The use of Six Sigma is to improve business processes by eliminating the causes of errors that lead to product or service shortages, essentially allowing an organization to achieve aim to streamline their business processes so they can deliver the best products and services with a minimal amount of defects (3.4 defects per million opportunities). At this point, the organization is at a point where results are consistent, stable, and predictable. This is achieved by implementing a management system that systematically identifies errors, then providing a variety of methods to remove them. The methodology provided by Six Sigma is the DMAIC (Define, Measure, Analyze, Improve, Control) approach, which is mainly used to improve existing processes in a company. Six Sigma can benefit a hospital by reducing wasted time, whether it is the flow of communication of results from the laboratory to the patient or the planning procedure. By minimizing wait times in both scenarios, a hospital will not only be able to provide better customer service, but can also have a dramatic impact on its financial performance. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay The ability to resolve issues around variation in services allows for better use of resources, meaning more resources can be invested in other aspects of the hospital to improve the customer experience and increase the likelihood that a customer return in the future. The Six Sigma tools used in the book “Lean Six Sigma Case Studies in the Healthcare Enterprise” (Sandra L.Furterer, 2014) within the DMAIC cycle are Initial VOC, Detailed VOC, Root Cause Analysis, Value Stream Map, PDCA respectively. While the tools mentioned can be effective, there are several that are more applicable to the healthcare industry. First, the use of Voice of Customer (VOC) is a tool suggested by the literature to define and measure project objectives, problems, improvement activities and customer requirements. This tool is a method of fact-finding by customers to the organization's management, which may include interviews, focus groups, complaints and surveys. It provides information regarding customer expectations regarding the service provided by the organization. While the use of VOCs is useful for an organization to understand customer expectations in many industries, it is a tool that can be potentially ineffective in healthcare services. The fact that customers (patients) in hospitals are normally under stress due to the nature of this service industry itself, can be seen as inconsiderate and intrusive in bothering them for feedback. This can result in a lack of attention when filling out a survey by a customer, which can lead to inaccurate information about your services. Furthermore, the VOC process can be financially expensive. When you take into consideration the cost of implementing VOCs along with the potential inaccuracy of the information, this method is not ideal for a hospital to implement. When improving customer satisfaction in hospitals, it is essential to identify service characteristics that meet the Critical to Quality tool. The book “Solutions to the Healthcare Quality Crisis: Cases and Examples of Lean Six Sigma in Healthcare” (Søren Bisgaard, 2009) states that “customer expectations are brainstormed and considered.” In theory this is ideal, since the research is based on brainstorming that does not involve input from a struggling patient. Furthermore, it provides aaccurate judgment, if done correctly, about the factors that matter most to improve customer satisfaction. This introduces Kano's model of prioritizing customer needs which, when used alongside brainstorming, allows for a very effective methodology. Regarding the measurement phase, the book “Six Sigma for Organizational Excellence: a Statistics Approach”, (K. Muralidharan, 2015) recommends using the data collection plan like control sheets. This data collection method is simple and focuses on collecting data in real time. The ability to classify problems into categories, using a simple count to record the number of problems, gives workers a visual overview of problem areas that need improvement. This is an effective tool for hospitals to measure the number of errors in real time, which can help reveal the areas that tend to cause the most variance. The literature (Sandra L.Furterer, 2014) recommends the Root Cause tool for process analysis to determine root causes of variation or possibilities for defects. This tool focuses on identifying the potential impact of the event. Additionally, this tool reveals the causes of errors after a problem has occurred, making it efficient to implement and enabling the prevention of similar future events. The tool should ideally be applied as soon as human error is detected. However, since the Kano model will be used in the definition phase, the Pareto chart method is the most obvious tool to use as they complement each other extremely well. Using Pareto charts will help hospitals focus on the elements that provide the most significant impact on the healthcare service. Regarding improving process performance by addressing and eliminating the root causes identified in the analysis phase, the literature (Sandra L.Furterer, 2014) recommends using the Lean Six Sigma Value Stream Mapping technique. The efficient flow of information and customers is crucial not only to the function of a hospital, but also contributes enormously to customer satisfaction. This method can be considered ideal for improving services in the healthcare sector. Finally, the control phase of the Six Sigma DMAIC process involves executing a control plan to maintain and monitor progression after the improvement phase. This is to ensure that the expected improvement of a project has occurred. The