FEATURE Using Lean Six Sigma

Streamline production, eliminate waste and improve efficiency BY ROBERT KURTZ


or an ASC striving to bring about improvements throughout the facil-

ity, applying Lean Six Sigma principles can be an effective method to achieve desired results, says Erin Huston, RN, the Lean Six Sigma Black Belt con- tinuous improvement specialist for The Urology Group and its ASC, The Urol- ogy Center, in Cincinnati, Ohio. Lean Six Sigma combines the con- cept of lean production, a waste-elim- ination method often associated with the Toyota Production System, and Six Sigma, a set of process improve- ment techniques and tools developed by an engineer for Motorola. “Lean Six Sigma is basically a process improve- ment module that eliminates waste out of your processes but still maintains your quality,” Huston says. That makes it a natural fit for ASCs,

says Charles Wallace, site administra- tor for the Surgical Center of Connect- icut in Bridgeport, Connecticut, and a Lean Six Sigma Green Belt. “The goal


of freestanding ASCs is to be efficient, so it really behooves us all to look at processes in a very mindful manner. Lean Six Sigma improves efficiency by reducing process variability and the potential for errors.” Todd Logan, CASC, senior vice president of sales for AmkaiSolutions, a provider of electronic solutions for ASCs and practices based in Alpharetta, Georgia, earned his Six Sigma Green Belt more than 10 years ago while working for General Electric. When he later began working as an administrator of a multi-specialty ASC, he says his Six Sigma training came in handy. “Six Sigma provides a rigorous approach to identifying areas you want to improve and puts the process in place to accomplish your objectives,” Logan says.

Numerous Applications Wallace says there are many different types of waste in ASCs, and Lean Six

Sigma has the potential to help reduce or eliminate all of them. “Any time you have to do some- thing more than once, it is wasteful,” he says. “For example, a staff mem- ber picks instruments and supplies for a case, puts it in a bin and brings the bin into the operating room (OR). One would hope that this nurse or techni- cian would not need to leave the OR to get anything else throughout the entire procedure. But people frequently need to leave the room, which is expending unnecessary energy and time.” Another example of waste Wal- lace points to concerns patient intake. “When patients are waiting for any- thing, that is wasteful. It is common in ASCs to have patients arrive an hour before surgery. Do you really need patients to come an hour early? The lon- ger patients wait, the more they take up space and use resources.” Huston says her ASC has brought about a number of improvements, thanks to Lean Six Sigma. “One of the tools associated with it is a simple but detailed process map that drills down to the time you spend on each step of a process and allows you to identify and eliminate the unnecessary steps—the waste,” she says. Thanks to this process map, her

practice and ASC reduced by about one-third the average number of days between when it was determined that patients would undergo a specific treat- ment for prostate cancer to when they actually had their procedure. The prac- tice and ASC also reduced the amount of time for patients with kidney stones to receive treatment.

Huston recalls another recent Lean Six Sigma project that brought about significant improvements. “It con- cerned our efforts to maintain normo- thermia. We thought our patients were cold, but the process determined the thermometer we were using to measure patient temperature caused a misread.” After conducting research, Hus- ton says a thermometer was found that

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