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View photos of projects and results from some of our happy clients. Scroll further down the page to read detailed Case Studies.
CASE STUDIES
What’s the Connection Between Lego People, Paper Dolls, and Operating Rooms?
Beth Israel Deaconess Medical Center, Needham MA
Beth Israel Deaconess Medical Center, Needham MA
The answer to this question was revealed during an April 2012 3P* Kaizen Event focused on envisioning a new Operating theater for the Beth Israel Deaconess Medical Center (BIDMC) campus in Needham, Massachusetts. A cross functional group of employees supporting Operating Room activities at BIDMC Needham joined facilitator, Bruce Hamilton of GBMP, for a 1.5 day event focused on developing “patient-centered” processes that also meet the needs of the many people who care for patients undergoing surgery. In Bruce’s words, “These are the folks who are actually touching the patient, both knowledgeable and deeply compassionate.” BIDMC had already selected JACA Architects of North Quincy, Massachusetts to design the new surgical space, and GBMP was asked to help employees and JACA work together to analyze existing processes and develop improved flows so that effective floor plans for the new area could be created.
With the support of the BIDMC steering team, a cross functional group consisting of eight clinicians – doctors, nurses, technicians and housekeepers – with support from facility managers and architects was selected to participate in the event. The composition of the team alone was energizing. Holly Sousa, Director of Perioperative Services, and a participant in the event, explained it this way: “I know that my staff who were able to be a part of this event really gained valuable perspectives and were definitely engaged in "thinking outside the box."
I have to admit that I was unsure how we could begin to make change, but count me in as a true believer in the process. I have always believed that if you need change to happen, it needs to happen with the caregivers first- it needs to be their ideas or the change never happens. I think this is only the beginning for us and I hope to be able to use what I learned from now on every day.”
The event opened with a short training by Bruce on the principles of 3P (Production Preparation Process-- a powerful means of taking a big-picture look at how a product or process is designed in order to create breakthrough “out of the box” solutions.) The 3P process uses a creative method called “try-storming” (combining brainstorming with rapid prototyping) that is based upon fundamentals of Lean such as flow, pull and waste elimination. It encourages multiple possible designs, but then helps the team to narrow choices to those that provide the best patient and provider workflow and quality of care. A goal was set to have at least one consensus image for an improved design to present to the steering team by the end of the event. The group was first charged with mapping the current processes from the patient’s point of view. The team visualized their processes with simple stick figure drawings to collectively track the flow of the patient. From their “process at a glance” worksheets the team was able to see many opportunities for improvement in the current processes. Everyone had a new appreciation for what patients go through based on the mapping exercise. And it was from this perspective that the Lego People were introduced for the follow on activities.
The next steps included providing the team with a toy Lego person to serve as the patient. The team was asked to use the Lego Person to test their ideas and to verify the impact of their designs on patient flow during the balance of the event. In other words, move the Lego Person through the design layout as if it were the actual patient, to ensure the patient’s perspective in the overall design process.
Bruce also introduced a set of functional requirements for “ideal patient flow” gathered through interviews with Needham staff members, as well as items summarized from employee wish lists. Participants were asked to consider these items when try-storming designs for the surgical area. After lively discussion of their many ideas, they were asked to play “paper dolls”, using miniature blank layouts of the proposed new space in Needham to consider adjacencies (what functions/activities should be next to each other) and flow patterns. They inserted to-scale size components needed for patient care into the layout, such as pre-operative bays, operating rooms, supply rooms, and post-operative care areas to come up with a variety of layouts that reflected improved patient flow and enhanced care. Next they had to move their “Lego Patient” through the processes to get a feel for how their designs and layouts served patients under a variety of common patient scenarios.
