leveraging six sigma to improve organizational performance

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LEVERAGING SIX SIGMA TO IMPROVE ORGANIZATIONAL PERFORMANCE Dale Wood, C.A.M.C.,Vice President System Improvement and Chief Quality Officer

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Page 1: Leveraging Six Sigma to Improve Organizational Performance

LEVERAGING SIX SIGMA TO IMPROVE

ORGANIZATIONAL PERFORMANCE

Dale Wood, C.A.M.C.,Vice President System Improvement and Chief Quality Officer

Page 2: Leveraging Six Sigma to Improve Organizational Performance

CAMC Leadership Team

Provide system leadership in achieving performance excellence – Connecting hearts and minds to raising the bar in system-level results.

Page 3: Leveraging Six Sigma to Improve Organizational Performance

Will all of our efforts and projects add up to great quality and value for those we serve?

Page 4: Leveraging Six Sigma to Improve Organizational Performance

So…. How Is It Going?

Page 5: Leveraging Six Sigma to Improve Organizational Performance
Page 6: Leveraging Six Sigma to Improve Organizational Performance
Page 7: Leveraging Six Sigma to Improve Organizational Performance

Heart Failure: Cost Vs Composite Quality Percentile Rank ComparisonsPremier Hospital Quality Demonstration Project Participants

October 1, 2003 - December 31, 2003N of Hospitals =270

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Wage and Severity Adjusted Cost Percentile Rank

Co

mp

osi

te Q

ual

ity

Sco

re P

erce

nil

te R

ank

Inc

rea

sin

g Q

ua

lity

Top Decile = 85.64%

2nd Decile = 80.38%

Decreasing Cost

Charleston Area Medical Center

Page 8: Leveraging Six Sigma to Improve Organizational Performance
Page 9: Leveraging Six Sigma to Improve Organizational Performance

IOM Dimensions Measures 1. Safe Adverse drug events

Work days lost 2. Effective & Equitable Hospital specific mortality

Functional outcomes 3. Patient-centered Inpatient satisfaction

% Patients dying in hospital

4. Timely ED Wait Time, Discharges <Noon

5. Efficient Hospital costs per discharge

Health care costs per capita

Organization Transformation?

Page 10: Leveraging Six Sigma to Improve Organizational Performance

What is the “Right Recipe”, Sequence and Alignment for Organization Transformation

Why – “It’s What You Do andWhen You Do It That

Produces The Most Leverage”

Page 11: Leveraging Six Sigma to Improve Organizational Performance

“Deg

ree

of

Ch

ang

e”4

2. Have the skills to do what’s required. 2

1. Agree with Change1

3. See people they respectmodel the changes.

The “champion” effect

4. Consistent practicesapplied over time.

Discipline + Habit = philosophy

3

“Deg

ree

of

Ch

ang

e”4

2

1

3

Average organization = minimal change Program level

4. Consistent practicesapplied over time.

Discipline + Habits = Philosophy

3. See “leaders” and thepeople they respectmodel the changes.

The “Champion” effect.

2. Have the skills todo what’s required.

1. Agree with “Change” andwill at least “give it a try.”

“Deg

ree

of

Ch

ang

e”4

2. Have the skills to do what’s required. 2

1. Agree with Change1

3. See people they respectmodel the changes.

The “champion” effect

4. Consistent practicesapplied over time.

Discipline + Habit = philosophy

3

Program Focus

Time and Difficulty

“Deg

ree

of

Ch

ang

e” 4

2

1

3

Su

stai

nab

le P

erfo

rman

ce

Low

HighPerformance Culture

Average organization = minimal change Program level

2. Select systemic framework. Expand healthy and fit culture dialogue.

1. Programs to address immediate needs.

Initiate healthy and fit culture dialogue.

3. Align management systems. Leaders model healthy and fit cultures.

4. Integrated performance, healthy and fit cultures applied over time.

Program Orientation Organization

OrientationPerformance

Culture

CAMC Creating Performance Excellence

Page 12: Leveraging Six Sigma to Improve Organizational Performance

What are the differencesProgram Orientation Performance Culture

Page 13: Leveraging Six Sigma to Improve Organizational Performance

What is CAMC’s Strategy for Changing the System?

