Saturday, 31 March 2012 21:01

How Lean Six Sigma can help trim waste

If you’ve tuned into a news program or read a newspaper recently you’ve undoubtedly noticed that health care providers are struggling with increased cost, increased workload and funding cuts.

While looking for ways to deal with these problems, some health care institutions have found a possible solution in a very interesting place. Taking a page from the manufacturing industry, health care institutions are incorporating the Lean Six Sigma methodology. “Health care providers have started to understand they need to look from a process-based approach to gain efficiencies,” says Ed Siurek, Director of Quality at Corporate College. “Because of the increased scrutiny on costs, they have to find ways to keep patient care at a high level while minimizing as much process waste as possible.”

Smart Business spoke with Siurek about using Lean Six Sigma within health care institutions and its impact.

What does health care see in Lean Six Sigma?

Lean Six Sigma is a process-based set of tools. It can be applied to anything that follows or should follow a standard process. While the practice of medicine doesn’t really fall into this category, most things within a health care facility do. Think for a moment about all the administrative processes involved in running a hospital. Optimizing these not only increases efficiency, but the ancillary benefits to the staff, doctors and patients can be significant.

What’s driving this approach?

Quite simply, these organizations understand they must become more efficient in order to maintain their current business. Patient populations are continuing to grow, procedures are becoming more expensive and liabilities are a real part of everyday life. There is also the push from the ‘payers.’ Insurance companies and the federal government continue to push the industry to reduce costs.

In addition, there is the availability of information to the consumer. Consumers (or patients) have increased capabilities to understand their choices. While some individuals might not have the luxury to evaluate which facility they will use, many outpatient or elective procedure patients do. They shop for the best services available and hospital patient satisfaction results play a big role in some of these decisions. Creating the best possible patient experience means eliminating waiting times, paperwork and any other problems.

Is there a difference in the approach taken by health care versus manufacturing?

Essentially, there is no difference. Because Lean Six Sigma is a process-based tool, it can apply to any individual process. However, many health care facilities choose to use their own terminology to ease the process. Because Lean and Six Sigma are often associated with a manufacturing environment, the difference in terms and even modification of the key practices allows a smoother transition into the ultimate goal of continuous improvement.

Are there any pitfalls or obstacles to implementing this type of program in a hospital?

Many Lean Six Sigma practitioners have seen some level of resistance. Although this isn’t unusual, it is a bit different in clinical settings. Lean Six Sigma is not something to be applied to the practice of medicine, but rather to the processes within the institution. It has been applied to the transport of patients, medical billing, and redesign of work cells to optimize the flow of information and to reduce the amount of waiting by doctors, nurses and patients. If this point is carefully defined in the early stages and there is diligence in keeping a processed-based approach, individuals can see the benefits and ultimately adopt the program. Unfortunately, there have been examples where the lines between process improvement and patient care have become blurred and the program most likely fails to achieve any positive impact.

What are the benefits to using Lean Six Sigma in health care?

Lean Six Sigma is merely a tool used in the continuous improvement process of an organization. With the external regulatory and financial pressures placed on health care today and the increased demand from patients for the best possible experience, these organizations need to have a way to continuously monitor and improve all of their processes.  In the end, the benefits are seen not only by the institution, but much further into the community. Better processes make employees feel better about what they are doing. Customers (or patients) have a better experience and the institution is able to eliminate wasteful processes that can directly impact their bottom line.

In addition to improving the patient experience, health care institutions can and have seen significant impact within the administrative portion of their business. As it does in any office setting, Lean Six Sigma can help to reduce variation and waste. Determining root causes and then streamlining processes saves time, effort and headaches for everyone involved. Consider the number of transactions conducted in one day at a typical hospital that do not directly involve the treatment of a patient. If you are able to cut even 5 to 10 percent, you can achieve significant cost savings.

What do you see as the end result of these programs?

Continuous improvement is a critical component to any business. In the field of health care, it can result in organizations increasing their internal efficiencies, patient satisfaction, employee involvement and overall strength of the business.

For medical staff, optimization can lead to the elimination or reduction in wasted time and effort, allowing more time with patients. Health care professionals always say they became involved in the field to help people. Elimination of wasted activities gives them that opportunity.

Lean Six Sigma is a preventive medicine that can be used on processes to avoid problems in the future. Many institutions have become more involved in using these techniques and the success stories become more significant every day.

