Process Improvement can be complicated when it comes to understanding the overall process and the different steps involved. We hear all these terms such as DMAIC, DFSS, Plan Do Act Check (PDAC), and the list goes on. Some of these terms fly over our heads, especially if we are new to process improvement. We’re often left with the lingering question, “What exactly are the necessary steps for improving my business process?”
At a minimum successful process improvement efforts have at least the three phases discussed below. For the sake of illustration, we will be using the healthcare industry as a point of focus; and more specifically, lengthy hospital ER wait times.
Define the Factors Influencing Your Processes– Look at the independent variables that have the most impact on your business and its processes. Even finding a few of those all important factors can make a huge difference. Like Pareto’s Principle states, “20 percent are vital, the other 80 percent are trivial.” If you take a hospital ER as an example, you can see many factors that play into longer than ideal wait times. But tackling all of them probably isn’t practical, or even possible. This is where you may want to look for bottlenecks and hindrances in the process, that strongly influence the process.
For example, while you may not be able to control how many patients come into the ER during a certain time of the day, but you can control your physician and nursing staff levels to ensure patients are seen more quickly, and thus ensuring a more expeditious process. Another controllable factor on the hospital’s end, is prepping each station prior to patients coming in. The idea here, is removing set up time as an influencing factor in lengthy visits. Deciding what you will spend your time and resources on analyzing and changing is vital.
One important thing to note is going out and “living the process” and seeing how things are done, often reveals a lot of variables that might have other wise gone unnoticed. This is known as Genchi Genbutsu (“Go and see”).
Once you have done this and have a good grasp of the business process, and the key variables involved you can move on to the next step.
Finding Your Ideal State– You have to find what is considered to be “acceptable” in the eyes of the stakeholders. This is everything that the customer (internal or external) considers to be of “value” in the end, ultimately this is all that matters. This is known as capturing the Voice of the Customer (VOC). From the hospital’s stand point the two main, external customers are the patients and their insurance companies.
One way to find a good baseline for ideal ER wait times, is by taking a survey of a random group of patients from the larger general population. For example, after an ER stay send a follow up assessment for 1 out of every 5 patients and see if they considered their stay too long, and if so what would they consider ideal wait time. While some data may be unrealistic number that skew the average, most will give practical feedback to assist you in this phase. This now leads us to the final phase.
Improve Towards Your Ideal State – Once you have determined what is your ideal state, you can then work towards it. What you find during this last step will determine the tools, team and relevant steps to your effort.
During this phase, you will be convening a team of subject matter experts that know the current process, work it on a daily basis, and as such can give you insight on ways to improve it. Using a Current State Map to get a holistic view, as well is probably a good idea, as this is a quick and easy way to not only get an over all view of the process that stakeholders agree on, but also to look at the low hanging fruit that can be improved with minimal effort.
Final Analysis: A Successful Process Improvement Initiative - The logistics, tools, and specific steps for each project will vary on a case by case basis. But the steps involved always incorporate some form of the three steps discussed above. When employed correctly, your final result will be a successful process improvement initiative each and every time.