Lean Six Sigma for Healthcare

Lean offers you the opportunity to transform your care and business processes to capitalize on the latest changes in US healthcare.

Lean Sigma Healthcare (LSH) is SigmaMed’s unique approach to helping healthcare facilities incorporate the tools and thinking of Lean Six Sigma into their organizational DNA.  When done right, Lean offers the best possibility to transform your care and business processes to capitalize on changes in US healthcare, but when done wrong, Lean can become a drain on finances, energy, and belief.

All our training is done through project-based learning-by-doing and team members leave sessions energized and immediately able to utilize the tools of Lean Six Sigma.  We help you choose and scope the right projects, closely mentor teams to ensure they succeed, and guarantee the returns on your efforts will exceed your costs.  If they don’t you don’t have to pay us or we will continue working for free until they do.

“We are in the process of implementing SigmaMed’s Lean Sigma Healthcare training at Riverside Medical Center.  He has coached us through 4 live projects at the moment and the experience has been good.  The process is straight forward and SigmaMed provides quality hands on coaching for the staff that will be incorporating Lean into their business model.  As someone that previously went through a Lean Six Sigma Green Belt course and can compare to the product he provides, I would recommend this version because it is more scaled down and understandable making it easier to implement and continue moving forward at an affordable price.”

Brandon Anzaldua, CFO
Riverside Medical Center
Franklinton, Louisiana

Keys To Success

Lean Six Sigma has become the leading improvement methodology in healthcare today because of its ability to deliver significant and lasting results in several key areas, often simultaneously:

  • Patient and Staff Satisfaction
  • Quality of Care and Patient Safety
  • Clinical Labor Productivity
  • Non-Labor Expense Management

Simultaneous improvement in all these areas seems improbable to the uninitiated, but for those who’ve seen the results of a successful Lean transformation first hand, it’s just as hard to understand why everyone isn’t rushing to implement Lean Six Sigma immediately (see this Time magazine article on Thedacare’s Lean Transformation; or this one on Virginia Mason’s Lean Journey; or this article in Mayo Clinic Proceedings).

What makes this virtuous cycle possible is the central focus Lean Six Sigma places on the customer, usually patients in healthcare, as the final word on the quality of the work you do.   In LSS terminology, value is something the customer would pay for if they knew why it was being done, and the methodology directs all effort at improving the processes by which you deliver value to customers.  In the course of maximizing value to patients, mistakes and rework disappear, your operating costs fall, satisfaction scores in all areas — patient, provider, and staff — improve, and your safety and quality of patient care all take a turn for the better.

By eliminating commom mistakes in your daily operations, frustration is minimized and patient’s perception of your competence is enhanced.   The daily work of your staff becomes more fulfilling as they spend more time working at what they trained to do and less time fixing errors created by others (see our blog post about “Knocking Down the Fix-it Factory”).

With more and more people working at the top of their licenses the dollar value of your work processes is improved and your revenue position and chances for long-term viability are improved.  When you add it all up, your facility gradually becomes a happier place to work, a more credible source of patient care, and the kind of place you would take your family for care without reservation.

Common Barriers

Lean Six Sigma (LSS) has proven to be a tremendous catalyst for the complete transformation of finances and culture for many health care facilities. But in just as many, facilities end up on the hook for tens or even hundreds of thousands of dollars for LSS training and activities without ever seeing a return.  We think the disparity can be traced to the following three major misconceptions that can be overcome with relative ease:

  • Improper Implementation — In a low risk attempt to try out LSS, many executives send one or more staff to a week of Lean Six Sigma training.  These staff return with a “Green Belt”, but entirely lacking the experience and higher level skills necessary for project success.  We can’t tell you all the CEOs we’ve heard lament, “…I sent 4 staff to Chicago to get their Green Belts, but they haven’t the slightest clue how to run a project.”  In other failed cases, facilities commit to large scale training and a ramp up of activities, only to realize insignificant or inadequate returns.   Without meaningful results after the large investment, support is lost, the effort fizzles, and with it, the high hopes that ushered in the Lean initiative.
  • Equating Lean Six Sigma with Cutting — Another problem with LSS is the frequent misconception of LSS as merely the act of cutting and maximizing efficiency without the corresponding attention to patient value.   And while cutting costs and minimizing defects is a key idea in LSS, cuts are never made at the expense of the patient’s perception of value.  It’s a highly competitive healthcare marketplace and only by enhancing quality and becoming more efficient in your delivery of patient value can you hope to grow into the future.
  • Leaving out the Six Sigma — A third barrier to effective adoption of Lean Six Sigma is the idea that Lean alone is the same as Lean Six Sigma.  Lean is excellent if all the data needed to determine root cause is readily available and all the right people can get together in the same room for several days, but on significant problems this is rarely the case.   This leads to a churn of activity on essentially unimportant issues and the perception that the effort is a waste of time and money.  Six Sigma adds project management, reproducibility, data-driven root cause analysis, and long-term control to maintain the gains.

Helping you avoid the pitfalls and get it right the first time is why we pulled together our experience into the methodology we call “Lean Sigma Healthcare” (LSH).