•Clearly communicate system-level strategy and goals

•Align strategy, measures and projects

•Focus leadership time on improvement work

•Connect the hearts and minds of all to improvement

•Increase improvement capability (skills and infrastructure)

Page 14: Leveraging Six Sigma to Improve Organizational Performance

CAMC’s Strategy

WHO WE ARE (Mission) 

WHAT WE WILL BECOME (VISION 2010)

 We provide the best health care to every patient, every day-

• Best place to receive effective, efficient, timely, safe, equitable and patient-centered

care.

• Best place to work

• Best place to practice medicine.

• Best place to learn.

• Best place to refer patients.

WHAT WE WILL ACCOMPLISH 

Charleston Area Medical Center, the best health care provider and academic medical center in West Virginia.

Clearly communicate system-level strategy and goals

Page 15: Leveraging Six Sigma to Improve Organizational Performance

Mission: To improve the total health of our communities working in partnership with the people we serve.

StrategicInitiatives

FinancialReach and sustain alevel of financialperformance that assures our long-term viability and enables us to investin strategies to achieve our mission.

Patient SatisfactionEnsure and energizea patient-focused culture.

Employee RelationsBe the best place towork.

SafetyGrow and sustain a patient safety focused environment.

Medical StaffCreate and sustaina “Best Place to Practice Medicine”environment.

Quality ImprovementImprove key clinicaland operational processes that significantly enhanceCAMC’s reputationfor assuring qualityoutcomes.

2005 Charleston Area Medical Center Strategic Initiatives

Goals Goals Goals Goals Goals Goals

Build market share.

Reduce expense per discharge.

Improve patient satisfaction scores with a focus on improving “definitely recommend.”

Strengthen leadership.

Improve Human Resourceprocesses.

Grow the next generation.

Promote an environment for sharing information and lessons learned.

Assure compliance with National Patient Safety Goals.

Foster effective teamwork regardless of a member’s position of authority.

Ensure adequate Medical Staff.

Enhance Medical Staff retention and satisfaction.

Ensure Medical Staff clinical quality involvement and leadership.

Improve CAMC standardized mortality rate and standardized complication rate.

Achieve effective care by embedding clinical science into care processes.

Design processes for safety,efficiency and timeliness asa function of Siemen’s implementation to ensureCAMC can derive themaximum benefit from information system investments.

Improve hospital throughput.

Indicators

•“Definitely” Recommend•“Excellent” Overall Experience

•Patient Safety Culture Survey•National Patient Safety Goals and National Quality Forum Projects

•Employee Satisfaction Survey•“For me, this is a good organization to work for.”•“I would recommend my organization to friends as a good place to work.”•Voluntary Turnover

•Medical Staff Appointments•Number of Active and Associate Physicians on Medical Staff

•Inpatient Discharges•Outpatient Visits•Excess of Revenue over Expense•Expense Per Adjusted Discharge•FTE per AOB

•CMS Composite Indicators•Gross Mortality Rate•Patient Discharges Before Noon

IndicatorsIndicators Indicators Indicators Indicators

Clearly communicate system-level strategy and goals

Page 16: Leveraging Six Sigma to Improve Organizational Performance

Communication Plan

Meeting Timing Presenter Data thoughts

monthly Dale Wood current CAMC numbers

2 X year QIC'sprojects/outcomes associated

with Indicatorsmonthly Dale Wood current CAMC numbers

2 X year QIC'sprojects/outcomes associated

with Indicators

monthlyClinical Director/ Assoc

Administrator current CAMC numbers

PRN Assoc Administratorprojects/outcomes associated

with Indicators

monthly Manager/Chairperson current CAMC numbers

Initial education to Case Coordination for initiation into this process

PRN Manager/Chairpersonprojects/outcomes associated

with Indicators

monthly Nurse Managers/ Case Coordinatorscurrent CAMC numbers/ current

unit specific numbers

data drilldown taken to each unit on a monthly basis by Martha/Lisa

PRN Nurse Managers/ Case Coordinatorsprojects/outcomes associated

with Indicators

New Hires at orientation Debbie Kisereducation on indicators:

importance and what is counted

MIMseach meeting

(quarterly) Dale Woodcurrent CAMC numbers + projects around indicators

Case Coordination Staff Meeting

every other month/ quarterly Debbie Kiser

Questions/concerns/projects /general education

Case Coordinators get data monthly electronically

Med Exec monthly Dale Wood current CAMC data

monthlyClinical Director/ Assoc

Administrator current CAMC dataprojects of interest presented PRN

PRN Assoc Administratorprojects/outcomes associated

with Indicatorsquarterly Clinical Director physician specific numbers

monthly Clinical Director compliance issuesContacted directly by Clinical Director

