1. POWER OF SIX SIGMA IN HOSPITALS & HEALTHCARE MANAGEMENT
DR. PRADEEP BHARDWAJ Medical Director & CEO Six Sigma Star Healthcare, Delhi Six Sigma Accreditation Board
<< 7 National Awards I 2 LIMCA Book Record Holder >>
Visiting Faculty : IIM-Ahemdabad, IIM-L, ISB-Hyderabad, AIIMS, National Board of Exam, GIHM Delhi
Listed under India’s TOP-10 Doctors (Hospital Management)
Rajiv Gandhi Award – 2010 (First in Healthcare Management)
Youth ICON Award – University of Delhi
Rashtriya Ratan Award in Healthcare
Youngest Medical Superintendent in India (Limca Book)
Padma Award (Nominated by CM Delhi)
Indian Achiever Award – UAE Govt.
Shram Shri Award – 2012
Best Enterprise Award – Oxford, UK

2. Briefly About “Six Sigma Healthcare” Delhi
Rated No – 1 (Healthcare Management Company) by HBS.
Six Sigma Managing hospitals and successfully delivered over 1200 healthcare projects. (Hospital Planning/ O & M / Med. Education/ Quality)
Managing operation of more than 2600 bed across the India, having staff strength of 7500.
Managing 30 Post Graduate Hospitals/ Institute.
GIHM Offering 45 Doctorate/ PG/ Master Degree / Diploma in Healthcare
Offering one stop solution for all healthcare management (MM, July 2010)
Geographic footprint in 42 Cities of India.
2 Monthly Magazines – Medgate Today & Six Sigma Health Express
High Altitude Medical Services at Any Time- Any Where – Any Amarnath Yatra - JK, Kailash Mansarover- China, Nepal Earthquake, UK Flood
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

3. Outsource it to Consultants
Current Scenario of QUALITY in Healthcare
QUALITY : BUSINESS OF OUTSOURCING
Outsource it to Consultants
If u can’t do it yourself….

4. Six Sigma - Global Acceptability
“Six Sigma aims for world-class performance”
Encourage and stimulate greater
Accountability and Transparency
NO Constraint if you Implement Six Sigma
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

5. CPD (Continue Professional Development)
How you are DIFFERENT ?
What value addition you can do ?
What is yours STRATEGY ?
If “SYMBIOSIS Post Graduate” does not showcase the ‘Next Big Things..then WHO will ?
Rules of the GAMES are going to CHANGE..Be ENSURE, You change them.
If you Don’t GROW, the Competition will grow
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

6. INTRODUCTION Patients are the foundation of our medical practice.
A Patient can survive without a Doctor but
A Doctor cannot survive without a Patient.
Poor customer-service is a Worldwide problem.
Great customer-service is the Backbone to all successful businesses

7. DEALING WITH THE QUESTION OF LIFE & DEATH
IN OUR PROFESSION THERE IS
NO SCOPE FOR ERROR.
FOR,
ANY ERROR COMMITTED
IS ALL THE DIFFERENCE BETWEEN
LIFE AND DEATH,
BETWEEN
RELIEF AND DISABILITY
THERE IS NO SECOND CHANCE

8. Your first question is likely…. What is Six Sigma?
Your second question is likely…
Why Six Sigma?
The term “Six Sigma” was coined by Bill Smith, an engineer with
Motorola
•Late 1970s - Motorola started experimenting with problem solving
through statistical analysis
• Motorola officially launched it’s Six Sigma program
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

9. Presentation Outline
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI (

10. Presentation Outline ….
An Introduction ….What is Six Sigma ?
International Accreditation..Country wise
JCI vs NABH vs Six Sigma
What Six Sigma can do ?
Most Popular Outcomes from Six Sigma
How Six Sigma is Different ?
Steps in Six Sigma.
When to use it.
Implementation Road Map.
Education & Training in Six Sigma.
Success Factor for Six Sigma.
Six Sigma Learning Institutes.
Six Sigma online learning centre.
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

11. Six Sigma in Healthcare
Six Sigma can change the face of modern hospital & healthcare delivery system.
Corporatization and Competition in healthcare sector is forcing the organization to look for the new ways and mean for improving their process so that the quality of the products and services improve, dissatisfaction reduces and patient satisfaction increases.
Hospitals involve highly qualified professionals dealing with the question of Life & Death.
Hospital Administration is more complex than Administration of any other Business Institute / Organization .
“GREAT CAREER Opportunities in Six Sigma International Levels”
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