literature (Sandra L.Furterer, 2014) recommends PDCA (Plan-Do-Check-Act), while the literature of (Søren Bisgaard, 2009) suggests the use of statistical process control charts as a way to maintain progression inside the hospital. One flaw that makes the PDCA methodology less than ideal for implementation in hospitals is the ignorance of the “people” element. Because of the constant changes needed for the PDCA to work, workers must constantly adapt, which can lead to workers in a hospital becoming confused about relatively simple procedures. The SPC method, however, can incur a substantial cost to an organization due to the need for professionals to ensure the tool is used correctly. That said, ongoing review of improvements is vital for hospitals, and the fact that the SPC includes activities such as review frequency and system capacity verification makes it one of the best tools for the audit phase. The intellectual quality of the analysis. Although hospital staff are not normally considered customer service providers, they are actually very similar to traditional customer agents in the way customers view them.Customers of a hospital can judge the “quality” of services based on factors such as customer support, care provided, treatment with minimal delay, quick responses and aptitude for communication. In addition to the services provided by hospital staff, hospitals must provide customer care in a variety of contexts such as delivering lab results and providing patient updates in a timely and thoughtful manner, which can also affect customer satisfaction. patient with a hospital. Since most hospitals currently in existence provide identical products and services, an emphasis on customer satisfaction is important for a hospital to differentiate itself from others. Continuing with the above mentioned, customer satisfaction in hospitals depends on whether the customer feels that the value-added services provided outweigh the non-value-added procedures, such as long waiting times before treatment, the acceptability of the hospital atmosphere , the convenience of transportation and even the ease of finding parking spaces. At the forefront of improving a hospital's financial performance is reducing costs. Optimizing financial performance is critical for hospitals due to reasons such as persistent economic weakness and massive budget deficits. That said, the demand for hospital facilities remains high due to continuous technological advancements, which hospitals are required to procure. The most obvious way to improve a hospital's financial performance is to reduce treatment error rates and efficiently allocate resources within the hospital. To do this, the Six Sigma method can help the hospital identify and solve problems in healthcare delivery. Kano model analysis is a tool that can be applied to the hospital to improve overall quality, as it helps to identify opportunities for healthcare service differentiation. Kano analysis involves classifying customer preferences into three main categories: basic attributes, performance attributes, enthusiasm attributes. When hospitals compete with each other, since all hospitals provide similar products and services, customer satisfaction becomes a key point of differentiation. With the help of Kano analytics, a hospital will not only be able to identify service attributes that lead to higher levels of patient satisfaction, but will also be able to classify customers and thus provide patient-oriented approaches. Data Collection Plan - Tracking Cards Although this data collection method is simple, it can be a very effective tool for measuring and tracking improvement efforts, due to the consistent nature of the method itself. This tool can help a hospital measure areas that require urgent improvement by collecting real-time data over a period of time. Furthermore, the simplicity of the tool means that implementing this methodology would not pose a significant financial burden to the hospital, but by solving problems it can reduce the variability of procedures. Pareto charts can also be used to improve hospital processes. The Pareto principle states that, in any group of things that contribute to a mutual effect, relatively few contributors account for the majority of the impact. A Pareto chart is a form of bar chart that displays the variety of factors that contribute to an effect on an organization. corresponding to their impact rate. In a hospital setting, Pareto charts can be used to facilitate the identification of vital factors that require maximum attention. The use of graphsPareto will help hospitals identify and focus on the elements that provide the most significant impact on healthcare. Value Stream Mapping (VSM) is another tool that can help a hospital improve the quality of care by allowing management to map and visualize the flow of information, materials (drugs), and patients. The “value stream” describes all the steps needed to complete a pre-established process, and VSM is often used to reveal waste, such as patient wait times, to enable a more streamlined process with minimal disruption. Additionally, VSM can reveal ways to reduce drug costs and waste, such as saving on labor costs and achieving fiscal responsibility. In the case of this hospital, VSM can be used to map a patient's journey before treatment, including waiting time. This tool is highly dependent on acquiring reliable data regarding the patient's course of treatment, including the amount of time spent in each patient phase. Another tool within Six Sigma that can be used in the healthcare industry is Root Cause Analysis. Once an error event has occurred, the first step would be to define the action consequences, retrospectively. This is followed by the identification of the action and the monitoring