New Residents at orientation Clinical Director (?)education on indicators:

importance and what is counted

Vital Signs newslettermonthly to quarterly Dale/Deb/Kim

Positive recognition of units related to indicator work

CAMNetmonthly to quarterly Dale/Deb/Kim

Positive recognition of units related to indicator work

PIC

Board on Quality

QIC

CELEBRATIONS

Collaborative Practice

Physicians

Medical Department Meetings

Nursing Units

Clearly communicate system-level strategy and goals

Page 17: Leveraging Six Sigma to Improve Organizational Performance

Align Strategy, Measures and Projects

How will we achieve the goals?What is my part?

How is it connected?How will we know if we are making progress?

Page 18: Leveraging Six Sigma to Improve Organizational Performance

Q Projects in a unit, office, or department…

Strategically important system-level performance measure

Will these projects, in aggregate, move that Big Dot?

© 2001 Institute for Healthcare Improvement

Page 19: Leveraging Six Sigma to Improve Organizational Performance

AIMReduce mortalityrate 25% below

baseline

6. Improve Key clinical and operational processes that significantly enhance Charleston Area Medical Center'sreputation for assuring quality outcomes.

6.1 Improve CAMC standardised mortality rate and standardized complication rate

How will weknow ...

DriversMeasures of

DriversInitiatives

Measures ofInitiatives

Inadequate clinicalcommunication

Failure to identify,monitor and rescuevulnerable patients

Patient placementat appropriate level

of care

Inappropriatevariation in

management

Appropriatetreatment of highrisk populations

Inconsistant end oflife care

Mortality asmeasured

internally andcompared to

externalbenchmarks

What do wewant toachieve

Number oftransfers to higher

level of care

Percent ofcompliance with

guideline(VAP)

Number of non ICUcodes

Number of unitsparticipaing in

rounds with dailygoal sheets

Appropriate use ofclinical protocols

LOS of referrrals topaliative care or

hospice

Staff satisfaction

MET

Vent Bundle

Risk Assessment

CMS/SIPPSIndicators

Pallative CareTeam

Communication /SBAR

MedicationReconciliation

Mortality Review

Rounds/ goalsheets

Intensivist / e-ICU

weaning protocol

Bed Management

Stroke Protocol

Glycemic Control

Sepsis Bundle

Improve use ofAdvanceDirectives

Survey's

Increased use ofIPOC

Number of MET Calls

Review of codesresulting in death

Number of UnitsParticipating

Box 3/4 reviews

Percent bundleuse

Percent ofCoverage

Percent of use

Number ofpatients

transferred to ICUwithin 72 hours of

admission /readmissions

Improved rankingof indicattorNumber of

patients usingprotocols and

bundles

Reduce day toconsult/ number of

consults

Decrease inadmits from

nursing homesand increased

advance directives

IPOC

Central Line

Page 20: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

•Align strategy, measures and projects

Page 21: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

Financial Projects

Align strategy, measures and projects

Page 22: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

Financial Projects Continued

Align strategy, measures and projects

Page 23: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

Financial Projects ContinuedAlign strategy, measures and projects

Page 24: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

Safety Projects

Align strategy, measures and projects

Page 25: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

Medical Staff Projects

Align strategy, measures and projects

Page 26: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

Quality Improvement ProjectsAlign strategy, measures and projects

Page 27: Leveraging Six Sigma to Improve Organizational Performance

Six Sigma Online Project Manager Application – SI Report

Quality Improvement Projects ContinuedAlign strategy, measures and projects

Page 28: Leveraging Six Sigma to Improve Organizational Performance

Charleston Area Medical Charleston Area Medical Center – Clinical Center – Clinical

Performance Initiatives GoalPerformance Initiatives Goal

CAMC will focus on Clinical Performance Initiatives in specific focus areas with a goal to achieve top decile

performance in quality, cost, and safety through focused collaborative efforts to bring

evidence-based best practices into widespread use.

