IIE Best Practices in Applying Lean & Six Sigma to Healthcare 2013 




Joyce T. Siegele (program chair), productivity improvement manager, Northside Hospital

Healthcare Kaizen: Key Leadership Behaviors that Foster a Culture of Continuous Improvement

Mark Graban, speaker and consultant, Lean Enterprise Institute
9-10 a.m.

Many healthcare organizations talk about the desire for a "culture of continuous improvement." The Institute of Medicine says it is critical that healthcare organizations be continuously learning and improving. So why is there often a gap between that goal and reality? Why is continuous improvement lacking or nonexistent in so many settings? 

Employees and managers almost always have many ideas for improvement, so leaders need to help foster an environment that allows people to speak freely about problems, waste, and opportunities for improvement, while giving them the time and coaching required to make improvement happen. It will lead to improvements in safety and quality, waiting times, patient satisfaction, and cost.

In this webinar, Mark Graban will share practical actions and behaviors that leaders at all level need to practice and model for their organizations. What behaviors help encourage the identification, testing, evaluation, and sharing of improvements? What are best practices for how to collaborate and work together on improvement? When do leaders need to get involved … and when do they need to get out of the way?

These questions will be answered with tips and specific practices that you can put into place immediately and over the long term.

Cut the Waste Out of Your Kaizens! 

Matt Morrissette, president, More Effective Consulting, LLC.
10-11 a.m. 

What you’ll learn:

  • Techniques for minimum effort to gain maximum impact
  • Many ideas for improving your kaizen deployment
  • Real examples from a rehab hospital kaizen 

Success Factors & Lessons Learned in Creating Sustainable Lean-Six Sigma Improvements

Ron A. Phipps, project director, The University of Texas MD Anderson Cancer Center
11-12 p.m.

This session will provide attendees with some highlights of the MD Anderson Division of Pathology & Laboratory Medicine’s lean Six Sigma journey that started in early 2004. It will review how the deployment approach has been modified to address issues of employee engagement and sustainability. The session will also look at some specific tools, techniques and approaches and how they have made an impact on project success.

Six Sigma Saves Lives

Jeanne M. Huddleston, M.D., associate professor of medicine, Mayo Clinic
1-2 p.m.

Since 2003, Mayo Clinic nurses and physicians have reviewed more than 10,000 consecutive deaths. These mixed method (qualitative and quantitative) reviews are performed to identify system issues that prevent the clinical providers from giving the absolute best care they can give every day. The Morbidity & Mortality Council was created to measure, analyze and recommend improvements based on the findings from these reviews. Statistical process control charting is used to follow system-wide performance for these system issues. This session will review Mayo Clinic’s historical development of this process, lessons learned from these reviews, and the impact the DMAIC approach has had on quality of care, including the mortality rate.

At the end of this session, the attendee will be able to:

  • Understand the mixed method approach used for mortality review at Mayo Clinic
  • Identify key system of care issues that negatively impact quality of care
  • Describe the impact targeted quality improvement initiatives have had on overall hospital mortality

Error-Proof Healthcare – How to Accelerate Your LSS Efforts

Kevin McManus, performance improvement coach, Great Systems!
2-3 p.m.

Six Sigma levels of quality cannot be achieved by simply asking people to be careful. How do the high performance health care systems achieve very low error rates on a consistent basis, while others struggle to even get their people to capture the errors that occur daily? How do you get your teams to do great preparation prior to surgery? What approaches are used to obtain much higher levels of rule enforcement? This presentation will give you the details on several best practices you can use to better "mistake proof" the different processes in your healthcare system.

Significant examples of success – where error and incident rates are very low – do exist. The Blue Angels excel at process planning and review. Pal’s quick serve restaurant chain has a superior training and certification system. Oil field workers consistently achieve miniscule safety incident levels that many organizations would often consider as being unobtainable. How do these groups of people find ways to standardize their work practices while also improving their work systems? This presentation will give you the system details used by these organizations and others, and show you how to put them to work in a healthcare setting.

In this session, you will learn how to: 

  • Identify those work systems that are key to reducing human error rates
  • Make improvements to the error minimization approaches you already use
  • Better measure the effectiveness of your error proofing approaches
  • Develop your own prioritized, "mistake proofing" plan

Practice-Based Clinical Leadership Team Infrastructure Leads to Significant Improvements 

Mary S. Coniglio, MBA, project manager for quality and patient safety; Senthil Balasubramanian, senior management engineer, University of Pennsylvania Health System; and Christopher Klock, performance improvement consultant, Penn Medicine
3-4 p.m.

A practice-based clinical leadership team (PBCL) was created in the outpatient cancer center to identify, evaluate, and implement initiatives to improve safety, quality, and patient satisfaction. The methodology followed is called Performance Improvement in Action (PIIA), and includes just-in-time process improvement training in conjunction with completing projects in a 90-day period. The PIIA approach embeds quality/lean tools in the organization. The training provides structure, common terminology, and stresses the use of data to make decisions, relying on the voice of the customer and clear articulation of the problem statement. The team is facilitated by a quality leader and includes nursing and physician leaders as well as subject matter experts. Positive results have been realized: a 36 percent increase in the number of patients in the exam room prior to their appointment and an 18-minute reduction in patients that are “fast-tracked” for selected infusion medications. Incorporating clinical leadership in a structured framework for quality improvement increases the buy-in to change while maintaining an objective, data driven approach. The team approach and the use of performance metrics provides the opportunity to expedite pilot project testing while raising the awareness of key metrics to inform team of additional opportunities.

Closing Remarks

Joyce T. Siegele, FACHE, DSHS, productivity improvement manager, Northside Hospital