As the event unfolded, the team was thinking deeply about the issues and, at about one day into the activities, struggling mightily to develop a breakthrough design. After lunch that day, one participant lamented, “If we can’t fix the recovery area problem, the rest of this expansion won’t matter.” “Go with that idea,” Bruce suggested. A new layout developed quickly working back from an ‘ideal patient
recovery area.’ The principle was right: patient-focused. Ideas were popping now: trystorming and more trystorming took
place. Within an hour, the team was sensing a breakthrough, and anxiety turned to excitement. By four o’clock, an operationally superior plan emerged that was, in the architect’s words, “totally different from what we would have drawn.” The group presented this common vision for an improved layout/flow to the steering team at the end of the event. “The team did a great job presenting and I thought they had a really nice final result! In fact, I was so pleased by what I heard I told Holly Sousa I thought they should make their presentation to our board of directors”, said BIDMC Needham CEO, John Fogarty, after attending the end-of-event report out. Another event participant, Dr. Brett Simon, of the Department of Anesthesia, Critical Care, and Pain Medicine, agreed the 1.5 days was time well spent. “I thought we had great participation, very thoughtful input, and a very impressive result! I can't wait to see the designs that come out of this!” he said. After the event, facilitator Bruce Hamilton offered a new take on the concept of 3P as a result of the BIDMC Needham team’s efforts. “This team reminded me that if the right people (in this case the direct patient providers) have the passion to improve, then the keystone to improvement is the right principle. The technical side of lean is important, but the people side is essential. The event at Needham suggested another definition for 3P: 3P = People + Passion + Principle!
*3P, “Production Preparation Process,” is a method introduced to the US in the mid-80’s by Chihiro Nakao, a contemporary of Mr. Ohno of Toyota, and founder of Shingijutsu consulting.
With the support of the BIDMC steering team, a cross functional group consisting of eight clinicians – doctors, nurses, technicians and housekeepers – with support from facility managers and architects was selected to participate in the event. The composition of the team alone was energizing. Holly Sousa, Director of Perioperative Services, and a participant in the event, explained it this way: “I know that my staff who were able to be a part of this event really gained valuable perspectives and were definitely engaged in "thinking outside the box."
I have to admit that I was unsure how we could begin to make change, but count me in as a true believer in the process. I have always believed that if you need change to happen, it needs to happen with the caregivers first- it needs to be their ideas or the change never happens. I think this is only the beginning for us and I hope to be able to use what I learned from now on every day.”
The event opened with a short training by Bruce on the principles of 3P (Production Preparation Process-- a powerful means of taking a big-picture look at how a product or process is designed in order to create breakthrough “out of the box” solutions.) The 3P process uses a creative method called “try-storming” (combining brainstorming with rapid prototyping) that is based upon fundamentals of Lean such as flow, pull and waste elimination. It encourages multiple possible designs, but then helps the team to narrow choices to those that provide the best patient and provider workflow and quality of care. A goal was set to have at least one consensus image for an improved design to present to the steering team by the end of the event. The group was first charged with mapping the current processes from the patient’s point of view. The team visualized their processes with simple stick figure drawings to collectively track the flow of the patient. From their “process at a glance” worksheets the team was able to see many opportunities for improvement in the current processes. Everyone had a new appreciation for what patients go through based on the mapping exercise. And it was from this perspective that the Lego People were introduced for the follow on activities.
The next steps included providing the team with a toy Lego person to serve as the patient. The team was asked to use the Lego Person to test their ideas and to verify the impact of their designs on patient flow during the balance of the event. In other words, move the Lego Person through the design layout as if it were the actual patient, to ensure the patient’s perspective in the overall design process.
Bruce also introduced a set of functional requirements for “ideal patient flow” gathered through interviews with Needham staff members, as well as items summarized from employee wish lists. Participants were asked to consider these items when try-storming designs for the surgical area. After lively discussion of their many ideas, they were asked to play “paper dolls”, using miniature blank layouts of the proposed new space in Needham to consider adjacencies (what functions/activities should be next to each other) and flow patterns. They inserted to-scale size components needed for patient care into the layout, such as pre-operative bays, operating rooms, supply rooms, and post-operative care areas to come up with a variety of layouts that reflected improved patient flow and enhanced care. Next they had to move their “Lego Patient” through the processes to get a feel for how their designs and layouts served patients under a variety of common patient scenarios.
