Group 4: Project Agenda

1. Group 4: Project Agenda • Overview of Business Process Redesign models used in healthcare. • Applicability of principles of Business Process redesign related to overall Project Management methodologies. • Effectiveness of such models as part of a Healthcare IT initiative. • Examples where organizations have used such a model as part of a Healthcare IT initiative. • Class exercise and questions.

2. Health Care Challenges that encourage use of BPR: • Medical errors and high costs of healthcare • Underinsured or uninsured population • Increasing number of heterogeneous and older population, • Globalization/ medical outsourcing, • Maintaining quality for given cost and cost minimization for given quality • Shortage of clinical and nursing staff

3. Expectations from BPR models: • Increase in efficiency • Reduce medical and medication errors • Health care cost reduction • Better access and quality in healthcare • Procedure optimization • Time effectiveness • Customer and health care provider satisfaction

4. Highlighted solutions: • Automating and monitoring processes in healthcare • Redesigning or improving clinical processes where necessary and possible • Identifying patient expectations and improving patient care processes for better customer services. BPR models: The business process redesign (BPR) models are the processes that target improvisation and optimization of process outputs while maintaining quality.

5. Six Sigma: (Six sigma was invented by Motorola in the 1980s) • Analytical approach to indentify the inefficiencies and inadequacies in the process and provide a step by step solution based on analysis of real time data. • Process must have < 3.4 defects per million occurrences (Carrigan, 2006) • Statistical calculation that suggests customer needs /satisfaction to meet 99.99997% or 6-Sigma level. (Caldwell 2006) • Focuses on customer satisfaction, process improvement and cost reduction. (Breyfogle, 2003) • Uses structured methodology and powerful statistical tools that provide a scientific approach to process improvement and patient safety. (http://www.medscape.com)

6. Six Sigma Sub methodologies • DMAIC: Define, Measure, Analyze, Improve, and Control; (improve existing processes ) • DMADV: Define, Measure, Analyze, Design, Verify; (develop new processes or products at Six Sigma quality levels) (http://www.isixsigma.com/sixsigma/six_sigma.asp) • Implementing 6sigma: “Black Belt” = organize of Six Sigma project “Green belt” = implement and monitor the project.

7. Applications of BPR models: • Scheduling appointments • Emergency room allotment • Diagnostic imaging • Patient follow up appointments • Cancer screenings • Bed allotment systems • Minimizing duplication of records, bills, scheduling of follow ups and refills • Reduce “off time” of the systems to improve accessibility and promptness • Reducing wait times at Dr.’s office and many more.

8. BPR Obstacles: • Internal and external challenges such as resistance to change, financial challenges, hierarchical tensions, changing workforce, lack of commitment, lack of implementation • Six Sigma requires a clear goal setting, ample training of employees and commitment to implement the projects thoroughly. • success is not guaranteed (Corn 2009)

9. Bibliography: • Corn, J.B.,Six Sigma in Health Care, Radiologic Technology. September/October 2009; 81(1): 92-95 • Breyfogle, F.W., Implementing Six Sigma: Smarter Solutions Using Statistical Methods, 2nd ed. 2003, Wiley, New York, NY. • http://www.isixsigma.com/sixsigma/six_sigma.asp) • http://www.medscape.com/viewarticle/449692_6) • Carrigan MD, Kujawa D. Six Sigma in health care management and strategy. Health Care Management. 2006;25(2):133-141 • Caldwell, C., Lean-Six Sigma tools for rapid cycle cost reduction, Healthcaare Financial Management. Oct 2006, 60 (10) • Schweikhart SA, Dembe AE. J Investig Med. 2009 Sep 2 • http://www.pqa.net/ProdServices/sixsigma/sixsigma.html