Posts Tagged ‘Six Sigma Tools’

Quality Guru Chosen to Head CMS

Tuesday, May 11th, 2010


Donald Berwick


Donald Berwick, a Harvard University professor and leading advocate for improving health-care quality and efficiency, has been named by President Obama as his choice to head the Centers for Medicare and Medicaid Services (CMS.) Berwick is well-known in Quality circles for aggressively advocating quality improvement in healthcare. Berwick, who specializes in health-care policy and pediatrics, has never led such a large organization. As head of the Boston-based Institute for Healthcare Improvement, however, he is known for persuading doctors and hospitals to adopt innovative methods for reducing medical errors. Dr. Berwick is author of numerous articles and books, including the classic work demonstrating the application of quality technology to health care issues, Curing Health Care. He is one of the nation’s leading authorities on health care quality and improvement. He is also Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School, and Professor in the Department of Health Policy and Management at the Harvard School of Public Health.

If confirmed by the Senate, Berwick will face a number of daunting challenges. One is the sheer size of the CMS, which is about to become even larger. The agency, which is part of the Department of Health and Human Services, must oversee a massive expansion of Medicaid, the federal-state insurance program for the poor, with an estimated 16 million people expected to join its rolls by 2020. At the same time, Medicare, the insurance program for the elderly, will need to reduce payments to health-care providers by about $400 billion over 10 years without impacting the quality of coverage. Lean Six Sigma and Quality technologies provide an approach for doing this while minimizing the impact on value-added health care processes, operations and activities. Berwick’s familiarity with these areas provides reason for optimism or, at least, hope. This blog has frequently posted examples of poor quality in health care. Let’s hope that Dr. Berwick will have a positive impact at CMS.

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Creating Customer Value or should I say Removing Non Value

Monday, April 12th, 2010

I have seen many companies trying so hard to get their employees to work harder creating more value for their customers. Trying constantly to keep a competitive edge over the competition. And yet when they really look around their employees are working already so hard. In fact, I’d say, people are busy 99% of the time trying to do a good job. So how does a company today meet this challenge, it is in the things the people do. The process! It is not the “people” that creates the value, but the activity (process) they do that creates it. You can actually see this but looking at the “things” (paper or product) in the process evolving into customer needs. If you focus on the “things” in the process and NOT the people you will see that those “things sit there not doing a thing 99% of the time. So to increase value to your customers you need to take the time wasted by the things in the process  just sitting doing nothing and remove it.

How do you do that? Simple, buy looking at the entire process. Look at things people are working on. If you see things that no one is working on then you can bet there is no value being added. Those steps/activities should be eliminated thus removing wasted time from the process. This concept is applied using what is called a Value Added Flow Analysis and I am going to quickly give you the “How To” perform one.

Value Added Flow Analysis

  1. Capture all the steps in the entire activity/process from beginning to end.
    1. To do this you follow one of those “things” (paper or product) from the receiving dock to the customers hands.
    2. Record EVERTHING that happens and how long it takes. I mean everything! Including, for example, the “step” of the thing (order) sitting is a briefcase or notebook as it is transported back to the office to be entered into your system. Or the “step” of the thing (your lunch order at a restaurant) sitting on the note pad as it travels to the kitchen. EVERYTHING! This list will be long both in time and steps.
  2. Next you will take this list and look at each of those step and determine if it is value added or not. So how do you  determine if it is value added? Value added steps can be identified by answering three questions about each step. All three questions have to be answered YES! If any are answered no then they are “non value added steps” and need to be put on the list to be elimination or improvement. Here are the three questions:
  1. Does the thing in the process change? If the “thing” is paper was some information recorded on it? If the “thing” is a product was something added to it?
  2. Does the customer care about the change? In other word are they willing to pay for the change that happened to the thing in the process.
  3. Was it done right the first time? Remember that you, as a customer, do not what to pay for mistake or redo’s and you surely do not want to wait for the error to be corrected. This is of no value to you.
  1. Once you have identified all the value added step then you need to eliminate or significantly improve all of the others. In a simple world you would just eliminate all of the non-value added steps. But our world that is not so easy to do, but I do feel you can eliminate about 75% of them.