As the event unfolded, the team was thinking deeply about the issues and, at about one day into the activities, struggling mightily to develop a breakthrough design. After lunch that day, one participant lamented, “If we can’t fix the recovery area problem, the rest of this expansion won’t matter.” “Go with that idea,” Bruce suggested. A new layout developed quickly working back from an ‘ideal patient
recovery area.’ The principle was right: patient-focused. Ideas were popping now: trystorming and more trystorming took
place. Within an hour, the team was sensing a breakthrough, and anxiety turned to excitement. By four o’clock, an operationally superior plan emerged that was, in the architect’s words, “totally different from what we would have drawn.” The group presented this common vision for an improved layout/flow to the steering team at the end of the event. “The team did a great job presenting and I thought they had a really nice final result! In fact, I was so pleased by what I heard I told Holly Sousa I thought they should make their presentation to our board of directors”, said BIDMC Needham CEO, John Fogarty, after attending the end-of-event report out. Another event participant, Dr. Brett Simon, of the Department of Anesthesia, Critical Care, and Pain Medicine, agreed the 1.5 days was time well spent. “I thought we had great participation, very thoughtful input, and a very impressive result! I can't wait to see the designs that come out of this!” he said. After the event, facilitator Bruce Hamilton offered a new take on the concept of 3P as a result of the BIDMC Needham team’s efforts. “This team reminded me that if the right people (in this case the direct patient providers) have the passion to improve, then the keystone to improvement is the right principle. The technical side of lean is important, but the people side is essential. The event at Needham suggested another definition for 3P: 3P = People + Passion + Principle!
*3P, “Production Preparation Process,” is a method introduced to the US in the mid-80’s by Chihiro Nakao, a contemporary of Mr. Ohno of Toyota, and founder of Shingijutsu consulting.
Team Streamlines Clinic Paperwork at Signature
Signature Healthcare, Brockton & Bridgewater, MA
Signature Healthcare, Brockton & Bridgewater, MA
Signature Healthcare, based in Brockton, is a regional healthcare provider for Southeastern Massachusetts. SHC is the parent organization of Brockton Hospital (245 beds), Signature Medical Group (one of the largest multi-specialty, multi-site group practices on the South Shore with 14 sites and more than 150 physicians), Brockton Hospital School of Nursing, and the Signature Healthcare Foundation. SHC has approximately 2500 total employees, 550+ affiliated physicians and providers, a residency program, and 300 nursing students.
Leveraging a workforce training fund grant from the state of Massachusetts, Signature began working with GBMP in 2011 to support targeted training sessions for an extended group of managers and associates. Led by GBMP CI Manager Bruce McGill and supported by GBMP CI Manager Dave Wesche, training topics so far have ranged from Introduction to Continuous Improvement to Value Stream Mapping to 5S/Workplace Organization to Pull Systems to Team Problem Solving and Mistake-Proofing. In January 2013, Bruce McGill facilitated an improvement effort at a SHC outpatient clinic in Bridgewater, a site which has four primary healthcare providers (PCPs). Over a two day span, a multi-disciplinary team worked on simplifying and streamlining the paperwork process. One provider participated in the event and agreed to test the new method devised by the team with the ultimate goal of standardizing the process across the entire clinic.
At the end of the event, the team reported-out to management and shared the results listed below:
“After the provider who participated in the event tested out the process for a couple of months, all three providers agreed the new process made sense and it was rolled out clinic wide,” according to GBMP CI Manager Bruce McGill. “When the stakeholders in a process like this put their heads together on how to improve it, so much opportunity is brought to the surface. My job is really to get them to ‘go see and ask why?’ so that they are dealing in facts and thinking deeply about how to provide greater value to patients and other customers of the process by making the work simpler and the flow more logical. With just a little training and some guidance along the way, this group was
really able to accomplish a lot in just 2 days.”
Once again, GBMP has shown that they are an invaluable partner in the lean deployment at Signature Healthcare. The dedicated time afforded by the lean event combined with the world-class training and support from GBMP created an environment that allowed the team to work collaboratively on solving a complex problem through the use of lean tools, thinking and methods. The implemented countermeasures had immediate positive impacts, which have been sustained through problem solving and integration with our lean management system” according to SHC Lean Development Manager David Marshall.