Align strategy, measures and projects

Page 29: Leveraging Six Sigma to Improve Organizational Performance

CAMC will focus on Clinical Performance Initiatives in specificfocus areas with a goal to achieve top decile performance in

quality, cost, and safety through focused collaborative efforts tobring evidence-based best practices into widespread use.

Heart Failure CABG AMIPneumonia Hips/Knees

Assumptions:Structured teams will be in place for each focus group.Non-Administrative Physician involvement is critical.Groups will use Premier Perspective to identify opportunities.Black Belt resource needed to help scope opportunities and track team progress.Cost data for 2004 must be available.Change Agent available in each focus group.

Strategic Goal - Financial1.3.1 and Quality

Improvement 6.2.1

Strategic Goal -Quality Improvement

6.2.2

Strategic Goal -Quality Improvement

6.2.1

Strategic Goal -Quality Improvement

6.2.1

Strategic Goal -Quality Improvement

6.2.1

AA - Karen StewatClinical Director -

Kathleen MimnaghBlack Belt - Kim

KendrickClinical QualitySpecialist - Deb

KiserClinical ChangeAgent - Martha

Taylor

AA - Karen StewatClinical Director -

Kathleen MimnaghBlack Belt - Kim

KendrickClinical QualitySpecialist - Deb

KiserClinical ChangeAgent - Martha

Taylor

AA - Ron MooreClinical Director -

James BolandBlack Belt - Karen

MillerClinical Quality

Specialist - BarbaraWhite

Clinical ChangeAgent - Joan Reed

AA - Josh FlorenClinical Director -

Constantino AmoresBlack Belt - Steve

CunninghamClinical Quality

Specialist - TeresaHill

Clinical ChangeAgent - DebbiRectenwald

AA - Tiny ArthurClinical Director -

Kathleen MimnaghBlack Belt - Glen

MartinClinical Quality

Specialist - AnneMatthews

Clinical ChangeAgent - ?

Align strategy, measures and projects

Page 30: Leveraging Six Sigma to Improve Organizational Performance

DefineDefine MeasureMeasure AnalyzeAnalyze ImproveImprove ControlControl

Standardization

Redundancy

Critical Failure Mode

ReliabilityModel

By using a combination of DMAIC

and Reliability we can identify gaps in our process and implement/

validate tests of change

Align strategy, measures and projects

Page 31: Leveraging Six Sigma to Improve Organizational Performance

RolesAssociate Administrator•Process Owner•Leads team•Agenda Planning and Coordination•Approves Changes and removes barriers•Reports progress to Steering Committee

Black Belt•Tool Facilitation •Assists with tracking tests of change•Analysis of data•Agenda planning

Quality Nurse•Data Abstraction•Outcomes Review•Analysis of data

Clinical Director•Brings Physician Perspective•Physician Change Agent•Physician Champion

Case Coordinator•Assist with Education on units•Identify process variation on real-time bases

Clinical Change Agent•Education on Units•Coordination of changes•Follow up non-compliance with Nurse Managers

Align strategy, measures and projects

Page 32: Leveraging Six Sigma to Improve Organizational Performance

Project ToolsDefineDefine MeasureMeasure AnalyzeAnalyze ImproveImprove ControlControl

• Project Charter• Stakeholder Analysis• Communication Plan• Elevator Speech

• Current State Process Map• Sigma Level• Understand Process Capability

• Reliability Model Questions answered• Variation analyzed• FMEA

• Impact/Effort Matrix• Best Practice/Benchmark

• Control Charts• Control Plan

Align strategy, measures and projects

Page 33: Leveraging Six Sigma to Improve Organizational Performance

Define the Project: This team will focus on Clinical Performance Initiatives Related to Heart Failure with a goal to maintain top decile performance in quality and safety through focused collaborative efforts to bring evidence-based best practices into widespread use. Based on 4th Q 2003 comparative data CAMC was in the top decile with a composite score of 93.48%.

