A sample of the Quality Clinic Do-It-Yourself Kit -- a set of high-quality training resources for healthcare Lean Six Sigma.

1. Quality Clinic
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Lean Six Sigma Foundational Training
DO-IT-YOURSELF KIT

2. Quality Clinic
Objectives
1. To teach the essential, foundational concepts of
Lean Six Sigma
2. To change the way you perceive the work around you,
as well the opportunities for improvement
3. To introduce specific tools that are used to analyze
and address common business problems
4. Provide a step-by-step guide for problem-solving
5. To help you solve problems more effectively
The goal:
Inform, equip and empower
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3. Quality Clinic
What IS Lean Six Sigma?
Lean + Six Sigma = Powerful Improvement Partnership
• Data-driven, structured approach to improving business
performance and solving organizational problems
• Puts the customer first in judging quality and performance
• The marriage of two complementary philosophies & toolsets:
1. Lean
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2. Six Sigma
Reduces waste
Improves flow / speed
Visual tools
Increases value-added
nature of the work
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Reduces variation / defects
Strives for perfection
Statistical / analytical tools
Builds quality / value into
the process from the start
A powerful 1-2 punch for process improvement
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4. Quality Clinic
What Lean Six Sigma DOES
Lean Six Sigma is a proven methodology for:
• Reducing cycle time -> YOU are not moving more quickly … your
PROCESS is
• Reducing defects -> YOU are not trying harder … your PROCESS
is working better
• Reducing delay -> YOU are not PUSHING things through … your
PROCESS is flowing and PULLING them
• Boosting profits -> Your PROCESS is profitable … for the
organization, the customer and the community
• And for gaining competitive advantage -> Your processes cost
less, your margins are higher and you solve problems more
effectively
This is what you can do with it.
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5. Quality Clinic
The Decision
At a high level, Lean Six Sigma is the decision that you’re going to
judge or measure your performance, and compare it to something
meaningful, objective and far-reaching.
Then comes the question – what to compare to?
At this point, you realize that:
• Your customers define your existence.
• They define what Quality means.
• Your Quality should vary as little as possible in their eyes,
and objectively; and
• You should measure Quality the same way they do.
And so ultimately, Lean Six Sigma is the decision to define and
measure Quality the same ways your customers do.
Lean Six Sigma, therefore, is not just a methodology, or a toolset, or a
statistical measure … it is a decision.
The decision has been made
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6. Quality Clinic
Work is a Process
“If you can’t describe your work
as a process, you don’t know
what you’re doing.”
W. Edwards Deming
American statistician, professor, author, lecturer and consultant
http://www.brainyquote.com/quotes/quotes/w/wedwardsd133510.html
You have no business having no process
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7. Quality Clinic
Work is a Process
All work is – or should be – a process
• Process: A series of ordered steps designed to accomplish
a specific goal or purpose
Start
Step A
Step B
Step C
Step D
Finish
Lean Six Sigma focuses on the process
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8. Quality Clinic
Customers
S
P
O
C
Suppliers
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I
Inputs
Process
Outputs
Customers
Provides a bird’s-eye view of the process flow in its context
Allows team to brainstorm full range of customers/recipients/benefactors
Typically eye-opening when done with cross-functional team
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9. Quality Clinic
Benefits of Flow
How does Flow help a health system?
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Shortens process cycle time
Enhances customer service and satisfaction
Lowers unit costs
Increases productivity
The ultimate reason
for eliminating waste in a process
is to ensure that value can flow
to the customer as quickly as possible.
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Reduces harmful delays
Reduces boarding
Fewer off-service patients
Eases ED overcrowding
Improves safety and
effectiveness
Improves access to, and quality of, healthcare
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10. Quality Clinic
The Goal
You want value to
flow freely …
VALUE
… from your business
to your customers
?
But your process gets in the way
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11. Quality Clinic
Enemies of Flow & Value
What gets in the way?
