| Six Sigma for Quality Improvement |
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Striving for Perfection
 You may be asking, "What is Six Sigma?" Simply put, it is a method used to improve quality. This method is unique, because it uses such a highly disciplined approach. More importantly, it has a lofty goal: to improve processes to make them as near perfect as possible. It involves questioning the way everything is done. It means that "good" is not good enough and "better" may not be the best.
Six Sigma at Deaconess
Beginning in July 2003, Deaconess Health System began ongoing training of leadership and staff to use rigorous Six Sigma methods including DMAIC, Lean Change, Acceleration Process, and Work-Out ™.
Six Sigma Method
DMAIC - Rigorous, data driven problem solving approach; DMAIC is used to improve existing processes and stands for the following steps:
- Define - the problem or the issue that can be improved
- Measure - current practices and/or results
- Analyze - all data for key relationships
- Improve - by implementing changes to the process
- Control - the improved process using measurement
Lean - Improvement strategy that focuses on identifying and eliminating waste and non-value added work in processes.
Change Acceleration Process ("CAP") - Process for effectively implementing and sustaining change. Process uses tools to build acceptance and overcome resistance.
Work-Out ™ - Well planned and facilitated working session used to develop solutions by the frontline staff that can be rapidly implemented.
Deaconess has been recognized for the results of two Six Sigma projects so far. A project in surgery to reduce cancellations and a project to reduce the door-to-inflation time for heart attack patients have received national and regional awards and recognition. Both initiatives have been published and presented at national, state and regional conferences. The door-to-inflation team was presented the Anthem Best Practice award for Indiana in 2006. Of course our patients are the true winners who reap the rewards daily. Recent projects include:
Worker’s Compensation Expenses
Deaconess applied Six Sigma methods to review Worker Compensation Injuries and expenses. The injuries were about 650 per year, and the dollar amount was approaching $1,000,000. Data analysis revealed that the most expensive injury and the worst injury for an employee was a back injury. Further analysis of the data showed that back injuries occurred frequently with the movement of patients. Back strains did also occur with non patient care; however, the primary focus became the patient care areas.
The team held a sensing session with nursing staff (RNs, PCAs) and Worker’s Compensation employees to obtain feedback on what works best for the employees. Suggestions included a lift team, new equipment that was easier to use, and keeping equipment more readily available. After the first sensing session, the team brought in several different types of vendors to review lift equipment, with the initial set of staff used for the sensing session. If new equipment was purchased, the staff using the equipment would have to agree that this was the appropriate equipment for them.
In addition, they benchmarked with other hospitals that were using a Lift Team. A Lift Team would allow the nurses and PCAs to have two qualified persons come to the floor to move their patients for them. This team would also use the lift equipment already in place and would learn the proper techniques.
After all options were reviewed, it was decided to pilot a Lift Team. The Lift Team is currently available to all units at Deaconess Hospital’s main campus. They complete about 150 lifts, turns, etc. per week. The nursing staff and patients both agree that the Lift Team is a great concept.
Gateway Universal Beds
Gateway Heart Unit was designed to allow patients who need critical care, telemetry or step down care to stay in the same room regardless of treatment being received. This improves patient care and efficiency of care by not having to move a patient from unit to unit.
To establish the flow of and coordination of care for patients, a Work-Out was held with various staff members from the Heart Unit, Bed Assignment, Emergency Department and other pertinent areas. The nursing team for the Heart Unit is made up of ICU and Telemetry nurses who are trained to provide the ideal level of care needed by individual patients at each stage of the patient’s recovery and healing.
The following improvement strategies were identified in the Work-Out:
• Defined levels of care
• Determined components of education for staff
• Identified additional equipment needed
• Established workflow processes that enables the Heart Unit staff to deliver safe, efficient, high-quality care
The Work-Out has allowed the universal bed concept to become a reality. Patients are provided with quality care in a private room without having to be transferred from unit to unit.
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Evansville, Indiana