Measure the Process: 1st 6 months – Top Decile = 85% we were at 93%

Set a Goal: 98-100% Composite Score and top decile composite performance.Is there a Std Protocol/Order Set/Process? Yes – Standard ProcessUsage Rate of Process? 90-95%

Analyze variances (From FMEA and Survey of Case Coordinators related to Heart Failure): • Failure to Identify as Heart Failure patient – Sample showed that 96% of patients were admitted to the unit with admit diagnosis of HF.• Inconsistency between units• Physician Resistance• Lack of Communication

Improve: • Smoking Cessation Education/Counseling – added to Our Commitment” brochure and Patient Agreement for all Patients.• Case Coordination follows up with Physician via Case Coordinator Notes (LVF Assessment and ACE Inhibitor)• Case Coordinator pull old Echo reports• Discharge Sheets updated to combine Worsening Symptoms and Weight Monitoring check box• Dr. Mimnagh to follow-up on Physician Outliers

Process Owner: Karen Stewart

Next Steps:• Notification of Unit Managers/AA’s of defect results• Analyze results from Case Coordination Survey • Research using IPOC as the standard Nursing/Case Coordination check list for indicator completeness• Special Education/Communication for Nursing Units – Mardi Gras theme

Timeframe

Pro

port

ion

1.0

0.9

0.8

0.7

0.6

_P=0.9262

UCL=0.9827

LCL=0.8698

1 2

1

Tests performed with unequal sample sizes

P Chart of Heart Failure Composite Score

Top Decile

CMS Indicators - Heart Failure Composite

Align strategy, measures and projects

Page 34: Leveraging Six Sigma to Improve Organizational Performance

Timeframe

Pro

port

ion

Jun-

04

Apr-0

4

Jan-

04

Oct-

03

Jul-0

3

Apr-03

Jan-

03

Oct-

02

Jul-0

2

Apr-02

Jan-

02

1.0

0.8

0.6

0.4

0.2

0.0

_P=0.947UCL=1

LCL=0.752

1 2

11

Tests performed with unequal sample sizes

P Chart of Compliance with Smoking Cessation Education (Heart Failure)

Align strategy, measures and projects

Page 35: Leveraging Six Sigma to Improve Organizational Performance

Timeframe

Pro

port

ion

Jun-

04

Apr-0

4

Jan-

04

Oct-

03

Jul-0

3

Apr-03

Jan-0

3

Oct-

02

Jul-0

2

Apr-02

Jan-

02

1.00

0.95

0.90

0.85

0.80

0.75

0.70

_P=0.9200

UCL=1

LCL=0.7603

1

Tests performed with unequal sample sizes

P Chart of Compliance with ACE at Discharge (Heart Failure)

Align strategy, measures and projects

Page 36: Leveraging Six Sigma to Improve Organizational Performance

Timeframe

Pro

port

ion

Jun-0

4

Apr-04

Jan-

04

Oct-

03

Jul-0

3

Apr-03

Jan-

03

Oct-

02

Jul-0

2

Apr-02

Jan-

02

1.0

0.9

0.8

0.7

0.6

0.5

0.4

_P=0.8901

UCL=1

LCL=0.7763

1 2

22

1

1

Tests performed with unequal sample sizes

P Chart of Compliance with Discharge Instructions (Heart Failure)

Align strategy, measures and projects

Page 37: Leveraging Six Sigma to Improve Organizational Performance

Timeframe

Pro

port

ion

Jun-

04

Apr-0

4

Jan-

04

Oct-

03

Jul-0

3

Apr-03

Jan-0

3

Oct-

02

Jul-0

2

Apr-02

Jan-

02

1.00

0.95

0.90

0.85

0.80

0.75

0.70

0.65

_P=0.9704UCL=1

LCL=0.9114

1 2

11

1

Tests performed with unequal sample sizes

P Chart of Compliance with LVEF Evaluated (Heart Failure)

Align strategy, measures and projects

Page 38: Leveraging Six Sigma to Improve Organizational Performance

Define the Project: This project is dedicated to meeting the CMS quality standards for patients undergoing Hip and Knee surgeries.

Measure the Process: See control chart for composite score.

Set a Goal: 100% compliance (6 for each individual indicator.

