Merging Lean and Six Sigma

Disclaimer: I'm a lean six sigma blackbelt (though currently working in a non LSS environment )

Absolutely LSS principles could improve health care by cutting out waste while maintaining focus. Immediate opportunities to cut waste are glaringly obvious. For example, why must first-time patients fill out 5 - 7 forms each of which ask for more-or-less the same information? It not only wastes the patient's time, but inflates the clerical cost of intake 5 - 7 times. It also increases the opportunities for errors in record keeping by 5x - 7x. How many of the every-time-you-visit measurements are really necessary? If a patient is complaining of flu symptoms, is measuring his or her height and weight really a value-added step? It may be for some patients, but not for all, so don't do it for all. Is an every-visit measurement of height really value-added for people aged 25 - 65?

Cutting out non-informative measurements conducted at each visit could save 5 minutes per patient. For 20-minute consultation visits, that's one extra visit slot available for every four patients currently seen. Cutting out non-value-added administrative or routine measurement tasks would allow a shift in staffing levels from administrative personnel to medical service personnel, making it possible to take advantage of the extra time freed up by cutting out non-value-added steps.

Because so much administrative waste is governmentally mandated, however, the LSS principles would need to be applied to government policy in tandem with the private system. It's a big, but doable, task.

"Because so much administrative waste is governmentally mandated, however, the LSS principles would need to be applied to government policy in tandem with the private system. It's a big, but doable, task."

Your first statement is realistic.

Your second, optimistic.

I agree with GKC, in his thinking, but believe that these are not the tools needed. This smacks of when all you have is a hammer everything looks like a nail" mentality.

Much of the redndancy and hence waste and cost is related to defensive medicine and fear of lawsuits. (Here in US)

Tort reform is the real tool needed. When the medical industry is no longer crippled with fear over lawsuits, then they will be able to shed some waste. Until then, Nothing doing.

Milo

Personally I never found anything in six sigma that was not common sense with exception to the lean practices - Six sigma is not practical in the real world - for instance a bank that has not lost a nominated percent to bad loans has not taken enough risk. six sigma try to believe we can operate with little or no waste, so little or no loss or risk - so no 2000 ways to make a lightbulb that didn't work so we could have one that did. If my staff are sitting around drinking coffee on non break times,it is because they work flatout and take a break when they decide they need it, so when working are always optimal, if you just cruise because you have to fill in the time and won't get a break when you need it because you gave your all to the company, why would you? Any Idiot that thinks they can push staff to run at a high rate all the time will simply burn out good staff and make everyone hate the company - I would not employ a six sigma person if the government provided them free of charge, unless of course they wanted to be the ones shifting the bricks in a set time frame.

Six sigma fails because it has no time derivative or trust factor-

100 meters in 20 seconds - anyone can run that

1000 metres in 200 seconds ?

10000 metres in 2000 seconds??

staff tire the longer they are at work at a set pace

staff tire after days at a set pace

after 2 months of 7 days 12 hours a day even those of us who a walking weapons crash.

My philosophy

"Get the best out of your staff when they have their best to give"

1. Let them go flat out and take breaks when they need them,
2. If you can see they don't work flat out, let them go when you don't need them.
3. If you can't trust a staff member to perform get rid of them
4. If you can't trust any staff member, they need to get rid of you.

A Quinn

Enerventure

Get ISO 9001 and ISO 14001 accreditation and you have solved all of these issues