PDF | Hospitals today face major challenges. Lean Six Sigma is a programme that can help healthcare providers to achieve these (seemingly) conflicting. PDF | On Jan 1, , H. Koning and others published Lean six sigma in healthcare. on Lean. Six Sigma at Stanford Hospital and Clinics. PDF | The hospital can be likened to an industrial enterprise with a high level of In this article, we will try to define the concept of Lean six sigma in care.
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The Application of Six Sigma Strategies to Medication Second, hospitals and physicians must use the latest scientific evidence as the basis of their . quality tools, definitions of errors and principles of Lean manufacturing and Six. Sigma. application of Lean Six Sigma in Healthcare FM or relatable sectors to gain . The combination of Lean's concepts and principles with Six Sigma's DMAIC .. medical records department of a hospital: An application of Lean Six Sigma. Flawless Healthcare By Jay Arthur EBOOK EPUB site PDF Get Instant Access to Lean Six Sigma For Hospitals: Simple Steps To Fast.
The book begins with a description of the Enterprise Performance Excellence EPE improvement methodology developed by the author that links several methodologies including systems thinking, theory of constraints, Lean and Six Sigma to provide an enterprise-wide prioritization and value-chain view of health care.
The EPE methodology helps to improve flow at the macro or value-chain level, and then identifies Lean Six Sigma detailed improvements that can further improve processes within the value-chain.
The book also provides real-world health care applications of the EPE and Lean Six Sigma methodologies that showed significant results on throughput, capacity, operational and financial performance.
The case studies include a wide variety of processes and problems including: Skip to main content Skip to table of contents. Advertisement Hide. Authors view affiliations Sandra L.
Journal of Healthcare Engineering
Front Matter Pages i-xviii. Pages Lean Six Sigma Roadmap. Hospital and Emergency Department Throughput Improvement. Sepsis Protocol Design Project. Then, a simple scale system was used for ranks, such that 5 indicated high suitability, 3 medium suitability, and 1 low suitability.
Table 4 shows suggested criteria and their average rank according to the survey findings. Table 4: Findings of VOC used to determine criticality categorization criteria. Define the Parameters That Will Be Used to Assess the Cost Level of Products Determining the parameter that will be used for assessing the cost of medical supplies will be based on item downloading cost.
A simple scale system was used for ranks, such that 5 indicated high cost, 3 medium cost, and 1 low cost. The warehouse keepers the process owners classified the items as having high performance, medium performance, and low performance.
The Applicability of Lean and Six Sigma Techniques to Clinical and Translational Research
Also, the keepers estimated the desired targeted performance for each item and measured the gap. High-performance items are items whose average inventory is well matched to the demand. Medium-performance items are items whose average inventory is less matched to demand. While, low-performance items are items whose average inventory is much higher than the quantity needed to cover the demand. A simple scale system was used to rank items in terms of performance level, such that 1 indicated high performance level, 5 medium performance level, and 9 low performance level.
Then, depending on the gap between the performance level and desired target level, the level was multiplied by the factor F3, such that the larger the gap, the higher the value of the factor F3. The factor F3 has a value between zero and one. High-criticality items were those for which a stock-out condition was life-threatening for the patient.
Medium-criticality items had less effect on the patient in case of a stock-out but did affect the diagnosis or treatment. Low-criticality items were of almost no effect in case of stock-out except the inconveniences of the patient. A simple scale system was used to rank items in terms of criticality such that 9 indicated high criticality, 5 medium criticality, and 1 low criticality.
Then, depending on the gap between the criticality level and desired target level, the level was multiplied by the factor F1, such that the larger the gap, the higher the value of the factor F1. The factor F1 has a value between zero and one. Cost indicators were based on downloading cost data that were acquired from the procurement department, and then, process owners estimated the desired targeted cost for each item and measured the gap.
A simple scale system was used to rank items in terms of cost such that 9 indicated high cost, 5 medium cost, and 1 low cost. Then, depending on the gap between the cost level and desired target level, the level was multiplied by the factor F2, such that the larger the gap, the higher the value of the factor F2. The factor F2 has a value between zero and one. As a sample for demonstration in this paper, Table 5 shows the Importance Index calculations for some of the items.
Note that the two items with the highest II value among all items were included in the sample in Table 5. Measure Phase 4. Map Current Process Based on the acquired knowledge in the define phase, the information and material flow chart of the logistics system at the case hospital were developed as shown in Figure 1. Figure 1: Logistics activities process map at the medical supplies warehouse.
