Mapping Lean Six Sigma in a Hospital Environment

Hospitals and health plans know that the high cost of care is squeezing the U.S. economy. That’s why so many of them are using Lean Six Sigma to control spending by refining internal processes—while still satisfying customers in a highly competitive market.

I have been talking with Ralph Jarvis, principle of Jarvis Business Solutions of Grapevine, Texas (I love that name). He and his staff used ConceptDraw MINDMAP to kick off a Lean Six Sigma implementation at a Texas hospital, then used ConceptDraw PROJECT to manage the process. The project resulted in a dozen ways for the hospital to improve its insurance validation process.

Hobie: What were you trying to do to help the hospital?
Ralph: The goal was to improve the patient experience by reducing wait times. By improving the way it captured and reused information, the hospital could reduce the amount of paperwork needed to move patients within and between hospitals in the consortium.

Hobie: That sounds like a big project. How did you get started?
Ralph: We kicked the project off with brainstorming sessions with our team and key hospital stakeholders. The goal was to gather ideas and insights that would help identify potential trouble spots. We used MINDMAP to capture the ideas:

Ralph: We decided early on to use the DMAIC methodology (Define, Measure, Analyze, Improve, Control). Critical to DMAIC is the ability to gain a clear understanding of the “voice of the client.” Experience has taught me that while the client may have already identified a main problem, it often turns out that the real problem is somewhere else. Part of the Lean team’s job was to combine the DMAIC roadmap with empirical data to identify and then solve the real problem behind the validation process.

Hobie: How did you go about finding the "voice of the client"?
Ralph: We found it by talking a lot. The fun part about any kind of consulting is when you get to brainstorm with the client, to extract information regarding the issues, regarding the problem. This is an opportunity to tap in on the creative side of your clients. Once analyzed, this information can lay the foundation for a successful project.

Hobie: So what was the result of the brainstorming?"
Ralph: It was pretty interesting. We discovered that what they thought was one problem was, in fact, three separate but connected problems: One customer-focused, one focused on the hospital and the doctors, and the third focused on insurance. It took us a few meeting to make this realization. But it was worth the effort.

Hobie: Okay. So you found increasing complexity. That's always fun. How did you handle that turn of events?
Ralph: We created three project teams. Each team included from 15 to 20 participants, from senior executives to the data entry clerks. And each team used mind mapping to keep track of their progress. In fact, mind mapping made note-taking a central byproduct of each team's meeting process.
One person on each team was responsible for creating the notes. But unlike most note-taking methodologies, mind mapping enables that person to be an active participant in the meeting. And by projected on a wall or screen, we could use the mind map format to give each team member instant feedback on if and how new ideas fit into the overall plan.

Hobie: So you used MINDMAP to kickoff the project, then to capture team meetings. Anything else?
Ralph: The maps started to get really useful when we wanted to add relevant data. The DMAIC road map is a data-driven process. That’s why, as part of the DMAIC process, participants must agree at the beginning of the process to provide needed data.
In a sustained environment, stakeholders from, say, accounting, IT, and process owners would capture that information through system usage. But in this case, the data wasn’t immediately accessible.
So each team set about linking the maps to new information and data in the form of reports, spread sheets, slide shows, and Web sites. MINDMAP's drag-and-drop functionality made it pretty easy for us to place supporting data immediately adjacent to the relevant insight or idea:

Hobie: So you added this empirical data to the same map that you used for brainstorming?
Ralph: Yes, we did. Being able to combine information and data with the ideas and insights of the members of each team is what makes MINDMAP so interesting. I think it really promotes good thinkng and planning. Because it enables you to see what kind of objective information there is to back up any given idea.
And then it enables us to actually start sketchiing out how we're going to put those ideas into action:

So you used MINDMAP to manage tasks and everything?
Ralph: No. I'm a licensed project manager and wanted to be in that environment to run the project. So we used ConceptDraw MINDMAP's connection to ConceptDraw PROJECT to put all the tasks we'd gathered in the map into a regular PM environment.
We could instantly view our planning details inside of Gantt charts. That enabled us to jump right into establishing project timing, coordination among the various departments, and milestones and guidelines:

Ralph: Being able to go directly from mind mapping to project management was a great information-management tool. But what made it really stand out was that it also made it easy for us to demonstrate to hospital execs how our Lean Six Sigma approach was producing results.

Jarvis says that the combined power of mind mapping plus project management supported his teams through the entire project lifecycle and made it possible for them to provide hospital management with 12 critical recommendations for its customer satisfaction improvement – all under “Beat the Clock” conditions.

Ralph: What you're really trying to do with Six Sigma is to create a perfect process that eliminates defects--all the things that don’t add value to the end customer. You want to increase the customer's satisfaction with your products or services, and reduce costs associated with defects and inefficiencies. It’s all about focusing on what you need to get to the marketplace and satisfy the customer's needs. It's as simple as that. And the ConceptDraw MINDMAP/PROJECT suite helped us get there quickly and accurately.

ConceptDraw gets a lot of kudso for having such a nice integration with project management functionality. Other mind-mapping products can export to PM apps. But only ConceptDraw MINDMAP has its own "sister" app that, like all siblings (!), immediately understands what the other one is trying to say. (No, really. They do understand each other. These are two computer program, after all--not two people.) To learn more about (and get a free trial to) the ConceptDraw MINDMAP/PROJECT family of apps, please visit www.conceptdraw.com.

And for more information, please see Project Management Approach for Business Process Improvement.