Non Value Added Step Eliminating:

How can I be so sure that you can eliminate 75% of these steps; experience. Over the years I find over and over again that you can eliminate about 75% of the non value added steps. Look at one of your processes. When you first developed this “process” it was done a certain way. If lucky that way was written down as a procedure. But as time changed so have customer needs and to meet those needs you have adjusted your process. Over time with all the “adjustments” you now have a process that has several steps that are not needed any more to meet old needs that are no longer there. Another example maybe that the “process” has been handed down from employee to employee (no documentation) and each has done it slightly different. So in time the process has shifted from a originally good one to one that is different during which time the customer needs have changed as well. In either case steps have been left that create no value for your customer and need to be eliminated.

Non Value Added Step Improvement:

OK not everything can be eliminated. Why? Because many time we have more than one customer set of values and we have to prioritize, not eliminate, what we are doing. Be careful you are not micro managing something for you own interest and NOT your customers. A good example of a non value added step that can not be eliminated is Taxes. The “Paying Customer” does not care whether you pay them or not. But to stay in business you have to. Some look at the IRS as another customer (although not a paying one). So in these cases you have to look at ways of completing those steps as quickly and correctly as possible.

Well there you have it. How to create value without something new, but by eliminating waste. That is of value to the customer in that it reduces cost without reducing quality and they receive it sooner than expected. If you like this article I have written several others on my blog http://www.sixsigmatrainingconsulting.com/knowledgebase/ . As always, if you have any questions feel free to contact me.

Bersbach Consulting
Peter Bersbach
Six Sigma Master Black Belt
http://sixsigmatrainingconsulting.com
peter@bersbach.com
1.520.829.0090

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The Seven Types of Waste a Summary

Thursday, March 18th, 2010

Bersbach Consulting LLC provides Six Sigma training coaching and support across Arizona, including the Tucson, Phoenix, Scottsdale, and Glendale areas. At this time we would like to thank our friends and clients for their support. If you have landed here looking for our Six Sigma training, coaching or support services in Tucson, then please follow this Six Sigma Training link.

You may have seen a couple of posts I have done on the seven types of waste. I have completed seven articles on all seven types of waste you might find in your organization. Below is a listing and a short description for each of the seven types of waste plus a link to the full article. I believe if you read these articles you will have a new way of looking at your business.


The Seven Types of Waste:


Correction – Corrections are and time you redo, rewrite, rework, repair, or scrap something. This can be as simple as rewriting a grocery list. Say you have a grocery list but you want to rearrange the items on it in the order you will encounter them in the store. Even though it will speed things for you shopping it had to be redone instead of thinking of making the list ordered in the first place. Redoing the list did not add any value to you; it took longer to write it a second time instead of doing it right the first time.


Overproduction – Overproduction is when you make too much of something or you perform too much of a service for some one. Have you ever held a meeting and made copies for that meeting? Most people make a few extra, do you? That is overproduction they will end up in the trash. Or have you every as a question about something in a store and the salesman goes on an on answering your question when all you wanted was the simple answer? That salesman was overproducing


Movement of material or information – This type of waste is when you take any material for information and have to move it from one place to another. You may ship it or carry it your self but that movement does not create any value for the customer in fact it is lost time because it delays your product or service from getting to your customer


Motion of employees – This type of waste is when you or an operator has get up and walk or travel to get something to do their job.  Just like movement of materials and information, motion of the operator does not create value. In fact the “thing” in the process is not changing at all


Waiting – This type of waste is when you, other employees, customer, material, or equipment sits idle waiting. Think about all the waiting rooms there are. As a customer do you want to wait? No but we sometime have come to expect the wait. I have been to doctor’s office where the waiting room is empty or full did not matter but in some I was seen on time and other I have waited over an hour.


Inventory or other resources - This type of waste is not just supplies and materials on shelves but also any recourse your company has that is not being utilized. We normal see inventory as parts and supplies sitting on a shelf like boxes of cereal in the grocery store. But here inventory also include equipment that is standing idle or in storage and employees that have skill that are not being used to their fullest.


Processes - This type of waste is when you are doing more than required by the customer. This is a hard one to understand because sometimes doing more for free has a WOW factor for your customers. That is why it is important to know what is of value and what is not. You see sometime you do sometime more that you think the customer wants and they do not care. That is when it becomes a waste.

If your business is located anywhere in the World including the US, Tucson, Oro Valley , Oracle, Phoenix, Glendale, and Scottsdale, Marana, Green Valley Arizona or beyond and you would like to learn more about our Six Sigma training, coaching and support services please call  Bersbach Consulting LLC at 1-520-829-0090  Now!