Measure Process Criticality Parameters All items at the medical supplies warehouse were checked for criticality by the Six Sigma project team and then classified into high, medium, or low criticality level using the same scale system used by the process owners. Measure Process Cost Parameters The cost of all items at the medical supplies warehouse was assessed by the Six Sigma project team using the same scale system used by the process owners. Calculate Performance Index Using the output of the 3 steps above, the levels were set, and factors were then estimated depending on the desired targeted levels provided by process owners in the define phase.
The Importance Index was calculated for all items at the medical supplies warehouse by the Six Sigma project team. Again, as a sample for demonstration in this paper, Table 6 shows the Importance Index calculated by the Six Sigma team for the same sample of items in Table 5. Therefore, the project selection done during the define phase is still valid, and the Six Sigma team proceeded the work with the defined project reduce the II value for Intra-aortic balloon and Seroquel mg tablet.
Table 6: Importance Index calculated for sample items.
Analyse Phase 4. Improve the Process The Six Sigma team carefully observed the as-is process and used value stream analysis to improve it, which included eliminating and minimising nonvalue-added activities, developing and moving inspection points forward, or eliminating them.
Figure 2 shows the improved process.
This eliminated the possibility of having stock outs as the check is done after each prescription is given. Figure 2: Improved process. Figure 3: Cause-and-effect diagram showing possible causes of the low performance level for Seroquel mg tablets. Since this alternative was less expensive and approved by the Ministry of Health, many physicians switched to prescribing it.
The rest of improvement options were directly related to the current policies used for material management.
One of the suggestions was to set up a policy concerning checking up for new development on current medical supplies or alternatives each time a download is done to reflect that on the quantity downloadd.
Another suggestion was to set up a policy to download items depending on demand forecasting rather than on offered discounts. The hospital is recommended to conduct demand forecast for all important items stored and order them depending on forecasted demand.
The last suggestion was to implement the first-in-first-out FIFO method within the warehouse and not to download new products while still holding considerable stock from it, from its equivalents or from its older version products. Improve Phase The new improved process developed in Section 4. Also, at this stage and after selecting the alternatives to be implemented for reducing the II index, the Six Sigma team met with the process owners; explained the alternatives, the selection criteria for the best alternative and the selected alternative.
The selected alternative was then implemented and the improvement resulted from its implementation was measured. Even though customer satisfaction rates were not compared before and after the project, it is expected to see a marked improvement as well.
Control Phase Six Sigma control phase ensures that all root causes of the problem seize to exist and that the process will never go back to its old state. Conclusions and Future Work Six Sigma is a pioneer problem-solving technique and a leading process improvement method. We presented how it can be used effectively to deal with healthcare logistics issues, including deciding the major problems to be solved and solving them.
We also showed that some tools used for manufacturing applications might not be very useful in service applications such as healthcare logistics without modifications, so we built a framework that could be used to select and implement Six Sigma projects.
This work revealed new contributions on all the published work especially those shown in Table 1 in many ways: First, it reveals a new practical method to select projects based on criticality. Second, it showed how we can include competing performance measures in one calculated measure we called importance index.
This article paves the road for research to elaborate on ways to use Six Sigma in the area of improving healthcare logistics, especially that this area of research is almost untouched thus far. This research can be completed and complimented by others who can use this methodology, conduct calculations of the importance factor, check the model validity and implement it in other countries and different types of hospitals, and report case studies in future research.
For hospital management, this work reveals the idea of prioritization of all stocked items based on criticality, cost, and performance. Hospitals should use the II calculations for all items in stock in order to establish current-status review and continuous performance reviews for all items at stocks. Six Sigma is a management tool. Hospital management may differ from that of a typical company; thus, future research may also reveal obstacles and opportunities when dealing with hospital management while implementing a Six Sigma project in healthcare logistics.
Data Availability The data used to support the findings of this study have not been made available because they are confidential to the case study hospital. Conflicts of Interest The authors declare that there are no conflicts of interest regarding the publication of this paper. References W. Wolper, Ed. View at Google Scholar E. View at Google Scholar P.
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Six Sigma Application in Healthcare Logistics: A Framework and A Case Study
Pyzdek and P. Jin, M. Switzer, and G. Craven, J. Clark, M. Cramer, S. Corwin, and M.In particular, the percentage of colonized patients was reduced from 0. Clark, M. The causes were categorized into 4 different areas: Mohamed Gamal Aboelmaged. Full Name Comment goes here. Over the past decade, the need and desire for healthcare institutions to operate more International Journal of Health Care efficiently has been driven largely by financial concerns.
Since , there have been a variety of projects applying Lean and Six Sigma strategies to health care quality improvement.