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Hand-offs
Decision points
Bureaucracy
Batching
Silos
Redundancy
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Variation
Errors
Complexity
Lack of a process
Out of the norm
(“cash vs. card”)
Uneven workload
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12. Quality Clinic
The 8 Types of Waste
D efects
O verproduction
W aiting
N ot utilizing employee ideas
T ransportation
I nventory
M otion
E xtra processing
• Just in case…
• We might need it…
• It’s possible…
• You never know…
Can you think of any examples?
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13. Quality Clinic
Food-for-Thought
Are there any bottlenecks
or delays where you work?
What types of inventory
do you have?
What is/are the constraint(s)?
How can you mitigate them?
How is your world similar to Alex’s?
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14. Quality Clinic
Variation
Where do defects come from? (Part 2)
Variation
Sigma (s) = Greek letter
• The way work is done tends to vary
(person-to-person, day-to-day, etc.).
used to represent variation
in set of numbers
• This leads to variation in outcomes and Quality.
(“Results may vary.”)
• To minimize defects, waste and errors, variation must be
controlled.
• The goal of Lean Six Sigma is to reduce variation so that
performance always meets customers’ requirements.
Variation is what we notice
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15. Quality Clinic
How big is an index card?
MAN
(People-related factors)
METHOD
(Process, policy)
MACHINES
(Equipment, computers)
Why aren’t the
measurements
the same?
MATERIALS
(Supplies, software)
METRICS
(Data, numbers)
MOTHER NATURE
(Environment, culture,
regulations)
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16. Quality Clinic
Standardization
What is Standard Work?
• A simple description of how to consistently perform a
particular process or task
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Safest
Highest quality
Only acceptable way
Most efficient
• Provides guideline for time required
• Regularly reviewed, taught and improved
• Applied to all work areas
What SHOULD be standardized?
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17. Quality Clinic
Why do we call it “5S?”
1. Sort
– Keep only what is necessary
2. Set in Order
– Everything with a place …
everything in its place
3. Shine
– Wipe, clean, polish, prepare all surfaces
4. Standardize
– Make the first 3S’s a routine – at job & co. level
5. Sustain
– Rewards, incentives, recognition, pictures, data
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18. Quality Clinic
What is Lean Six Sigma?
“
Lean Six Sigma is the most robust
methodology used today for solving
problems in an organization.
It ensures that a structured approach
based on data is used so that the best
solutions are generated and that they are
then embedded in an organization.
100% Effective Training
”
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19. Quality Clinic
DMAIC
Define
the business opportunity.
What is the customer’s expectation of the process?
What is the process that needs to be examined?
Measure
the process current state.
What are the key metrics for this process?
Analyze
the data to determine root causes.
How is this process currently performing?
When, where, and why do defects occur?
Improve
the process by reducing variation and eliminating waste.
What are the root causes?
How can we fix the process?
Control
and sustain the improvements.
Are the customer needs met?
How can we keep the process fixed?
DMAIC starts and ends with the customer
OSSS LSS Green Belt v9.0 - Introduction
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20. Quality Clinic
Define
KEY DELIVERABLES:
• VOC
• Customer CTQ
• Project Team
• Project Charter
• Observation
• SIPOC
GOAL:
Define the problem
and the project
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21. Quality Clinic
Measure
KEY DELIVERABLES:
• Data Collection Plan
• Sampling
• Validation
GOAL:
Collect appropriate
data
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22. Quality Clinic
Analyze
KEY DELIVERABLES:
• “Pictures” of the data
• Key statistics
• Process capability
• Root-cause analysis
• “Pictures” of the
process
GOAL: Identify root causes … “peel the layers”
There are a thousand hacking at the branches of evil to one who is striking at the root.
-Henry David Thoreau
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23. Quality Clinic
Improve
KEY DELIVERABLES:
• Prioritized list
of potential
solutions
• Standardized
procedures
• Visual improvements
• Error-proofing steps
• Pilot
GOAL:
Formulate specific improvements
that address root causes
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24. Quality Clinic
Control
KEY DELIVERABLES:
• Implementation
Plan
• Control Plan
• Validation
• Assessment
GOAL:
Implement changes
that last
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25. Quality Clinic
A3
Purpose of A3:
1. Document your improvement project
2. Tell your story
3. Gain buy-in
4. Guide your work
5. Track progress
Provides flow and clarity
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