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What is a Black Belt?

Monday, August 17th, 2009

Who are they and what do they do?

I‘m often asked about the term “black belt” as it relates to six sigma. What, precisely, is a black belt? Where did the term originate? For that matter, where did the term “six sigma” originate? And, while we’re on the subject, what’s a green belt or master black belt?

Let’s start with the term “six sigma.” In a conversation with Ed Bales of Motorola University, I learned that Motorola coined the term in 1986. As those who have worked in quality for a while know, this term has statistical roots in the technique known as process capability analysis. Prior to the Japanese industrial invasion of U.S. markets, quality practitioners were happy with three sigma quality, which translates to about three errors or defects per 1,000 items for processes in a state of statistical control. Motorola discovered that its processes weren’t in statistical control–estimates based on field failure data indicated that Motorola’s processes apparently drifted by an average of 1.5 standard deviations. In a conversation with ex-Motorola trainer Mikel Harry, I learned that he considers the Cpk index–which measures short-term process variability under statistical control–worthless. Harry prefers the Ppk index, which measures actual performance rather than process capability. (Note that many experts, including me, disagree strongly with Harry on this issue.) In any case, before computing expected process failures, Motorola adds this 1.5 standard deviation. Thus, when we hear that a six sigma process will produce 3.4 parts-per-million (PPM) failures, we find that this PPM corresponds to the area in the tail beyond 4.5 standard deviations above the mean for a normal distribution.

Motorola also adopted the terms “black belt” and “green belt.” For my book The Six Sigma Handbook, I did extensive research into what employers expect of people with these titles. Here is a summary of these various responsibilities:

  • Master black belt–This is the highest level of technical and organizational proficiency. Because master black belts train black belts, they must know everything the black belts know, as well as understand the mathematical theory on which the statistical methods are based. Masters must be able to assist black belts in applying the methods correctly in unusual situations. Whenever possible, statistical training should be conducted only by master black belts. If it’s necessary for black belts and green belts to provide training, they should only do so under the guidance of master black belts. Because of the nature of the master’s duties, communications and teaching skills should be judged as important as technical competence in selecting candidates.
  • Black belt–Candidates for technical leader (black belt) status are technically oriented individuals held in high regard by their peers. They should be actively involved in the organizational change and development process. Candidates may come from a wide range of disciplines and need not be formally trained statisticians or engineers. However, because they are expected to master a wide variety of technical tools in a relatively short period of time, technical leader candidates will probably possess a background in college-level mathematics, the basic tool of quantitative analysis. College-level course work in statistical methods should be a prerequisite.

Six sigma technical leaders work to extract actionable knowledge from an organization’s information warehouse. Successful candidates should understand one or more operating systems, spreadsheets, database managers, presentation programs and word processors. As part of their training they will be required to become proficient in the use of one or more advanced statistical analysis software packages.

  • Green belt –Green belts are six sigma team leaders capable of forming and facilitating six sigma teams and managing six sigma projects from concept to completion. Typically, green-belt training consists of five days of classroom training and is conducted in conjunction with six sigma team projects. Training covers facilitation techniques and meeting management, project management, quality management tools, quality control tools, problem solving, and exploratory data analysis. Usually, six sigma black belts help green belts choose their projects prior to the training, attend training with their green belts and assist them with their projects after the training.

Although the martial arts terms described above are common, they are by no means universal. Companies and consulting firms often create their own titles to describe the work done by these technical leaders.

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Caution! Your Hospital Stay Could Be Fatal

Wednesday, March 25th, 2009

The Sunday paper’s Parade section on February 8, 2009 contained an interesting article entitled “Don’t Let a Hospital Make You Sick.” The article contained a number of facts that I knew, but that are not widely known by the general public. Facts such as 1300 times per year operating on the wrong patient or removing the wrong organ or limb. Or 98,000 deaths per year due to medical mistakes. Or surgical instruments being left inside patient at a rate of once per 5000 patients.

Anyone who has studied Six Sigma knows that these processes are performing far below Six Sigma levels. Why are we willing to tolerate such abysmal quality from such an important supplier? I’ve worked in healthcare enough to know that there’s no reason that our healthcare can’t be delivered with at least as high a quality level as a beer can.

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