Lean Sigma Healthcare

Lean Sigma Healthcare (LSH) is SigmaMed’s unique methodology for training health care improvement teams in the application of essential tools and techniques from Lean Six Sigma in the context of completing important projects they have to do anyway.  Teams don’t waste time learning concepts mainly applicable to manufacturing, as in most Lean Six Sigma training courses, and with the close mentoring of experienced healthcare Black Belts Key quickly guide their teams to significant and lasting change.  Keys benefits to LSH include:

  • ROI Guaranteed on the 1st LSH Project:  In the thinking of Lean Six Sigma it makes no sense to spend more money on solving a problem than it is costing you.  Though your eventual goal might be total Lean transformation, starting with a focus on attaining tangible financial results on important problems is by far the best way to start.  We help your leadership team select and scope LSS improvement projects that have a very high likelihood of complete ROI and we guide your teams to highly effective solutions that reach their full potential. 
  • LSH is Not An Additional “Thing To Do”:  LSH is an exercise in Learning-by-Doing and does not represent significant additional work load for team members.  Content training is integrated into a team’s work on improvement projects that have to be done anyway and when the team and team leader learn the methodology in a richer experiential manner they are better able to retain and apply the concepts to their work.
  • Minimal Executive Time Commitment:  Front line staff make up our teams and the resulting solutions are always better than those designed by executives in the conference room.  We lead the teams to optimal solutions and executives can rest easy knowing a big problem of theirs is being solved without taking their time.  When your Leadership Team is overloaded with problems, a LSH project might just be the ticket to reducing their problem lists and headaches!
  • Mentoring in Advanced Concepts:  New team leaders simply do not have the experience to lead highly successful LSS projects on their own.  That is why all the world’s leading corporations and health systems employ a heirarchy of skilled Black Belts and Master Black Belts to guide the efforts of the newly trained and ensure all projects attain a positive ROI.  This is the function SMS mentors serve for your teams.  Mentoring topics include: efficient data collection & analysis, team facilitation and problem solving, project management and change concepts.  All these skills are required for project success, but are not covered in a typical LSS course
  • Highly Efficient Use of Team Meeting Time:  Team meeting time costs are reduced and speed to solution is increased by providing team members with access to online training that can be completed on their own time, at their own pace.  Training time in team meetings is limited to elaboration of important concepts and most meeting time is dedicated to completing project work

Process improvements made by the front line have the buy-in of those who actually do the work and must exert effort to change their long-standing habits.  The result is process improvement that lasts and a group of employees newly empowered with a sense of purpose and skill set that may be widely applied to other areas of their work.  This new esprit de corps and connection to your mission may be the biggest benefit of an LSH project and we can help you spread that throughout the staff and transform your facility.

Example: Turn Around at a Wyoming FQHC

To cite an example from our project portfolio, an FQHC in Wyoming was bleeding cash and losing patients.   They turned to us to help stem the tide and keep their doors open.   In initial meetings clinic executives directed the conversation to how much of their reserve ought to be spent to better market the clinic to the public, provide transportation, develop relationships with large local businesses and colleges, enable the local military base to send Tricare insured patients there for care, etc.

Using the LSS concept of customer value, SMS refocused the conversation onto who their customers are, what they truly wanted, and the processes by which the clinic delivered that value.   With this focus on customer value, the team made up of front desk, call center, scheduling, eligibility, RN, MA, and a provider (some of the time) were able to implement process changes within 3 months that resulted in a year-on-year increase in patient visits and revenue of more than 40%.   The team’s changes also impacted a far wider spectrum of clinic needs, which resulted in a virtuous cycle of improvement, which is the ultimate goal of any improvement project:

  • Patient satisifaction improved with increased access, shorter wait times, same day nurse call-backs and prescription refills, more time with their provider and a better sense of clinic organization
  • Staff satisfaction and turn-over improved with with fewer frustrated patients, a reduced number of mistakes to fix, better definition of work responsibilities and interdepartmental expectations, a clear sense that the clinic was making forward progress, and increased job security
  • Quality of care was enhanced through greatly improved ability of providers to access results in the EMR at time of follow-up, proactive care management for high risk patients, a reduction in “telephone medicine” by redesigned telephone answering processes, and increased access to care for at-need patients through improved appointment scheduling and eligibility determination
  • Clinical labor productivity was enhanced through increased patient throughput, redesigning work so staff were mainly performing tasks appropriate to their license, and redeploying lower priced resources to maximize the utilization of provider’s money-making time
  • Team members were reported to feel a tremendous sense of accomplishment and renewed commitment to their work.  Following the first project, a team member was heard to say, “I can’t wait to start our next project.  We are making a difference and I just love that!”

Real Meaning

The true test of any improvement methodology or change effort is the extent to which the roll-out is embraced by staff and gradually transforms the feeling and work of your facility.  If our experience is any guide, employees want to feel like they are part of the solution and the principles of LSH have proven highly effective at harnessing staff commitment, while rapidly driving the kind of change that most healthcare facilities need.

This is not a superficial attempt to teach staff why it is important to be nice and attentive to the concerns of patients, as do several popular “culture change” efforts on the market today.   That kind of training is a superficial “process patch”, in LSH terminology, that doesn’t address the true causes of patient dissatisfaction and shoots the shotgun of staff training at the discrete problem of patient dissatisfaction or lack of commitment among your staff.

LSH aims the rifle of LSS tools at the root causes of your major issues and ensures you attain the results you need.  We don’t waste your money on culture improvement training, before generating staff buy-in with highly effective demonstration projects.   We don’t ask  the board to fund another round of  projects without demonstrating a concrete return on their initial investment that proves to them you are a good steward of their trust.

The ultimate goal of any LSS implementation is a complete Lean transformation of care processes, business processes, and employee culture.  We at SigmaMed Solutions believe that the right way to reach that goal is through delivery of improvement in discrete and quantifyable doses that return far more than they cost, and which before you know it have affected a significant improvement of your financial position and the general well-being of your facility.