1. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM How Six Sigma Can Be Applied to Healthcare Presentation for the Quality Colloquium By Roxanne O’Brasky, president

2. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 2 Setting the Table Appetizer: Brief 6σ introduction Main course: Six 6σ perspectives Widely applicable Including healthcare Dinner is prelude to dessert (Upcoming presentations, case studies)

3. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 3 What is σ? “ σ ” represents variation Inherent everywhere Inconsistency Defects Lack of predictability

4. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 4 What is 6 σ? Process-centered business management Data-driven, structured method Philosophy of evaluation & improvement (ducks in a row)

5. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 5 5 Steps of 6 σ D efine: customer, business process M easure: business-process performance A nalyze: defects’ root causes I mprove: using tech & discipline C ontrol: no backsliding

6. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 6 6 σ : From General to Bullseye Defects results from process inputs Breakthrough (not continuous) improvement 3.4 defects per million opportunities

7. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 7 In Sum… Flawed processes create business defects Data-driven method that reduces variation Goal: Breakthrough levels of improvement

8. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 8 Ways to View 6 σ Projects/Results Methodology Professionals Measurement Management System Culture

9. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 9 6 σ as Projects/Results Save money Average savings $150k (2004 ISSSP benchmarking survey) Improve quality Hospital mistakes = 195,000 deaths (Reuters, 7.27.04) Risk management, save money

10. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 10 HC Defect Opportunities Administrative errors Admission & discharge Claim submission Coding Hiring, payroll Patient records Payables & receivables Reporting & compliance Clinical errors Diagnosis & treatment Lab timing & errors Malpractice & litigation Medication type, frequency, & amount Operating room care carts Patient safety Take-home instructions

11. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 11 6 σ as Methodology But methodology remains the same DMAIC Project-management techniques Reporting methods Projects vary between industries…

12. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 12 6 σ is Flexible Used in diverse industries Manufacturing (to start) Service Transaction IT R&D Healthcare (!!) Integrates other methodologies Lean Hoshin BPM TQM

13. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 13 6 σ as Professionals Stratified by knowledge and expertise: Yellow Belts: Process members Green Belts: Process owners Black Belts: Process improvers Master Black Belts: Process- improvement improvers

14. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 14 6 σ as Measurement Data gathering & interpretation Business activity represented as numbers Justifies & validates: Project selection Project results 6 σ as rational tool

15. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 15 6 σ as Management Systems Includes: Strategic planning/integration Finance Human resources Communications IT Foundation that supports change projects & change professionals Foundation

16. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 16 6 σ as Culture “Little” culture - unique in every company A 6 σ culture is marked by: Shared belief systems Common language & stories Buy-in from management Sameness across business areas Training & learning

17. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 17 Cultural Differences Ketchup Catsup A condiment consisting of a thick, smooth-textured, spicy sauce usually made from tomatoes. (Dictionary.com)

18. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 18 “Big” 6 σ Culture Spans businesses & industries Professionals share, learn, network Industry events (thanks to our hosts) 6 σ -specific events Benchmarking Ongoing comparison & dialog ISSSP’s Web-based tool

19. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 19 To Recap…6 Views of 6 σ Projects/results Methodology Professionals Measurement Management system Culture

20. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 20 Putting it all Together Culture Measure- ment Profess- ionals Employ Method- ology Employs Projects Perform Mgmt. System Support Results Yield Quantifies

21. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 21 Putting it all Together (re)create Influence (re)create Projects Method- ology Culture Profess- ionals Measure- ment Mgmt. System Employ Support Enables Results Support Quantifies Yield Perform (re)create Influence

22. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 22 Summing it Up Q: How can 6σ be applied to healthcare? A: The same as it’s applied elsewhere Q: How can it do that? Q: What makes healthcare different? A: Projects and culture A: Flexibility & dynamism

23. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 23 Clearing the Table Appetizer: 6 σ overview prepared us for main course Main course: Structured understanding thru 6 perspectives Dessert: Upcoming presentations & case studies Before that: Any questions?

24. ISSSP INTERNATIONAL SOCIETY OF SIX SIGMA PROFESSIONALS ISSSP.COM 24 And now… Let’s have dessert