Comprehensive Guide to Lean Six Sigma and Process Improvement in Pharmacy

What is the definition of Lean Six Sigma?

a diciplined, data-driven approach to process improvementthat combines the principles of Lean manufacturing and Six Sigma methodologies to enhance efficiency, reduce waste, and improve quality in organizational processes.

What is Lean?

Process primarily focused on efficiency, doing more with less, and reducing waste (Muda). It asks: “Are there steps in this process that do not need to exist?”

What is Six Sigma?

Process focused on precision and reducing variation to eliminate defects. It asks: “Why isn’t this process producing the same exact results every single time?”

The combination of Lean and Six Sigma allows for Continuous improvement (CI), what is CI?

Iterating on a process repeatedly until a flawless result is achieved every time.

Developer of Six Sigma and what company?

Bill Smith (Motorola)

Where did Lean originate?

Toyota

What is the phylosophy of Lean?

If a step does not add value for the costumer, it should be eliminated.

What does Kaizen mean?

Continuous improvement; It is a culture of making small, intentional changes every day rather than waiting for something to break before fixing it.

The Lean Six Sigma standard of excellence euqates to less than ____ defects per million opportunities (DPMO)

3.4

What is Dr. Walter A Shewhart responsible for?

Developed control charts to track process variation, and the Plan-Do-Check-Act (PDCA) cycle

PDCA?

• Plan: Identify change or improvement

• Do: implement change

• Check: measure process or outcome

  • Act: Occurs when outcomes are not desired

Lean principle: Value

Defined by what the costumer (patient/player) is willing to pay for. It must improve safety, outcomes, or satisfaction..

Lean principle: Create value stream

Mapping every step to see that adds value and what causes waste

Lean principle: flow and pull

keeping work moving based on real costumer demand (Just-in-Time)

Lean principle: Empowerment

Ensuring the people doing the work are empowered to eliminate waste

Lean principle: perfection

constant striving for zero defects and zero waste

Roles in Lean Six Sigma project: executive management

senior organization executives who create vision for the project:

• Define the strategic goals, metrics, and business targets

• create and promote environment for Lean Six Sigma to be used

Roles in Lean Six Sigma project: Executive sponsor:

senior leaders who allocate resources, set strategic goals, and remove roadblocks

Roles in Lean Six Sigma project: Champions

upper-level managers who work with sponsor to align projects goals; responsible for deparmental communication

What is the DMAIC methodology?

step-by-step roadmap for running Six Sigma

DMAIC Step: Define

identify the problem, the costumer, and the project scope

DMAIC Step: Measure

establish a baseline and understand the process as it runs today using collection and process mapping

DMAIC Step: Analyze

Dig into data to find the real root cause (x’s) of the problem (y) using fishbone diagrams and the “5 whys”

DMAIC Step: Improve

Develop, pilot and implement a solution

DMAIC Step: Control

Lock in the win through monitoring and documentation to prevent the process from sliding back

Total Quality Management (TQM)

A broad phylosophy where quality is everyone’s responsibility (frontline to c-suite)

Business Process Re-engineering (BPR)

A radical, all-at-once redesign often triggered by new technology

Rummler-Branche

Uses a “Nine Boxes Model” to check performance at three levels (performer, Process, Organization) against three needs (Goals, Designs, Management).

Scrum

A fast-moving project management method with three phases: Pregame (planning), Game (working), and Postgame (QA/change management)

Costumer Experience Management (CEM)

An “outside-in” approach that starts with customer needs and works backwards

Jumpstart

A fast-paced session for solving a small, low-risk problem in a single day

The Eight Muda:

1. Overproduction: Compounding more meds than needed before they expire

2. Defects/rework: Mislabeling a prescription bottle

3. Inventory: Expensive meds sitting on shelves depreciating

4. Motion: Walking long distances to a printer or different floors

5. Transportation: shuttling meds between facilities unnecessarily

6. Waiting: Patients stuck in a drive-thru for prior-authorizations

7. Over-processing: Running five redundant checks when two suffice

8. Skills: using a PharmD for data entry tasks that a technician could perform

5S Methodology: workplace organization

1. Sort: Keep only what is needed; discard the rest

2. Straighten: Label a “home” for every item

3. Shine: Keep the area clean to prevent errors

4. Standardize: ensure everyone, not just the organization person, follows the rules.

5. Sustain: Maintain the habit over time even when not being watched

The Pareto Principle

“80/20 Rule” 20% percent of the cuases for errors lead to 80% of the problems

Pareto Priority Index

index used to prioritize a project based on estimated savings, likelihood of success, cost, and time required