12. Healthcare become more complex, the opportunities for error abound.
As Healthcare become more complex, the opportunities
for error abound. Most of the corporate hospitals functions at a three sigma to four sigma quality level and patient safety is usually described by medical mistakes.
There is a need to breakdown the traditional boundaries that
separate Physicians, Hospital Administration, Pharmacist, Technician, Nurses by shifting away from a culture of blame and working together to systematically design safer, more
effective and efficient systems
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

13. What is Six Sigma?
Statistically-based process improvement methodology which aims to reduce defects to a rate of 3.4 per million opportunities.
This reduction is achieved by identifying & eliminating variation in process.
Through defining “defects” the Six Sigma process focuses on customer requirements, and thus is very customer orientated.
Fundamental methodology of Six Sigma is based on “DMAIC” an acronym: Define, Measure, Analyze, Improve, & Control.
Six Sigma is not a quality management system, or quality certification system like ISO-9001.
THE FOCUS ON DEFECTS IS SHIFTED FROM CHECKING PRODUCTS FOR DEFECTS TO IMPROVING THE PROCESS SO THAT DEFECTS DO NOT OCCUR.
Quality excellence to enhance your customer and boost your organization’s bottom line

14. Six Sigma Belt’s
Master Black Belt: Highest level of technical & organizational proficiency. These individuals provide technical leadership to the program, as well as provide most of the training. Because of this communications & teaching skills are as important as technical competence.
Black Belt: A technically minded individual with a strong background in college level mathematics & statistics. The Black Belt provides much of the quantitative analysis involved in the daily six sigma project.
Green Belt: Six Sigma project leader, capable of facilitating six sigma teams & projects from conception to completion. Training for green belts in much less than Black, with emphasis on project management, and quality control. These individuals are not employed full time on six sigma projects.
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

15. International Accreditation..
India: National Accreditation Board for Hospitals & Healthcare Providers (NABH)
USA: Joint Commission International
United Kingdom: QHA Trent Accreditation
Australia: Australian Council on Healthcare Standards International (ACHSI)
New Zealand: Quality Health New Zealand (QHNZ), QHNZ quality standards are based on those used in Australia and Canada. QHNZ is accredited by the international umbrella organization, the International Society for Quality in Healthcare (ISQua).
Canada - Accreditation Canada
France - HAS (Haute Autorité de Santé)
ISQua is the umbrella organization responsible for accrediting the Joint Commission International (JCI) accreditation scheme in the USA and Accreditation Canada, as well as accreditation organizations in the United Kingdom and Australia.
UKAF ( United Kingdom Accreditation Forum) is responsible for accrediting accreditation schemes in the United Kingdom
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

16. JCI by FACTS JCI Founded – 1951 821 Accreditation Done (Total)
27 Accreditation in INDIA
15 Languages – JCI 5th Std.
90 Country having JCI Accreditation
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

17. NABH vs JCI NABH Accredited Hospital : 337
JCI Accredited Hospital in India : 027
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

18. Success is based on your PEOPLE ON THE OTHER HAND…..
ON THE ONE HAND…..
Success is based on your PEOPLE
ON THE OTHER HAND…..
Success is based on your PROCESSES
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

19. The Six Sigma Accreditation Journey: GENERAL SUGGESTIONS
Senior management must be committed: without top management support six sigma projects are doomed to failure.
Training the right people: People selected for a six sigma initiative should be motivated by compensation, rewards, recognition & promotion.
Selecting the right project: Initial six sigma projects should be focused on key problem areas with impact to critical aspects of business success.
Set a realistic timeframe for preparation, such as 3-6 months
Allocation of resources: may include facility enhancement, Six Sigma training, recruitment of Qualified Manpower, and redesign of systems
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

20. LEADERSHIP SKILLS FOR SIX SIGMA
Getting and Giving Information
Understanding Team Needs and Characteristics
Understanding Team Resources (SWOT)
Controlling the Team
Counseling
Setting the Example
Representing the Team
Problem-Solving
Evaluation
Sharing Leadership
Manager of Learning

21. DR. PRADEEP BHARDWAJ @ SIX SIGMA HEALTHCARE, DELHI

22. SIX SIGMA ACCREDITATION - NEW
Powerful Quality Tool – Low Cost Investment
Higher Patient & Staff Satisfaction
World class Recognition
Benchmark of Quality Healthcare Service
Eliminate the ‘I don’t know’
DMAIC - Methodology
Reduce overtime, Employee Turnover & Error
Improve Health Services & Accuracy
Make sound data driven decisions
Six Sigma Impact Bottom Line Improvement
Opportunity to serve organization with power & status
Matter of Great Pride for the Staff, patient & Management
A better ambiance for innovation & creativity is observed.
Error free process
NO chance of medication mistakes.
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