For more information about Signature Healthcare please visit www.signature-healthcare.org
Leveraging a workforce training fund grant from the state of Massachusetts, Signature began working with GBMP in 2011 to support targeted training sessions for an extended group of managers and associates. Led by GBMP CI Manager Bruce McGill and supported by GBMP CI Manager Dave Wesche, training topics so far have ranged from Introduction to Continuous Improvement to Value Stream Mapping to 5S/Workplace Organization to Pull Systems to Team Problem Solving and Mistake-Proofing. In January 2013, Bruce McGill facilitated an improvement effort at a SHC outpatient clinic in Bridgewater, a site which has four primary healthcare providers (PCPs). Over a two day span, a multi-disciplinary team worked on simplifying and streamlining the paperwork process. One provider participated in the event and agreed to test the new method devised by the team with the ultimate goal of standardizing the process across the entire clinic.
At the end of the event, the team reported-out to management and shared the results listed below:
- Reduced # of touches per document by 50% by creating a document processing “cell”
- Reduced travel distance on about 20% of the documents from over 80 feet to less than 10 feet.
- Reduced the number of documents going to the doctors by about 15%
- Created several “form letters” in their Electronic Medical Record (EMR) system that will significantly reduce the amount of time spent by clerical staff re-creating the same letters in Word. This will also eliminate the need to print and scan documents into the system.
- Created a form to improve the medical records release process. One Doctor received over 600 pages of medical records when only 2 were required! The revised process will allow Doctors to request only what they need versus the entire medical record.
- Created a visual system to make Doctors’ paperwork processing load more visible and the overall status clearer.
- Overall lead time of the process was reduced from 2.6 days to < 1 day.
“After the provider who participated in the event tested out the process for a couple of months, all three providers agreed the new process made sense and it was rolled out clinic wide,” according to GBMP CI Manager Bruce McGill. “When the stakeholders in a process like this put their heads together on how to improve it, so much opportunity is brought to the surface. My job is really to get them to ‘go see and ask why?’ so that they are dealing in facts and thinking deeply about how to provide greater value to patients and other customers of the process by making the work simpler and the flow more logical. With just a little training and some guidance along the way, this group was
really able to accomplish a lot in just 2 days.”
Once again, GBMP has shown that they are an invaluable partner in the lean deployment at Signature Healthcare. The dedicated time afforded by the lean event combined with the world-class training and support from GBMP created an environment that allowed the team to work collaboratively on solving a complex problem through the use of lean tools, thinking and methods. The implemented countermeasures had immediate positive impacts, which have been sustained through problem solving and integration with our lean management system” according to SHC Lean Development Manager David Marshall.
For more information about Signature Healthcare please visit www.signature-healthcare.org
Plastic and Oral Surgery Reap the Benefits of Lean at Boston Children’s Hospital
Boston Children's Hospital, Boston MA
Boston Children's Hospital, Boston MA
Boston Children's Hospital in Boston, MA is a 395-bed children's general facility. Nationally ranked in ten pediatric specialties, Boston Children’s includes one of the largest and most experienced pediatric Plastic and Oral Surgery centers anywhere in the world. Every year, staff within the Boston Children’s Plastic and Oral Surgery department serves ten subspecialty programs. These programs see more than 16,000 children of all ages and with all different types of conditions: those present at birth, those acquired later in life, those that are most common as well as those that are extremely rare and complex.
Dan Fleming, GBMP Continuous Improvement Manager, has been supporting improvement efforts within this department for the past year. Recent efforts have been focused in their patient clinic and in supporting processes. Teams have focused on workplace organization (5S) and Pull Systems/Kanban in both the clinic and administrative processes. They have also been successfully using the CEDAC (Cause and Effect Diagram with the Addition of Cards—see example below) method to work through problems.