Analyze variances: Reliability ModelA)Preop order sets have been in place since January. Orthopedic order sets have been in place since March.

B) Nursing staff is responsible to place the order sets on the charts in PACU and CRNAs assure that appropriate antibiotics and timing occurs.

c) Failures are caused when order sets don’t get put on the chart, physicians refuse to use appropriate antibiotics or when delays in case cause the case to start after the 1 hr timeline.

Improve: Tests of Change?

Currently team is evaluating the order set compliance and waiting to see the data on charts that fail to meet the standards. These charts will lead us to better understand which circumstances lead to failure and then to the development of an FMEA. The result will be a second cycle test of change to eliminate the failure modes.

Hips and Knees

Timeframe

Pro

port

ion

Oct-04Sep-04Aug-04J ul-04J un-04May-04Apr-04Mar-04Feb-04J an-04

1.00

0.95

0.90

0.85

0.80

_P=0.9500

UCL=0.9978

LCL=0.9022

1 2

Tests performed with unequal sample sizes

P Chart of Hip/ Knee Composite Score

Top Decile

Align strategy, measures and projects

Page 39: Leveraging Six Sigma to Improve Organizational Performance

DSS Manager Portal

Align strategy, measures and projects

Page 40: Leveraging Six Sigma to Improve Organizational Performance

DSS Manager Portal

Main Menu – Click on “+” sign on left navigation to expand list of available reports.Align strategy, measures and projects

Page 41: Leveraging Six Sigma to Improve Organizational Performance

DSS Manager Portal

Seen below is an example of the Quality Dashboard Report.Align strategy, measures and projects

Page 42: Leveraging Six Sigma to Improve Organizational Performance

DSS Manager Portal

Seen below is an example of how to run the Indicator graphs.Align strategy, measures and projects

Page 43: Leveraging Six Sigma to Improve Organizational Performance

Allocate Leadership attention to improvement

Project sponsors

Project owners

Project report outs

Hiring and Promotions (Administrators and Managers)

Performance Planners

Teachers Facilitators

Black Belts and Green Belts

Page 44: Leveraging Six Sigma to Improve Organizational Performance

What is CAMC’s Strategy for Changing the System?

•Clearly communicate system-level strategy and goals

•Align strategy, measures and projects

•Focus leadership time on improvement work

•Connect the hearts and minds of all to improvement

•Increase improvement capability (skills and infrastructure)

Page 45: Leveraging Six Sigma to Improve Organizational Performance

Connecting the Hearts and Minds

Power of the OverlapThe power of an

organization to realize its goals is directly

related to the amount of overlap between

Healthy and Fit

The power of an organization to realize

its goals is directly related to the amount of overlap between

Healthy and Fit

Economic StrengthReduced expenses, increased revenues, competitive returns,

economies of intellect, decreased turnover, increased

intellectual capital.

Reduced expenses, increased revenues, competitive returns,

economies of intellect, decreased turnover, increased

intellectual capital.

Fit:The organizations ability to meet the demands of

the marketplace with high performance

metrics and increased value to its

stakeholders.

Fit:The organizations ability to meet the demands of

the marketplace with high performance

metrics and increased value to its

stakeholders.

Healthy:The organizations

ability to support the needs of its

stakeholders and improve the

environment in which services are provided.

Healthy:The organizations

ability to support the needs of its

stakeholders and improve the

environment in which services are provided.

FitHealthy

Connect the hearts and minds of all to improvement

Page 46: Leveraging Six Sigma to Improve Organizational Performance

Fit Cultural

Practices

Healthy Cultural

Practices

The underlying health of the organizational culture. Attributes that impact it’s capacity to achieve

optimum fitness and support sustainable performance.

The operational capacity of the organization to perform and execute on it’s strategies that create sustainability.

Practices dependent upon the underlying organizational health.

Either/or or Both? Where should we focus for the greatest impact?

Balanced Approach

Connect the hearts and minds of all to improvement

Page 47: Leveraging Six Sigma to Improve Organizational Performance

Increase Improvement Capability and Infrastructure

• Firm up project methods to get even better results• Use the DMAIC Model consciously and actively• Link PDSA tests to conceptual models• Use run charts, and learn Statistical Process

Control• Use DFSS to design Six Sigma into the process• Find the “bar,” meet it, then raise it

Page 48: Leveraging Six Sigma to Improve Organizational Performance

Why Integrate DFSS?