23. SIX SIGMA COURSES
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

24. DR. PRADEEP BHARDWAJ @ SIX SIGMA HEALTHCARE, DELHI

25. TRAININGS & CERTIFICATIONS
If you want to make yourself more valuable and attractive to employers then get training and certification
Option I – Certification as Six Sigma Green Belt
Option II – Certification as Six Sigma Black Belt 25
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

26. National Record: Six Sigma Accreditation of
SIR GANGARAM HOSPITAL, New Delhi
Link - About IJCP- IJCP BOOK OF MEDICAL RECORDS The IJCP Group was founded in 1990 by Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal and was the pioneer of medical journalism in India. ‘The Indian Journal of Clinical Practice’ which was launched by Dr S D Sharma, former Vice President of India. Today, IJCP reaching over 200,000 doctors per month and working with over 60 pharmaceutical companies in a year. IJCP Book of Medical Records is the only accreditation body in India to document and publish exclusivity authenticated health and medical records. The records cover the firsts or the maximum in the medical and health field. The records are in the form of claims as authenticated by the sender as on the day of approval. The records can be used as part of a personal bio data or institution's achievements. IJCP -Recent Records- Gangaram Hospital, Delhi (750 Bedded) is awarded top quality accreditation – SIX SIGMA Heart Care Foundation of India: The Only NGO to have three national commemorative postal stamps Largest Health camp attendance in a day organized by an NGO Only DMA President to have received both Padmashri and Dr B C Roy National award Dr K K Aggarwal, First Indian to have chapters in first text book of Color Doppler Echocardiography Clot Dissolving Therapy in India Dr K K Aggarwal first Indian to have chapters in first text book in contrast echo 1st Pacemaker Bank in India 1st Public Conference of Heart Care Foundation of India 1st National Echo Cardiography Institute in India In Press Interviewing Dr Naresh Trehan 1st Color Doppler Echo Free Checkup Camp in India
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

27. MOST POPULAR OUTCOMES FROM SIX SIGMA
International Hallmark of Quality Excellence
Higher satisfaction (Patient/ Staff)
FEW COMPLAINTS.
IMPROVED PROCESSES
INCREASED ACCURACY.
REDUCED WAIT TIME & VARIATION.
SAFER & MORE EFFICIENT EMERGENCY SERVICES.
FEWER MEDICAL ERRORS & DEFECT.
Increase service orientation.
Eliminate the ' I don't know' factor.
Certification by External Agency
Matter of Great Pride
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

28. MOST POPULAR OUTCOMES FROM SIX SIGMA..Cont..
Generates sustained success
Sets performance goal for everyone
Enhances value for customers
Accelerates rate of improvement
Promotes learning across boundaries
Executes strategic change
Systemizes the processes
Adds great value in Medical Tourism
International Recognition
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

29. Six Sigma Hospitals Max Healthcare Long Island Jewish, New York
Stanford Medical Center, CA
Northwestern Memorial, IL
M.D. Anderson, Texas
Virtua Health System, NZ
Charleston Area Medical Center, WV
Boston Medical Center, MA
Yale New Haven Medical Center, CT
Verdugo Hills Hospital, CA
Johns Hopkins Hospital, MD
Good Samaritan Hospital, Ohio
Sir Gangaram Hospital, Delhi, India
Fortis Hospital
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

30. Companies in almost all sectors have a Six Sigma success story
SIX SIGMA COMPANIES
Hospitals: Gangaram, Max, Apollo, PD Hinduja, Fortis, Rainbow, Amrita
Pharma: Pfizer, Baxter, Johnson & Johnson
Hospitality: ITC Hotels, GRT Hotels, TajHotels
Manufacturing: Motorolla, GE, Wipro, Nestle, Samtel, Samsung
Banking: HDFC, HSBC, BOA, American Express
Telecom: Airtel, Vodafone, Siemens, Tata,
IT: Wipro, Satyam, Acenture, Infosys, TCS, Birlasoft
Companies in almost all sectors have a Six Sigma success story
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

31. Defects Per Million Opportunities Rate of Improvement 1  690,000 2 
Sigma Level
Defects Per Million Opportunities
Rate of Improvement
1 
690,000
2 
308,000
2 times
3 
66,800
5 times
4 
6,210
11 times
5 
230
27 times
6 
3.4
68 times
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

32. Six Sigma Project Methodology
Control
Define
Measure
Analyze
Improve
Establish standards to maintain process;
Design the controls, implement and monitor.
Evaluate financial impact of the project
Identify, evaluate and select projects for improvement
Set goals
Form teams.
Collect data on size of the selected problem,
identify key customer requirements,
Determine key product and process characteristic.
Analyze data, establish and confirm the “ vital few “ determinants of the performance.
Validate hypothesis
Improvement strategy
Develop ideas to remove root causes
Design and carry out experiments,
Optimize the process.
Final solutions
Project Phases
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