“The teams in the Plastic Oral Surgery department have really demonstrated the spirit of Kaizen,” according to GBMP CI Manager Dan Fleming. “They recognize that making the work easier for them makes a better experience for patients, and helps cut costs and improve quality. I have introduced them to several lean tools when a process or problem suggests application of the tool makes sense. They have done a great job adapting various tools and methods to really re-think how daily work gets done.”
Ronald Heald, MBA and Financial Administrator for the practice, led a team that tackled Oral Surgery’s estimate process. The team identified many issues that contribute to patient dissatisfaction and incorrect charges. Using the CEDAC method, they explored current state cause and effect information, set a target to reduce refunds and secondary bills, and are actively working through a formalized process to test several improvement ideas surfaced by the team. “This is still going well and we’ve further enhanced what metrics to track/how to measure success. We have the pre-intervention type data (and we are refining it a bit) and we’re looking forward to evaluating the post intervention data. The Lean ideology is great on so many levels. It is not only an all-inclusive, hands-on type process bringing together and engaging a diverse set of employees - from administrative staff to physicians - but also it is a very timely and vital tool to help us innovate and transform into a more efficient and effective business. This work has enabled us to look at processes in a new, safer, more engaging light, with a proven template for success that ultimately breaks down unnecessary barriers and points us towards improvement and value enhancement,” said Mr. Heald.
Kelly Muir, Practice Administrator, was involved in a team that looked at the patient photography process. “GBMP and Dan have really helped our employees learn how to collaborate to address problems using targeted lean tools, thinking and methods. The changes that have been implemented enhance both the patient and employee experience, and most importantly demonstrate to our staff that they can be the creators of good changes on a daily basis,” said Ms. Muir.
For more information about Boston Children’s Hospital please visit http://www.childrenshospital.org
Dan Fleming, GBMP Continuous Improvement Manager, has been supporting improvement efforts within this department for the past year. Recent efforts have been focused in their patient clinic and in supporting processes. Teams have focused on workplace organization (5S) and Pull Systems/Kanban in both the clinic and administrative processes. They have also been successfully using the CEDAC (Cause and Effect Diagram with the Addition of Cards—see example below) method to work through problems.
“The teams in the Plastic Oral Surgery department have really demonstrated the spirit of Kaizen,” according to GBMP CI Manager Dan Fleming. “They recognize that making the work easier for them makes a better experience for patients, and helps cut costs and improve quality. I have introduced them to several lean tools when a process or problem suggests application of the tool makes sense. They have done a great job adapting various tools and methods to really re-think how daily work gets done.”
Ronald Heald, MBA and Financial Administrator for the practice, led a team that tackled Oral Surgery’s estimate process. The team identified many issues that contribute to patient dissatisfaction and incorrect charges. Using the CEDAC method, they explored current state cause and effect information, set a target to reduce refunds and secondary bills, and are actively working through a formalized process to test several improvement ideas surfaced by the team. “This is still going well and we’ve further enhanced what metrics to track/how to measure success. We have the pre-intervention type data (and we are refining it a bit) and we’re looking forward to evaluating the post intervention data. The Lean ideology is great on so many levels. It is not only an all-inclusive, hands-on type process bringing together and engaging a diverse set of employees - from administrative staff to physicians - but also it is a very timely and vital tool to help us innovate and transform into a more efficient and effective business. This work has enabled us to look at processes in a new, safer, more engaging light, with a proven template for success that ultimately breaks down unnecessary barriers and points us towards improvement and value enhancement,” said Mr. Heald.
Kelly Muir, Practice Administrator, was involved in a team that looked at the patient photography process. “GBMP and Dan have really helped our employees learn how to collaborate to address problems using targeted lean tools, thinking and methods. The changes that have been implemented enhance both the patient and employee experience, and most importantly demonstrate to our staff that they can be the creators of good changes on a daily basis,” said Ms. Muir.
For more information about Boston Children’s Hospital please visit http://www.childrenshospital.org
Ellis Medicine Uses Lean Six Sigma to Create Opportunities
out of Problems - Savings estimates top $1.8 Million
Ellis Medicine, Albany NY
out of Problems - Savings estimates top $1.8 Million
Ellis Medicine, Albany NY
Ellis Medicine is a 438-bed community and teaching healthcare system serving New York’s Capital Region. With four main campuses, five additional service locations, more than 3,300 employees and more than 700 medical staff, Ellis Medicine offers an extensive array of inpatient and outpatient services.
