Lean Six SigmaThe UMC Journey

LISA BARRINGTON, PROCESS EXCELLENCE MANAGER

MARK FUNDERBURK, EXECUTIVE VICE PRESIDENT AND COO

Objectives• Review why UMC has chosen Lean and Six Sigma as a

Performance Improvement methodology.

• Review our organizational approach to a Lean and Six Sigma implementation strategy.

• Explore the 2015 Waste Walk including examples of ideas submitted and Lessons Learned.

• Identify our future trajectory for sustaining the methodology within our organizational culture.

Lean and Six Sigma

Lean and Six SigmaHistorical Foundation• Henry Ford Assembly Lines• Pioneers of Statistical Quality Control • Toyota Production System

Objective• Elimination of waste

o Over productiono Waiting or queuingo Transporto Over processingo Inventory (or storage)o Unnecessary motiono Defectso Underutilized employees

Six Sigma - 6σHistorical Foundation• Motorola introduced these principals in 1986• Motorola employee, Mikel Harry, develops the belt

naming convention• General Electric CEO Jack Welch made the method

popular

Objective• Reduce variation in processes• Achieve a Six Sigma level of perfection• Graphic display of data• Statistical analysis

Quality, Speed, and CostCreate process speed if you want to achieve high quality• A process that creates errors cannot maintain speed• A slow process is prone to errors

Low quality and slow speed are what make processes expensive

IHI Triple Aim• Patient experience• Population health• Reduce cost

Teams and ToolsTeams• Executive Sponsor• Physician Sponsor• Team Lead/Process

Owner• Team Members• Subject Matter

Experts• Data Manager• Facilitator

Tools• Project Charters• GOYA• Process Maps• Value Stream Maps• 5 Whys• HFMEA• Visual Controls• Error Proofing

MethodologyDMAIC

Define the problem and what the customers require

Measure the defects and process operation

Analyze the data and discover causes of the problem

Improve the process to remove causes of defects

Control the process to make sure defects don’t recur

Organizational ImplementationFoundation - 2013• Hired a dedicated person to manage the program• Invested in training for the new individual• Engaged a consultant• Selected the first 5 projects

First Five Projects – 2014• B Nursing Non-Value Added Time• B+ Professionals for the Effective Timing of Antibiotics• C OR Efficiency Improving Close to Cut Time• A Decreasing Lab Tests in the Emergency Center• A Discharge Planning: The Voice of the Customer

Organizational ImplementationCurrent Initiatives - 2015• Lean Forward Training• Sustaining the First Five Projects• Waste Walk• 2015 Projects• Lean Daily Management

Lean Forward TrainingLeadership Training

• A component of strategic plan• Focused on key elements of Lean and Six Sigma• Initial focus on hospital leadership (open to everyone)• Six hours of training• Began in January 2015 – 157 individuals trained to date• Leadership Development • 2014 – Pathways to Leadership training event• 2015 – Leadership Council monthly updates

Waste Walk - 2015Ideas will generate• $1,000,000 in savings • Lean and Six Sigma projects

Waste Walk - 2015Learning the Concept• Catholic Health Partners – Ohio• Lifespan Health System – Rhode Island• Floyd Medical Center – Georgia

UMC Plan• Leadership focused• All Directors submit two ideas• Learn to see Waste

Waste Walk - 2015179 Total Ideas• Wide variety• Some Directors submitted multiple ideas• Ideas focused on another department

Classification System DevelopmentComplexity • Just Do It• Moderate Complexity• High ComplexityValue • Non-Value Added Time• Direct Savings• Patient Wait Time Saved

Waste Walk - 2015Just Do It – 95 Ideas

• Focused and tangible• Within the control of a single Director• May not be easy

Resource Assistance• Saved 62 hours of non-value added time by changing how

documents are scanned.• $33,735 in employee time savings.

Food and Nutrition• Purchased a new meat slicer and reduced the amount of ham

and turkey used per week.• $10,601 in cost savings.

Waste Walk - 2015Moderate Complexity – 10 Ideas• Can be completed within 6 months• Require more than one department to implement• Additional review by Administrative staff required

Infection Prevention and Control and Environmental Services• Frost glass in patient rooms and eliminate privacy

curtains. • $29,631 in cost savings.

Waste Walk - 2015High Complexity – 17 Ideas (11 Ideas Considered for Projects)• Uncertain of timeline required to complete• Requires multiple departments• Possible capital request or multiple FTEs• Additional review by Administrative Staff required

Revenue Integrity• Minimize printing costs by duplexing copies• A 17% reduction = $61,250

Waste Walk - 2015The Value of an Idea

• Goal $1,000,000

• Value Categories• Non-Value Added Time• Direct Savings• Patient Wait Time Saved

Waste Walk - 2015Non-Value Added Time Savings = $453,979 • Non-Value added activities are inefficiencies within a process• Customers are not willing/should not pay for inefficiency

Laboratory• Leveraged available technology to auto-verify results• $19,198 time saved annually

Trauma Services • Identified unnecessary data abstraction• $6,261 time saved annually

Waste Walk - 2015Direct Savings = $1,408,514 • Evaluate current work from the perspective of Waste results

in cost savings

Trauma/Surgical ICU and Burn • Burn step down staff now manage all burn wound care

independent of Physical Therapy• $75,697 in annual savings

Nursing Education• Nursing departments will no longer pay administrative

time for nurses attending class that is not required• $6,205 in annual savings

Waste Walk - 2015Patient Wait Time Savings = $243,365• Waiting is considered Waste and impacts customer satisfaction

3 West• Patients are discharged home after their final physical

therapy session rather than returning to their room for nursing to complete the discharge process

• Patient Flow improvements worth $5,100

Heart Center• Increased Cardiology coverage minimizes diagnostic study

turn-around times• $132,000 in savings

Waste Walk - 2015Benefits and Lessons Learned

• Effective method to influence the development of a Lean culture

• Identifying Waste is not as easy as it seems• Ideas crossing departmental lines require management• Identify Waste in your own department is difficult and

requires transparency• Executive Leadership had to make decisions on some ideas.• Administrative Leadership assisted with idea valuation • Administrative Leadership has to ensure ideas are

implemented and budget changes made

2015 Projects• Idea themes generated by Administrative Staff • Physician Leadership Retreat ideas included in review• Themes refined and scoped for team development

Projects• Patient Flow - Discharge Process• Follow-Up Appointments• Supply Chain• Physician Handoff• Physician Call Schedules

Lean Daily ManagementLearning the Concept• North Mississippi Medical Center• Baylor• Zale Lipshy• Advocate, Chicago• University of Utah• Baltimore Medical Center• Virginia Mason

Goal• Turn our staff into accountable, focused problem solvers every shift• Visual transparency of patient outcomes at the point of care in real time• Use a standard, low tech method of data collection • Administrative staff rounding at boards for analysis and issue resolution• Begin 4th Quarter 2015

SummaryUMC Journey• Selecting the Methodology• Lead Forward Training• Waste Walk• 2014 Projects• 2015 Projects• Lean Daily Management

Questions?