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6σ 在醫院管理之應用

6σ 在醫院管理之應用. 一、六標準差 ( 6σ) 的意義 二、六標準差的戰術運用 三、六標準差的管理工具 四、醫院管理應用實務介紹. 六標準差 ( 6σ) 的意義 -- 99% Good guarantee ？？. EXAMPLES OF 99% GOOD: 20,000 lost articles of mail every hour. 15 minutes each day of unsafe drinking water. 5,000 incorrect surgical procedures per week.

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6σ 在醫院管理之應用

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  1. 6σ在醫院管理之應用 一、六標準差(6σ)的意義 二、六標準差的戰術運用 三、六標準差的管理工具 四、醫院管理應用實務介紹

  2. 六標準差(6σ)的意義--99% Good guarantee？？ EXAMPLES OF 99% GOOD: • 20,000 lost articles of mail every hour. • 15 minutes each day of unsafe drinking water. • 5,000 incorrect surgical procedures per week. • 4 or more accidents per day at major airports. • 200,000 wrong drug prescriptions each year. • 7 hours each month without electricity. Is it acceptable to you personally? How about to your organization? Reference:Harry, Mikel, Dr. The Vision of Six Sigma. Sigma Publishing Company, 1994.

  3. 六標準差(6σ)的意義--6之目標完全消除變異與浪費六標準差(6σ)的意義--6之目標完全消除變異與浪費 • 不斷提高客戶滿意度 • 持續測量 • 提高流程能力 • 降低不良品 • 增加獲利 持續改善導致經營成功

  4. Noises Man Desirable Machine Input Output Process Material Undesirable Control Method Control Environment

  5. Flooding, Earthquake, Labor Union Strike, ect Man Good Product Machine Input Output Process Material Process Control Defective Product Method Quality inspection & SQC Environment In-Practical

  6. In Practical User misapply, or even abused Engineering decision (ie, Configuration) Perform as specified CAE/CAD Input Output Material -durability -compatibility -Stability Product Validation and qualification Sub-Standard perform not perform, or other concern (ie, Safety) The way to use the product Final Functional Test prior to shipping Intended using Environment

  7. Exchange rate changed, political influence, business down-turns, ect Personal Priorities Favorable or popular decision Organization priorities Input Decision Making Output Wall-Street & BoD expectations Un-Favorable or un-popular decision Personal Feelings Recourse Constraints Consult with colleagues, legal counselor, financial advisor, ect Environment In-Practical

  8. 我們的追求 規格下限 規格上限 幾乎完美 接近完美 大多數狀況

  9. Perfect Condition Possible Defective ppm 317300 4500 2700 83 .57 .002 Spec. Limit +/- 1 +/- 2 +/- 3 +/- 4 +/- 5 +/- 6 Percent (%) 68.27 95.45 99.73 99.9937 99.999943 99.9999998 The most likely condition Possible Defective ppm 697700 308700 66810 6210 233 3.4 Spec. Limit +/- 1 +/- 2 +/- 3 +/- 4 +/- 5 +/- 6 Percent (%) 30.23 69.13 93.32 99.3790 99.97670 99.999660

  10. In Reality we will have Possible Defective ppm 697700 308700 66810 6210 233 3.4 Spec. Limit +/- 1 +/- 2 +/- 3 +/- 4 +/- 5 +/- 6 Percent (%) 30.23 69.13 93.32 99.3790 99.97670 99.999660

  11. α/2 α/2 x 平均值 變異數 平均值 標準差σ 樣本 群體 預估未來的群體

  12. 六標準差的戰術運用 - MAIC Process is to Improve as what we have 6s Control Measurement Improvement Analysis

  13. 六標準差的戰術運用- DMAIC Process is toImprove with changes but within the system 6s Define Control Measurement Improvement Analysis

  14. 六標準差的戰術運用 - DMADV Process is to Break through the existing barriers 6s Define Validation Measurement Design Analysis

  15. 六標準差的戰術運用 - DEOVI Process is to get it done the most effective way the 1st and only time 6s Define Incorporate Evaluate Validate Optimize

  16. 掌握特性(Characterization) 追求完美(Optimization) Six Sigma Road Map Define/定義 Measure/衡量 Analyze/分析 Improve/改進 Control/管制

  17. Project Focus: Define Getting Ready • Response variable • Dependent variable • Output • Symptom • Effect Measure Process Characterization Y Monitoring Systems Analyze • X1 . . . XN • Independent variables • Process inputs • Problems • Causes Improve Controlling Systems XX Process Optimization Control Goal: Y = f ( x ) Question: If we are so good at X, why do we constantly test and inspect Y? Question: To get results, should we focus our efforts on the Y or the XÖ ?

  18. Define, Measure, Analyze, Improve, Control Focus Phase Step x & y Define 1. Understand the needs, create the interval interest & motivation 2. Mapping the strategy x & y 1 Select Output CTQ or CTC 2 Define performance standards for response variable 3 Identify measurement system for input and response variables 4 Establish process capability of response variable 1 Define improvement objectives 2 Identify all sources of variation in y (inputs = xi) 3 Screen sources for potential causes of variation in y & identify vital few x – KPIV 1 Determine mathematical relationship between vital few xi 2 Establish operating tolerances for vital few xi 1 Validate measurement system for xi 2 Determine ability to control vital few xi 3 Establish process control plan for vital few xi y y Measure x & y y x1, x2, ... xn x1, x2, ... xn Analyze Vital Few xi Vital Few xi Improve Vital Few xi Vital Few xi Control Vital Few xi Vital Few xi SUSTAIN

  19. 六標準差的管理工具 • Common understandings and languages • Target setting and MBO • Score board and report card • Mapping KCDS (Key characteristics Designating system) • C/E Matrix • FMEA (Failure Mode & Effect Analysis) • Distribution, Probability & Modeling • Data Collection & Analysis • Basic statistical tools – Enhanced fishbone diagram, control charts, histogram ect. • Statistical tools – regression analysis, R/C analysis, DoE, ect • Advanced Statistical Tools – Regression Analysis, R/C Analysis, ANOVA, ect • Measurement System Analysis • Control plan • APQP (Advanced Product Quality Plan) • Robust Engineering • Streamlining & Error proofing

  20. 改善活動垂直展開分析 動支申請 輸入不正確 報銷明細 輸入不正確 出納付款 作業錯誤 使用者不熟 使用者不熟 a 廠商基本 資料檔錯誤 出納人員 疏失 f 管制人員 對項目不熟 銀行行員 資料輸入錯誤 b 主管對會計 與系統不熟 c 會計主管 疏漏 管制人員 手工登帳遺漏 遺失憑證 主管疏漏 流程費時/人工 作業成本高 遺失憑證 會計主管 疏漏 e d 系統故障 核判權責 規定過時 系統故障 未定期維修 會計人員 疏失 列印設備 故障 報銷資料 審核疏漏 資料轉檔失敗

  21. 3x 2x 1x 6σ的里程進行 利潤 100x 6σ 50x 5.4σ 10x 5.2σ 5σ 4.5σ 4σ 3.5σ 3σ 時間

  22. 6σ的成果 Answer: NO，只有方法、堅持與努力! but it does seek to destroy black-magic! 奇　蹟 ??

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