In 2013 Ellis made a commitment to change the way things get done at the century-old institution, to improve quality of care and financial strength by identifying more efficient processes and cost savings. Kristin May, Director of Organizational Performance and Innovation, leads the project and focused her attention first on building an internal team to apply principles from Lean management and Six Sigma.
From Dynamite to Dyno-mite
The first move was to send a couple of bright, young Lean leaders to a public Six Sigma course at a dynamite facility in Connecticut to learn about the methodology. It didn’t take Angelo Paglialonga and Christine Waghorn long to bridge the gap between explosives and healthcare and complete a project on laboratory blood specimen turnaround time (TAT) at Ellis Hospital with savings estimated over $600k annually.
Christine commented “At first it seemed odd to be driving to a dynamite factory to learn about the Six Sigma methodologies we were going to implement in a healthcare setting; but after a few classes, it began to make perfect sense.”
Phase two consisted of creating the six projects on site at Ellis hospital. The teams were mentored by Christine and Angelo in between training sessions, which was instrumental in bringing the projects to fruition. It was through their hard work of creating a ‘dashboard’ for the projects that the savings were validated.
As an advocate for Lean and Six Sigma continuous improvement, May implemented a hybrid of both techniques with assistance from the Greater Boston Manufacturing Partnership (GBMP). Initially, May and her team of seven part-time and five full-time Lean leaders used their time to introduce the concept of change and the process of continuous improvement to get the nurses, staff and other care providers involved in finding solutions and resolving problems. Together they found a solution to IV pump shortages and saved $500,000. Next the team turned their attention to the hospital’s lab department. By identifying tests that could be done in-house, the lab department saved $1 million. While May’s team brings the tools and the structure and the tracking capability to a department, it is the staffs in each department, and their knowledge of the processes and issues, who conceive of and implement the improvements.
Now May is pleased to say there is a waiting list of those who want to be certified in Lean/Six Sigma - people who have seen firsthand the positive outcomes of these techniques on specific problems and the effect of the new culture of change within Ellis.
The Department of Organizational Performance and Innovation provides three paths for those interested in an education in Lean & Six Sigma: the six phases of the Lean Leader Continued Education path, the four belts of Specialized Six Sigma Training and four levels of qualification in Project Management.
In September of 2015, six teams set out to tackle six difficult projects. In January of 2016, the teams presented their projects to senior management. According to Ron Pujalte, GBMP Continuous Improvement Manager & Six Sigma Master Black Belt: “Seeing the fruits of their labor only makes people want to do more, improve more and work together more. The passion and dedication of this particular group of people is evident in the amount of progress they’ve made, supported by these amazing report-outs and the pride that radiates because they have made a positive impact on patient’s and co-worker’s lives.”
The six team projects were: Bed & Equipment Rentals, Patient Falls, Pharmacy Calls, Safe Patient Handling, Primary Care Referrals and Structured Interdisciplinary Bedside Rounds (SIBR). Each team first identified the unique problem statement for their area of focus as well as a project goal. For example, the SIBR team defined the problem as “inconsistency in attendance, start/stop time, content, tools, level of preparedness and engagement by leadership and staff during morning interdisciplinary rounds.” The goal was to improve SIBR’s to create opportunities to impact several revenue-saving factors, for example Length of Stay (LOS).
Teams used Six Sigma DMAIC methodology to Define, Measure, Analyze, Improve, and Control their projects and the Lean PDSA approach (Plan Do Study Act) to implement countermeasures and effect improvements. An array of techniques from the DMAIC method (shown below) were employed to bring their projects to closure.
The Cost of Poor Quality was validated by the finance department for these projects culminating in an estimated yearly savings in excess of $1.8 million!
The teams are now working on new projects to further improve the quality and profitability at Ellis Medicine. All in all, the very realistic forecasted savings of the six projects totaled in excess of $1.8 million!
