NEWS
Lean Six Sigma. “In million in savings with an average monthly If a facility only
healthcare, [Lean Six savings of $110,000, he added. wants to adopt a few
Sigma] is uniquely All four not only have their differences in principles, Dietz rec-
suited to the needs of theory and practice but also may have their ommended a few
supply chain manag- differences in set- good places to start.
ers,” he said. “Many tings, according to “At least half of the
of the principles are Pat Klancer, senior Six Sigma projects in
identical and the director, Supply healthcare I com-
foundation of LSS is Chain Diagnostix pleted had similar
rooted in TQM/
Jeremy Belinski
Services, Amerinet conclusions and
Lisa Dietz
CQI. The reason LSS Inc., St. Louis. process improve-
would be best is because it allows an organi- In fact, all focus on ments,” she noted. “Significant time and en-
zation to change component parts of the sup- engaging organiza- ergy was expended gathering data and com-
ply chain while still moving forward with tional involvement pleting sophisticated statistical analysis with
the greater change management efforts as- to improve quality
Pat Klancer
the same result: The team was unable to iden-
sociated with LSS. The second reason LSS and operational and tify a specific process driver because there
would be preferred is the sophistication of financial performance through implement- was no process per se. When there isn’t a
the tools used to deliver results.” ing stable processes and all are based to some well defined process that everyone follows,
David Reiter, M.D., MBA, FACS, associ- degree on data, standardization and reduc- as is often the case in healthcare, the result
ate Chief Medical Officer, Thomas Jefferson ing process variance, Klancer said. will be significant process variation.
University Hospital, and professor of oto- “But Six Sigma is much more grounded “Therefore, the two recommendations I
laryngology-head & neck surgery (facial in this theory than the other methods,” would make to anyone trying to implement
plastic & reconstructive surgery), Jefferson she continued. “It is very scientific and these principles would be to first implement
Medical College, Philadelphia, concurred. numbers-based, focusing on using verifi- some basic standard operating procedures
“Lean is the only one of the four that fo- able data as the basis for decision-mak- and process controls,” she continued. “Then
cuses primarily on efficiency and reduction ing. Six Sigma can be very helpful in a implement a measurement system to help
of waste,” Reiter noted. “Six Sigma is highly complex healthcare setting where there identify the subsequent drivers of process
programmatic, provides a framework in are a high number of transactions, or mis- variation. Once the process is in better con-
which to evaluate and manage large-scale takes can be very expensive. These prin- trol, measurement will be crucial to monitor
process problems using proven repetitive ciples are very well matched because of and continuously improve. Where to focus?
methodology, and includes tools for ongoing the renewed focus on ‘never events’ and The specific area, inventory management, for
monitoring and maintenance of process potential for reducing medical errors. [Ex- example, is less important. What is more
control. TQM and CQI are less rigorous and, amples] can include improving enhanced important is that one focuses where the
therefore, provide a looser environment in claims reimbursement and reducing the change management hurdles will not be so
which to effect positive change. Application inventory of surgical equipment and re- great, where one can get an ‘easy’ win to
of Lean and Six Sigma methodology is easier lated costs. demonstrate successes.”
to teach and more consistent in achievement “In smaller settings, or where processes Belinski agreed with the “easy win” strat-
of goals.” are very simple, Six Sigma may be over- egy. In fact, he argued that “for a system-wide
Terry Murphy, di- kill, and not as effective or necessary as implementation, [Lean Six Sigma] is best
rector, supply chain Lean or TQM,” she added. “Six Sigma also implemented in a phased approach simply
management, Lee differs, especially from TQM and CQI, in due to the incredible task of system-wide
Memorial Health that it employs a top-down approach and change management.” He urged facilities “to
System, Fort Myers, is led by well-trained and accredited cham- start on projects that create immediate value,
FL, summed it up pions and senior management, who then use these results to garner C-suite champions
this way: “The goal involve other facets of the organization. who will then push the implementation at all
of Lean is to acceler- TQM and CQI focus on teams and place levels of the organization. Begin with depart-
ate the velocity of less of a premium on management involve- ment level implementations. Starting with the
any process by re- ment in actual activities.” supply chain is appropriate. Then managers
ducing waste in all can focus on the obvious customers of the
of its forms, such as
Terry Murphy
Making it happen supply chain, such as the [emergency depart-
shorten the cycle time. Six Sigma is about Putting any Lean or Six Sigma project into ment].”
removing the variability in a process or op- practice calls for multiple players spanning Implementing
eration.” As a result, his organization estab- the organizational chart and carefully cho- Lean or Six Sigma
lished Supply Management Action Teams as sen launch points, according to experts. methodology in
an alternative to value analysis teams to set In short, it’s all about “changing culture, supply chain man-
up a process “that sped up the decision-mak- existing mindsets and behaviors,” Klancer agement requires
ing process and created a process that en- said. vision and commit-
abled more consistency – less variation – “A system-wide implementation requires ment, as well as a
across the system.” (See October 2009 HPN, more than one person driving the project,” detailed process
“Redefining value analysis practices for a contended Lisa Dietz, director and Six Sigma plan, according to
healthcare reform-minded industry, p. 8.) In Black Belt, Aspen Healthcare Metrics. “The Reiter.
fact, through August of the current fiscal C-suite and even the board must be sold on “[Supply chain
year, the SMATs generated more than $1 the benefits and costs. management] should
David Reiter
See PERFORMANCE on page 10
www.hpnonline.com • HEALTHCARE PURCHASING NEWS November 2009 9
0911-Performance.pmd 9 10/9/2009, 5:04 PM
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