33. Six Sigma DMAIC Improvement Process Road Map
Define
Measure
Analyze
Control
Improve
Activities
Identify Problem
Validate Problem Statement
Gather Voice of the Customer & Business
Develop CCR’s & CBR’s
Validate Goal Statement
Validate Business Case
Validate Project Scope
Select and Launch Team
Develop Project Schedule
Complete Define Gate
Appropriately Map Process
Identify Key Input, Process and Output Metrics
Develop Operational Definitions
Develop Data Collection Plan
Validate Measurement System
Collect Baseline Data
Determine Process Performance/Capability
Complete Measure Gate
Identify Potential Root Causes
Reduce List of Potential Root Causes
Confirm Root Cause to Output Relationship
Estimate Impact of Root Causes on Key Outputs
Prioritize Root Causes
Complete Analyze Gate
Develop Potential Solutions
Develop Evaluation Criteria
Select Best Solutions
Develop ‘To-Be’ Process Map(s)
Develop Pilot Plan
Pilot Solution
Develop Full Scale Implementation Plan
Complete Improve Gate
Implement Mistake Proofing
Develop SOP’s, Training Plan and Process Controls
Implement Solution and Ongoing Process Measurements
Identify Project Replication Opportunities
Complete Control Gate
Transition Project to Process Owner
Kaizen, 5S, NVA Analysis,
Generic Pull Systems, Four Step Rapid Setup Method
Identify and Implement Quick Improvements with Kaizen
Tools
Project Charter
Project Selection Tools
PIP Management Process
Value Stream Map
Various Financial Analysis
Effective Meeting Skills
Stakeholder Analysis
Communication Plan
SIPOC Map
High-Level Process Map
Project Management Tools
VOC and Kano Analysis
RACI and Quad Charts
Process Mapping
Process Cycle Efficiency
Little’s Law
Operational Definitions
Data Collection Plan
Statistical Sampling
Measurement System Analysis
TPM
Generic Pull
Setup Reduction
Control Charts
Histograms
Constraint Identification
Process Capability
Value Analysis
Process Constraint ID
Takt Time Analysis
Cause and Effect Analysis
FMEA
Hypothesis Tests
Correlation Analysis
Simple and Multiple Regression
ANOVA
Components of Variation
Conquering Product and Process Complexity
Queuing Theory
Control Charts & SPC
Standard Operating Procedures (SOP’s)
Training Plan
Communication Plan
Implementation Plan
Process Control Plans
Visual Process Control Tools
Project Replication
Project Commissioning
Team Feedback Session
Brainstorming
Replenishment Pull/Kanban
Stocking Strategy
Process Flow Improvement
Process Balancing
Analytical Batch Sizing
Total Productive Maintenance
Design of Experiments (DOE)
Solution Selection Matrix
‘To-Be’ Process Mapping
Poka-Yoke

34. Real World Examples Organization Project Outcome Achievement
Charleston Area Medical Center
Supply chain for surgical supplies
Lower inventory, Improved supplier relations
Saved:
$163,410 immediately $841,540 future
Commonwealth
Health Corporation
Radiology
Decreased time between dictation and signature, Improved wait times and staff scheduling
$800,000 savings, 25% better throughput and eliminated 14 positions
Froedtert Memorial Lutheran Hospital
ICU lab times
Reduced turnaround times
Cut turnaround times from 52 to 23 minutes
Mount Carmel Hospital
Medicare+ Choice Plan reimbursement
Redefined coding working-aged Medicare recipients
Profit $857,000
Wellmark Inc.
Physician addition to managed care network
Reduced time for adding physicians to medical plan
Savings: $3 million per year
Scottsdale Healthcare
Over crowded ED
Improved transfer time from ED to inpatient hospital bed
Profits: $600,000
Slightly altered table adapted from “Integrating Six Sigma with Total Quality Management: A Case Example for Measuring Medication Errors”. Revere, Lee and Black, Ken. Journal of Healthcare Management. 48:6 November/December

35. Six Principles for Quality Improvement
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

36. Think and Plan Principle :2
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

37. Principle :3
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

38. Bring in Technology Principle : 4
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

39. Remain focused and not get distracted
Principle 5
Remain focused and not get distracted
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

40. REFERENCES http://www.isixsigma.com
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

41. JAI HIND…Thank you
Good Luck…,The Journey ahead is going to be CHALLENGING, EXCITING & REWARDING.
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI

42. Feel Free to Share your Query
DR. PRADEEP BHARDWAJ, Mob
E.Mail –
WEB –
DR. PRADEEP SIX SIGMA HEALTHCARE, DELHI