Academic Center Lab Implementing Six Sigma

Management system is expected to accelerate gains in laboratory quality and productivity

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CEO SUMMARY: Fairview-University Medical Center’s laboratory may be the nation’s first academic center laboratory to deploy Six Sigma and Lean management systems. Administration expects Six Sigma to accelerate the rate at which improvements in quality and productivity can be realized. The laboratory’s first black belt candidate is in training and enthusiasm is building among the laboratory staff.

SIX SIGMA and “Lean” management methods have arrived at Fairview-
University Medical Center Clinical Laboratories
(F-UMC), located in Minneapolis on the University of Minnesota campus.

As a rule, academic center hospitals are not early adopters of cutting-edge management systems developed by corporations outside healthcare. Intrigued by this unusual development, THE DARK REPORT recently traveled to Minneapolis to learn, first-hand, what motivated ad- ministration at this academic center to introduce the principles of Six Sigma and Lean into its laboratory.

Principles Already Known

“Although we may be the first academic hospital laboratory to employ Six Sigma, these management principles are not new to our health system,” said Rick Panning, Administrative Director of Laboratory Services at Fairview Health Systems, which owns seven hospitals and 35 clinics in Minnesota.

“Over several years, Fairview’s administrators and managers have undergone regular and extensive training in advanced management systems,” Panning said. “This includes education provided by Motorola University and the Juran Institute. Blue Fire Consultants has also provided training and consulting support. In addition, Fairview has long used the FOCUS-PDCA process improvement model when addressing change.

“Fairview Health System keys this training around what it calls ‘Performance Excellence’,” he continued. “We have a formula that emphasizes how quality management methods generate accelerated change to achieve effective results. (See sidebar on next page.) Our system uses this message to emphasize the importance of continuously improving patient care and raising service to higher levels.

“This is why the decision to introduce Six Sigma and Lean management techniques into the laboratory is simply one more step in Fairview Health System’s ongoing management evolution,” noted Panning.

But why was Six Sigma selected over other management options, and why now? “There’s a simple answer to that question,” responded Panning. “Our administration wants to accelerate the results that come from using quality management tools. It believes that Six Sigma and Lean are management systems which generate faster and bigger gains in quality and productivity than the management methods we’ve used to date.

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Lab Challenged To Improve

“Our administration is challenging us to measurably improve the quality of our laboratory services even as we eliminate unnecessary costs,” he added. “To help us achieve this, administration is willing to fund the expenses necessary to train our laboratory staff in Six Sigma and finance these black belt projects. Compared to many other hospital labs, we are fortunate in that respect.”

Panning explained that administration at Fairview sees management training as a worthwhile investment. “The cost of implementing Six Sigma and Lean will be more than recouped by the faster, larger gains in quality and productivity. The laboratory was singled out as the Six Sigma beta site for two main reasons. First, we are preparing to redesign the lab facility to accommodate automation. Second, we recognize that, if we can simplify the complex work processes in the laboratory, we can maximize efficiency and improve service,” he explained.

“Administration also supported working with a key vendor in the laboratory to help us in that effort,” continued Panning. “That’s one reason Johnson & Johnson’s Ortho-Clinical Diagnostics division was selected to provide guidance and training in Six Sigma and Lean. It was important to our administration that Johnson & Johnson is committed to implementing Six Sigma and Lean throughout its own company.”

First Black Belt Candidate

Approval for the laboratory’s first black belt project came in early spring. “The lab sent four individuals to champion training,” noted Kathy Hansen, Directory of Laboratory Operations at F-UMC. “Cindy Hudson, a supervisor in the acute care laboratory, was selected to be our first black belt candidate. Things have moved swiftly. Over the summer we completed Lean training, the lab underwent Value Stream Mapping, and the first black belt project was selected.”

“This project’s goal is to improve how we handle specimens passing through the acute care lab at Fairview-University Medical Center,” said Panning. “F-UMC handles a high level of patient acuity because large numbers of solid organ and bone marrow/stem cell transplants and other complex cases are performed here. So it is important for the lab to sustain a high quality of service. Our first black belt project covers work flow from when the laboratory receives a specimen until it is ready for testing.

Lab Staff Likes Six Sigma

“What’s been a pleasant surprise is the genuine enthusiasm and support of our lab staff to the arrival of Six Sigma and Lean,” added Panning. “During Value Stream Mapping, it was observed that our lab has many non-standard work processes and variation in sample delivery pathways. We’ve identified multiple interruptions in workflow, problems with our laboratory layout, and unnecessary handling and movement of specimens. There are plenty of opportunities to achieve substantial improvement.

“Along the way, analysis done with the Six Sigma and Lean tools validated that most of what we do in our lab is functioning at a high level already. It’s affirmation to our staff that the quality management tools they’ve been using have kept us ahead of the curve.”

Once Fairview’s administration has evaluated outcomes from this first Six Sigma effort in the laboratory, it is prepared to roll out these techniques in other areas of the health system. “We are poised to introduce this into one of our community hospital labs in 2003,” stated Panning. “We also see opportunities in transfusion services, microbiology, specimen processing/triage center, and in pre-analytic functions at all our system’s laboratory sites.”

Questioning The Status Quo

During THE DARK REPORT’S site visit to F-UMC, enthusiasm for the Six Sigma/Lean initiative was universal. Laboratorians, physicians, and administration are embracing these tools as aids in achieving quality and productivity goals. The willingness to rigorously question existing ways of doing business sets F-UMC apart from many academic center hospitals.

The reason for this support probably can be attributed to the extensive training in basic quality management philosophies and methods that Fairview has provided over the years to staff and physicians alike. Throughout the health system, stake- holders recognize how these tools can help improve work processes, reduce cost, and improve patient outcomes.

Fairview Health System is not the only early adopter applying Six Sigma methods in its laboratory. As many as 10 or 15 hospitals and health systems nationally have begun to implement Six Sigma and Lean methods.

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