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Lean - Six Sigma Project

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Lean - Six Sigma Project Homecare Physical Therapy Attempted Visits Project Team Champions: George Krempel & Paul Gorski Lead: Greg Horner Process Owner: Ewa Jaraczewska – PowerPoint PPT presentation

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Title: Lean - Six Sigma Project


1
Lean - Six Sigma Project
  • Homecare Physical Therapy Attempted Visits

Project Team
Champions George Krempel Paul Gorski Lead
Greg Horner Process Owner Ewa Jaraczewska
Team Members
Jerry Davis, PT Teri Kouchoukos, RN Pat Kralik,
PT Marlene Anderson, RN Deborah Muhammad, RN
Confidential For Quality Improvement Purposes
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2
What is Lean - Six Sigma?
  • Lean
  • Understanding value from the viewpoint of the
    customer
  • Identifying Business Value activities that do not
    add value but are required
  • Eliminating waste (process steps that do not add
    value)
  • Increasing velocity and creating a continuous
    flow of value added process steps
  • Six Sigma
  • Reducing process variation and defects.
  • Reducing process variation yields fewer defects,
    both of which can create havoc when trying to
    eliminate waste and create continuous flow.
  • A Lean - Six Sigma project uses the DMAIC process
  • Define - the project, process and defects
  • Measure - the process and what it produces
  • Analyze - the measurements and the process
    measured
  • Improve - Design for experiment and implement
    improvements
  • Control - the improvements and sustain results

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3
Problem Statement Attempted Physical Therapy
Visits occur when a home visit is scheduled and
the physical therapist assigned is unable to
complete the visit. From January 2006 to March
2007, attempted visits for Physical Therapy
totaled 315 (average 21/mo whereas 8/mo is
desired). The financial impact of attempted PT
visits are gt 34,700 in operating expenses during
this period.
Who are the Customers? Physical Therapists, Care
Coordinators, Dept Mgrs (Bud Var), Patients What
is Critical To Customer Satisfaction? Completed
Physical Therapy Visit
Project Objective Decrease Homecare Physical
Therapy attempted visits 60 to 8 per month 
Variation in the definition of an attempted visit
Variation in the distribution of scheduled visits
among Therapists
Why do PT Attempted Visits Occur ?
Patients scheduled for PT visits are not
appropriate for Physical Therapy
RN does not communicate an observation that is
significant to PTs ability to perform a visit
  • PT does not call patient to confirm before making
    a visit

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4
Measure and Analyze
  • The project team sought to improve sub processes
    of the Physical Therapy Visit Process
  • Improve communication sub process
  • 1. Nurse and Therapist communication
  • 2. Therapist assigned
  • Improve scheduling sub process
  • 3. Therapist scheduling

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5
Sub Process ImprovementRN to Therapist
Communication
Before
After
Objective Scheduling Office acts as a
communication clearinghouse for significant
observations
Known Factors - Paper based system delays
document flow. - Multiple RN's assigned to one
patient - Multiple PT's assigned to one patient -
It is not always known or clear which PT is
caring for the patient.
Significant observations have the potential to
impact ability to complete a scheduled PT
visit. - Patient is being discharged - Patient is
being hospitalized - Not appropriate for care -
Changes in care - Patient homebound status in
question - Deletions/additions of services
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6
Keys to Success in Reducing Process Variation
  • The need to reduce variation in each sub process
    was identified
  • Sub process improvements and maps were developed
    during brainstorming sessions
  • Sub process improvements were tested by the
    Homecare staff and then refined by the project
    team
  • Sub process improvements were successfully
    implemented and measured

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7
Project Summary
Lean Six Sigma Objectives
Actions Taken
Results
  • Improved communication methods
  • Improved process flow and throughput
  • Analyzed current state process flow.
  • Time and work analysis
  • Implemented operational changes

Eliminate Waste
Reduce Process Variation
  • Sub process maps were developed
  • Improvements were tested and FMEAs developed
  • Implemented cultural changes
  • Variation reduced to 4.3 (74 improvement from
    baseline)
  • Standard Deviation reduced to 2.1 (48
    improvement from baseline)

Reduce Defects
  • Implemented pre-visit verification call process
  • Implemented standardized visit cancellation alert
    process
  • Monthly attempted visits reduced to 8.7 (60
    improvement from baseline)
  • Process sigma increased to 3.80 (.34
    improvement from baseline)

Recover Operating Cost
  • Project moved through all phases of DMAIC
  • Control Phase monitoring in place
  • Project will produce gt 19,400.00 in hard cost
    recovery over a fifteen month period
  • Implementation costs 1,200

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8
Phase I Baseline Months 1-15
Phase II Define, Measure, Analyze,
Improve Months 16-19
Phase III Control Sustain Results Months 20-23
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9
Summary
  • Project results show stability and sustainability
  • Attempted visits reduced to 8.7, a 60
    improvement from baseline
  • 74 improvement in process variation
  • 48 improvement in standard deviation
  • Process sigma increased to 3.80
  • Project will produce gt 19,400.00 in hard cost
    recovery
  • Project results are sustainable

Confidential For Quality Improvement Purposes
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