Ed Siurek is Director of Quality at Corporate College.  Reach him at (216) 987-2838 or

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Has your company found it more difficult to compete in today’s marketplace? With the increased economic pressures and a more informed customer base, many organizations find it increasingly difficult to meet or maintain business objectives.

Six Sigma is a business management strategy initially developed by Motorola in 1986. Lean manufacturing is the result of years of practical operational efficiency tools developed by Toyota, often referred to as the Toyota Production System (TPS). Business practitioners have melded Six Sigma ideas with lean manufacturing to yield a methodology termed Lean Six Sigma. Put simply, it seeks to eliminate process variation and defects while optimizing the process by eliminating or reducing waste and increasing efficiency.

“Lean Six Sigma is a systematic approach using analytical tools to identify and remove problems within a process,” says Ed Siurek, director of Quality for Corporate College. “It creates efficiencies, drives productivity and reduces costs — all things companies are looking to achieve in a struggling economy.”

Smart Business spoke with Siurek about Lean Six Sigma, who should be involved within an organization and how the model should be evaluated.

Why is it important for companies to be aware of Lean Six Sigma?

In today’s global economy, consumers have become better informed and increased demands for higher quality, more consistent products at a lower price. Companies have been forced to perform at higher levels with the same or limited staff. Reduction of waste in the form of defects, operational inefficiencies and nonvalue-added activities is one place companies have turned. An additional benefit to reducing variation and defects is higher customer satisfaction. Having happy customers typically results in repeat business.

Why is Lean Six Sigma effective when compared to other management programs?

Plain and simple, it uses data. Lean Six Sigma uses a defined methodology when looking at process optimization. Part of this methodology involves collecting process data and using tools to pinpoint problems using statistical analysis. The approach takes into account variables that occur and may not necessarily be obvious. These process influencers are often not even considered when using other continuous improvement methods because they are not seen as directly involved in a process. Often management thinks they know what’s wrong with a process. But until they analyze the problem, it’s hard to identify the true root cause.

Is there an optimal time for an organization to implement a Lean Six Sigma program?

Any organization can see the benefits of Lean Six Sigma tools, but until an organization makes the conscious decision to deploy the program, the benefits will only be minimal and may not be sustainable. Organizations seeing the biggest benefits from Lean Six Sigma are those that implement the program before they ‘need’ to do it. Being proactive can allow companies to develop efficiencies and, more important, the culture necessary for continuous improvement. Implementing when it becomes a necessity is still very effective. Organizations must be diligent in the commitment and planning of their implementation to obtain the maximum benefits.

Who should be involved within the organization?

Lean Six Sigma is intended to be an enterprisewide program. Management must champion the different projects so they can help with major decisions and clear roadblocks. But the reality is that the people who are really analyzing and fixing the process are those who are doing the work — they are the closest to it. You also want to have individuals involved who are adept at identifying collateral damage. If the process you’re working on negatively impacts another process, you can create a bigger problem for yourself. This doesn’t mean every employee needs to be a Lean Six Sigma Black Belt, but every employee should be introduced to the basic concepts and principles. Individuals will then need to be selected to be trained to various levels within Lean Six Sigma, depending on their role in continuous improvement projects.

How should an organization get started with Lean Six Sigma?

First, make a commitment. Management needs to make sure they understand the program and commit to continuous improvement. Initially, many employees are afraid Lean Six Sigma will become the ‘program of the month.’ When implemented that way, it will fail. As management gets involved and employees see the personal benefits to their daily work, the program begins to take hold. Employees start to look for ways to optimize their work and others want to learn how they can benefit. At that point, the program has started to truly take hold and the benefits will quickly increase.

How should the effectiveness of Lean Six Sigma be evaluated?

Every project should have clearly defined measurables. Spending the time in the first phase of a project allows an organization to understand the process, the project scope and potential influencing factors. When evaluating a process, it is common for a Lean Six Sigma Black Belt to ask the process owner, ‘What’s your biggest pain?’ or ‘If you could fix one issue with the process, what would it be?’ Taking initial measurement of the process ‘as is’ is critical to understanding the impact of any continuous improvement project.

Effectiveness should be measured in defect reduction, time savings, monetary measures or anything else that can show direct benefit to the increased efficiency of the process.

Using Lean Six Sigma as an organizational tool for continuous improvement allows companies to constantly seek to minimize problems, increase efficiencies and maintain the highest levels of productivity, even during tough economic times.

Ed Siurek is director of Quality for Corporate College. Reach him at (216) 987-2828 or

Published in Cleveland