem when I was training clients whose employers were getting them trained specifically to use the approach in their organizations. I write this for those of you who are trained in Lean Six Sigma and are in the situation that you are not working for an employer who gives you the chance to practice your newly acquired skills.
However, nearly all of you have a big advantage: you have a lot of job experience. And much of your experience is closely related to Six Sigma. Many of you have led project teams, quality improvement teams, or other work teams. This is, of course, a big part of Six Sigma work. Play it up in your resumes!
You can also try finding projects where you can enhance your resumes by actually applying what you’re learning in your training. I’ve done pro bono work for community hospitals and charities such as Goodwill and Red Cross. Some of my self-study students are working with their physicians offices to reduce errors and improve efficiency. Others are working with church groups to help improve attendance at churches or church events, lower costs, or improve the satisfaction of those who attend. My guess is that few churches wouldn’t be interested in Six Sigma projects to increase collections!
The most important thing to realize is that you have an extremely useful skill set. Be bold and confident when you approach your prospective “client” for a project. Six Sigma has been proclaimed by management guru Jack Welch as the most significant management innovation in the past quarter century. You’re learning about an approach that few know and nearly everyone can benefit from. You’ll be surprised at how much fun it can be, and how productive. Finally, this stuff really works! You’ll soon find that your skills are soon in more and more demand. After all, the supply of processes that need to be improved is infinite!
Like many, I am concerned about healthcare in America. The above story outlines a number of issues with our system
A medical error rate 5 to 9 times higher than some other countries
Out of control healthcare costs
The author discusses the fact that Six Sigma has only recently been introduced in American healthcare, and then only on a limited basis. He details a horror story involving his father’s care and decries the fact that such stories abound. From this he concludes that the solution to these problems is…more government involvement in American healthcare.
I’m sorry, but I don’t get the connection. I agree with the above facts and would dearly love to have American healthcare professionals use more process excellence methods, including Six Sigma, Lean, and quality improvement. But I don’t see how more government addresses the root cause of our problems. In fact, I see little or no effort made to drill down to the root cause of the problems in healthcare. Let me make a stab at it.
I believe that government programs have contributed to the problem by helping create a disconnect between the patient and the healthcare provider.
I believe that the current system limits the choice of patients as to who will provide their care.
I believe that patients do not have access to the information they need to adequately assess the quality of their healthcare providers.
I believe that special interests (e.g., pharmaceutical companies, medical device companies, insurance companies, professional groups, etc.) manipulate government programs and limit access to information for their own advantage.
I believe that political groups use the fear of illness to manipulate voters for the interests of the politicians.
I believe that more government control of healthcare would exacerbate the above problems.
I believe that solutions that address the disconnect between the person who provides the healthcare and the person who receives and pays for it will ultimately be needed to fix the problem. This is, I believe, the root cause of our current problems. An ideal solution would be one that:
Provides patients with complete, up to date, and accurate information on their provider. This would include information on outcomes, error rates, complaints, etc.
Allows patients to choose their care provider.
Provides patients with price data in advance.
Protects patients from paying for poor quality care, including any problems caused by misdiagnoses, complications from poorly done procedures, infections due to poor practices, etc.
Requires patients to pay at least some of the cost of their care directly to the provider. Enough to make the patient care about costs.
In other words, I believe more freedom and more responsibility for patients would address the core problem of the current system. I believe that when patients are free to choose their care provider, have complete information on quality and price, and have a personal interest in the cost of their care, they will make better choices than faceless and nameless bureaucrats employed by insurance companies or the government.
Not to lay the whole blame on government. I believe that the process and quality improvement professions have a great deal to offer the healthcare profession in the form of methods, tools, techniques and systems to improve. But healthcare professionals are overly resistant to such suggestions, at least party because of parochialism and perverse incentives. Examples of perverse incentives include physicians paid to treat complications they either cause or could have prevented, or hospitals obtaining revenues for patients whose length of stay increases because of infections contracted in the hospital. If patients were provided the information they need to make the right choices, the ability to make these choices, and the financial incentive to do so, intransigent providers would either improve or pay the price in the market for health care services. Ultimately, this would drive the demand for the services of quality and process improvement professionals. It’s what did it for every other industry in the world.
It seems as if American managers are, for some reason, immune to learning the quality improvement approach that was invented in the USA. Until they manage to do so, expect to see continued declines and job losses.
Toyota Motor Corp (7203.T) said on Friday it would consider liquidating its stake in a California-based joint venture with General Motors Corp (GMGMQ.PK) after the U.S. automaker pulled out of the venture. The venture started 25 years ago and it was originally set up in an attempt to help GM learn more about Toyota’s Lean manufacturing technique. Toyota was looking for a US presence to help them deal with import restrictions imposed on them by the US government in an attempt to help protect US automakers from Japanese competition.
How has that worked out?
Toyota surpassed GM as the world’s largest automobile manufacture in 2008, while GM begged for a government bailout and declared bankruptcy. Over two decades later Toyota continues to practice lean in a culture dedicated to continuous innovation and improvement, US automakers GM and Chrystler seek government handouts. It seems as if American managers are, for some reason, immune to learning the quality improvement approach that was invented in the USA. Until they manage to do so, expect to see continued declines and job losses.