NEWS
The ups and downs of lean, Six Sigma
R
egardless of you leading your cus- We have re-engineered operating room turn- up several staff to do value-added work and
tomers and organization through a over processes and workflow to eliminate ap- removed some old legacy equipment that re-
long-standing rough spot or flopping proximately 20 percent of the physical dis- quired constant repair and maintenance.
with face-plant financially and operationally tance covered on foot by nursing personnel Most importantly, it helped to improve the
you can learn a great deal from Lean and Six between cases in our pilot rooms. quality and service to the patient/client and
Sigma project success stories and failures. – David Reiter, M.D., MBA, FACS, improved the staff morale – the always
More than a dozen experts shared their associate Chief Medical Officer, Thomas hoped-for ‘Win-Win’ result.
positive and negative anecdotes, as well as Jefferson University Hospital, and Here are keys to success based on the above
useful tips, with Healthcare Purchasing News professor of otolaryngology-head & neck case study:
that are chronicled below in edited transcripts surgery, Jefferson Medical College, 1. Documentation of current process
of their own words. Philadelphia 2. Outside-the-box thinking
3. Attention to quality along with productiv-
Lean Success stories
A hospital turned to the strategies of Lean to ity improvement
At a large government services organization help them achieve a goal to improve produc- 4. Re-engineering of processes while consid-
we implemented [Lean Six Sigma] in the lo- tivity of its food delivery process. ering newer ideas
gistics, supply and account management The team first started by documenting the – Michael Rudomin, principal, and
functions, touching an estimated 60,000 fed- ‘current state’ process from makeup of the Sandesh Jagdev, senior logistics consult-
eral employees. Success was a result of start- trays, to the delivery of the trays to the pa- ant, HealthCare Solutions Bureau, LLC,
ing small and growing step by step into each tients, and finally to the retrieval of the used Bolton, MA
part of the organization. All along the way trays. During this process the team observed
we implemented technology that allowed all many activities that led to process waste, in-
Six Sigma success stories
levels of the organization to trace improve- cluding waiting, over-processing and even Product selection – After the consultant came
ments and infuse accountability. Once the over-production. Patient surveys and com- in and reviewed our product selection pro-
five-year project was complete, [Government plaints were also assessed. cess, we restructured our main products and
Accountability Office], [Treasury Inspector During the preparation and serving of the clinical products meeting to reduce the time
General for Tax Administration] and Con- food, a ‘race-like’ scenario existed with the the initial request is received by Supply Chain
gress all produced reports praising the com- tray builders pushing the servers and the to the time it is presented and approved/re-
missioners who championed respective servers racing in and out of rooms to keep jected. We were able to reduce approval time
phases of the project, in addition to publish- up. Very little time was available to greet the from two months to four weeks.
ing documented improvements. The same patients and answer questions, as the wait- – Terry Cox, MA, MS, FAHRMM, CMRP,
thing can happen at any organization in ing trays of food would get cold. director, supply chain services, Texas
healthcare. The next step was to create a ‘future state’ Children’s Hospital, Houston
– Jeremy Belinski, vice president, that would eliminate the waste and produce
strategic development, Aspen Healthcare a more Lean process. Based on the future This concerned the development of Key Per-
Metrics, a MedAssets company state, an implementation plan was developed formance Indicators (KPIs) to measure the
to address the process changes. It was decided quality of service by different disciplines of
Our continuous improvement strategy com- the first critical step should be to improve the the supply chain, including Materials Man-
bines the Lean and Six Sigma philosophies. current process in order to prepare for the agement, Point-of-Use supply management,
Depending on the problem at hand, we de- more challenging meals-on-demand process. Pharmacy, Linen and Waste management.
ploy various tools and techniques from both. At the completion of their first future state, By measuring the performance of each sup-
Broadlane recently acquired a large teaching there were significant improvements. An old ply chain activity, the hospital was able to
hospital system on the East coast. To help unreliable piece of equipment was elimi- create a continuous improvement atmo-
successfully and rapidly implement the cli- nated, saving electrical as well as repair and sphere leading to better overall supply chain
ent on the Broadlane portfolio and recognize maintenance costs. Four positions were freed management quantity. Keys to success were:
significant savings as soon as possible, up that were used to increase the staff that 1. Staff participation
Broadlane’s Rapid Implementation Team ar- will deliver or prepare the food. This resulted 2. Collection of information without spend-
rived on site to utilize Lean Six Sigma pro- in the ability to add the valuable resources ing lot of time
cesses during the transition. The transition that were required to serve the patients when 3. Simplicity
was a huge success, and the client was very on-demand started. Pull and flow enhance- 4. Display of KPIs
pleased. At the same time, the project had ments from the preparation of the trays of – Rudomin and Jagdev, HealthCare
been properly scoped and defined, and the food to the delivery to the patient units were Solutions Bureau, LLC
data had been adequately gathered. From created in the system so that the food was
there, the Rapid Implementation Team was always fresher and didn’t have a chance to
Lean failed efforts
able to efficiently implement this client with- cool down while waiting to be served. I have had some false starts but those are al-
out extra steps or wasted work. This transformation in thinking and pro- most exclusively related to poor executive
– Ron Geguzys, senior vice president cess had a positive outcome that didn’t cost sponsorship. Once new champions were ap-
and Six Sigma Black Belt, operations, the hospital any additional staff or any addi- pointed, project execution was successful.
Broadlane Inc., Dallas tional equipment. In fact, the hospital freed – Belinski, Aspen Healthcare Metrics
12 November 2009 • HEALTHCARE PURCHASING NEWS www.hpnonline.com
0911-Performance.pmd 12 10/9/2009, 5:04 PM
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