of the causal factors, as well as the determination of the real cause to be subjected to an in-depth examination of the event. The primary reason for implementing the RCA approach is that it exposes the cause of errors by examining factors such as inadequate education or conditions; for example, not checking on the patient. The use of statistical process control is also an analytical tool used to measure, monitor and control various procedures related to quality control. Its main use is to ensure that an entire process works as efficiently as possible within an organization. This is a fundamental technique as it focuses attention on the idea of ​​identifying problems early, thus allowing workers to eliminate or minimize their effects. Counter the Root Cause Analysis tool to fix the problem after it occurs. Kano Model The Kano quality model is classified into three main categories: basic attributes, performance attributes, arousal attributes. A basic attribute is a minimum quality that is expected and which, if not met, can contribute to customer dissatisfaction. An example of this within a hospital is the expectation that a doctor has the medical knowledge and medical tools available. Performance attributes are qualities that are not absolutely necessary, however, if the qualities exist, they can lead to an increase in customer satisfaction. An example of this is free Wi-Fi service in hospitals. When the basic and performance attributes are satisfied for customers, the hospital can examine the excitement attributes, which refer to the element of surprise that customers do not expect, normally seen as “unexpressed fulfillment.” This can come in the form of complementary products such as offering a healthy snack in the hospital. This is a way to implement an excitement attribute, which doesn't cost the hospital a large financial burden, and the fact that it's a healthy snack means it's more likely to be enjoyed by patients. Excitement attributes, if implemented correctly in a hospital, can be a feature that offers a unique selling point and helps increase customer satisfaction, which in turn creates a sense of loyalty towards customers. For this reason, the hospital should use this methodology to improve customer services by creating extra value for theclients. Pareto Chart In the case of a hospital, this method can be used to minimize the possibility that a patient's medications or health report will not be delivered on time. Contributing factors may be due to under-stocked (out-of-stock) medications, orders not processed and read correctly, congested queue of patients waiting for medications, long transportation times from one end of the hospital to the other, and poor communication between departments . The first step would be to rank the causes based on the relative frequency of the cause, from largest to smallest. In this case, the causes could be classified in order of decreasing frequency: excessive queue of patients waiting for medicines, insufficient supplies of medicines, long transport times from the hospital pharmacy to the patient, poor communication between departments, order not processed and read correctly. The Pareto Principle can therefore provide insights, for example, 90% of delays arise from excessively congested patient queues. With this knowledge, the hospital will have clarity on which causes should be addressed urgently. With the use of Pareto diagrams along with cause and effect analysis (fishbone diagram) or brainstorming, a hospital will be able to reduce the chances of unnecessarily long waiting times for patients by allocating resources to improve the queue congestion. Furthermore, this tool, when used correctly, can have an extremely positive impact on customer satisfaction. For example, the nursing team will be able to place greater emphasis on services that provide the greatest impact. This means that customers will be more likely to use the hospital in the future, building customer loyalty, which has a direct influence on the hospital's financial performance. Value Stream Mapping A generic journey of a patient's treatment is shown below: Doctor > Hospital > Registration > Treatment Approximate waiting time between transfers: 30 minutes Throughout the entire process, a patient's time can be divided into value-added and non-value-added times. The goal of this tool is to minimize, if not eliminate, existing non-value-added time, given time for which the patient is not willing to pay. This can be anything that doesn't add value to the patient, such as a half-hour wait before an appointment. That said, while continuous flow is the ultimate goal, it is rarely possible. Instead, wait times could be minimized by analyzing the VSM to identify areas that require improvement, such as when a patient has to wait a long time for a bed to become available in the hospital. This is a very common problem in hospitals and can potentially be reduced by matching the supply and demand of treatment beds. The length of waiting time for patients requiring treatment beds is a revealed “waste” within the VSM and one solution to minimize this is to implement a “pull” system for transferring patients from one point of care to another next. This solution ensures that the demand for therapeutic beds is anticipated by measuring it over time, allowing an accurate judgment of the demand. This means that when a patient requests a therapy table, it will be ready as soon as the request occurs, unlike the “push” system, where the patient must wait until the offer is created. The VSM method in this situation allows for reduced waiting time per patient, which improves patients' perception of the hospital's services since less time is wasted on non-value-added services. The RCA root cause analysis tool increases the.