For more information about Ellis Medicine, please visit www.EllisMedicine.org
In 2013 Ellis made a commitment to change the way things get done at the century-old institution, to improve quality of care and financial strength by identifying more efficient processes and cost savings. Kristin May, Director of Organizational Performance and Innovation, leads the project and focused her attention first on building an internal team to apply principles from Lean management and Six Sigma.
From Dynamite to Dyno-mite
The first move was to send a couple of bright, young Lean leaders to a public Six Sigma course at a dynamite facility in Connecticut to learn about the methodology. It didn’t take Angelo Paglialonga and Christine Waghorn long to bridge the gap between explosives and healthcare and complete a project on laboratory blood specimen turnaround time (TAT) at Ellis Hospital with savings estimated over $600k annually.
Christine commented “At first it seemed odd to be driving to a dynamite factory to learn about the Six Sigma methodologies we were going to implement in a healthcare setting; but after a few classes, it began to make perfect sense.”
Phase two consisted of creating the six projects on site at Ellis hospital. The teams were mentored by Christine and Angelo in between training sessions, which was instrumental in bringing the projects to fruition. It was through their hard work of creating a ‘dashboard’ for the projects that the savings were validated.
As an advocate for Lean and Six Sigma continuous improvement, May implemented a hybrid of both techniques with assistance from the Greater Boston Manufacturing Partnership (GBMP). Initially, May and her team of seven part-time and five full-time Lean leaders used their time to introduce the concept of change and the process of continuous improvement to get the nurses, staff and other care providers involved in finding solutions and resolving problems. Together they found a solution to IV pump shortages and saved $500,000. Next the team turned their attention to the hospital’s lab department. By identifying tests that could be done in-house, the lab department saved $1 million. While May’s team brings the tools and the structure and the tracking capability to a department, it is the staffs in each department, and their knowledge of the processes and issues, who conceive of and implement the improvements.
Now May is pleased to say there is a waiting list of those who want to be certified in Lean/Six Sigma - people who have seen firsthand the positive outcomes of these techniques on specific problems and the effect of the new culture of change within Ellis.
The Department of Organizational Performance and Innovation provides three paths for those interested in an education in Lean & Six Sigma: the six phases of the Lean Leader Continued Education path, the four belts of Specialized Six Sigma Training and four levels of qualification in Project Management.
In September of 2015, six teams set out to tackle six difficult projects. In January of 2016, the teams presented their projects to senior management. According to Ron Pujalte, GBMP Continuous Improvement Manager & Six Sigma Master Black Belt: “Seeing the fruits of their labor only makes people want to do more, improve more and work together more. The passion and dedication of this particular group of people is evident in the amount of progress they’ve made, supported by these amazing report-outs and the pride that radiates because they have made a positive impact on patient’s and co-worker’s lives.”
The six team projects were: Bed & Equipment Rentals, Patient Falls, Pharmacy Calls, Safe Patient Handling, Primary Care Referrals and Structured Interdisciplinary Bedside Rounds (SIBR). Each team first identified the unique problem statement for their area of focus as well as a project goal. For example, the SIBR team defined the problem as “inconsistency in attendance, start/stop time, content, tools, level of preparedness and engagement by leadership and staff during morning interdisciplinary rounds.” The goal was to improve SIBR’s to create opportunities to impact several revenue-saving factors, for example Length of Stay (LOS).
Teams used Six Sigma DMAIC methodology to Define, Measure, Analyze, Improve, and Control their projects and the Lean PDSA approach (Plan Do Study Act) to implement countermeasures and effect improvements. An array of techniques from the DMAIC method (shown below) were employed to bring their projects to closure.
The Cost of Poor Quality was validated by the finance department for these projects culminating in an estimated yearly savings in excess of $1.8 million!
The teams are now working on new projects to further improve the quality and profitability at Ellis Medicine. All in all, the very realistic forecasted savings of the six projects totaled in excess of $1.8 million!
For more information about Ellis Medicine, please visit www.EllisMedicine.org