• Value of the integration is a more comprehensive roadmap

• Supports CAMC visions

• Used with excellent results

• Best of both: Siemens Implementation Methodology enhanced with Six Sigma tools

• Acts as a solution accelerator

• Can “Fill in the blanks…”

• Additional Business Case Benefits

• Improved Performance Levels

• Prioritization of Business Requirements

Page 49: Leveraging Six Sigma to Improve Organizational Performance

DFSS Methodology

• What is the end result ?– Complete and well designed solution– Clear linkage to the Business Case (lagging indicators)– Voice of the Customer (VOC) requirements identified

and met– Critical To Quality (CTQ) indicators tied to processes

(leading indicators)– Prioritization of System Requirements / GAPS– Risk identification and mitigation strategies– Confidence in the outcome

Page 50: Leveraging Six Sigma to Improve Organizational Performance

Typical Pattern

ResourcesCommitted

Time

Release

Release

Why Use Six Sigma - DFSS?

• Six Sigma - DFSS is different than the typical project in that it requires more up-front work to be done.

• Which curve is more efficient?• It requires more time in the planning stages, but the

project finishes sooner and with less overall work!

Page 51: Leveraging Six Sigma to Improve Organizational Performance

Soarian/Six Sigma Integration

Kickoff

DFSS Training

Verify / Validate

DesignAnalyzeMeasureDefine Control

Six Sigma DFSS Methodology

Integration Plan

Go Live ClosurePlanning & Initiation

Define Implementation

Soarian Methodology

Kickoff

Timeline

Today

127 8 9 10 111 - 6

Training Training

Page 52: Leveraging Six Sigma to Improve Organizational Performance

Soarian/Six Sigma Tool Integration

Initial project planning and preparation

Understand requirements and develop process

designs

Configure processes and test the system

Move from a pre-production to a productive

operation

Process flow diagrams and mapping

SIPOC User Requirements Gap Analysis System Requirements Benchmarking Brainstorming Process baselining on

key processes Implementation Plan Data Standards System Interfaces Voice of the Customer Quality Function

Deployment (QFD) Creativity Tools Score Cards Pugh Matrix MGPP –2 Stage Gate –2 & 3

Tool/Templates Sorian DFSS

X x

X X X X X XX x XXX X X X X X X X

Validation Testing Gap Analysis System Requirements Benefits Validation Control Charts Score Cards MGPP – 3 Stage Gate -5

Tool/Templates Sorian DFSS

X X XX x X X X X

Business Case Project Goals &

Objectives System Requirements Process baselining on

key processes Team Charters Scope Project Plan MGPP – 1 Stage Gate -1

Tool/Templates Sorian DFSS

X xX x

X xX x x X x XX x X X

Process flow diagrams and mapping

SIPOC Gap Analysis System Requirements Pilot Test & Verify Validation Strategy Training Plan Documentation Plan Communication Plan Capability Analysis Fault Tree Simulation Robust Design FMEA/EMEA Mistake Proofing Score Cards MGPP –2 Stage Gate -4

Tool/Templates Sorian DFSS

X x

X X X X xX x X X X x X X X X X X X X X

Verify / Validate

DesignAnalyzeMeasureDefine Control

Go Live ClosurePlanning & Initiation

Define Implementation

PE / DEx Methodology

Soarian Methodology

LegendX (Bold) - Preferred Template/Tool

x (Small) - Similar Template/Tool

X -Common/Customized Tool or Template

Page 53: Leveraging Six Sigma to Improve Organizational Performance
Page 54: Leveraging Six Sigma to Improve Organizational Performance
Page 55: Leveraging Six Sigma to Improve Organizational Performance
Page 56: Leveraging Six Sigma to Improve Organizational Performance

What is CAMC’s Strategy for Changing the System?

•Clearly communicate system-level strategy and goals

•Align strategy, measures and projects

•Focus leadership time on improvement work

•Connect the hearts and minds of all to improvement

•Increase improvement capability (skills and infrastructure)