Case Management

Mentor moment: The Lean Six Sigma process applied to case management

Case Management Weekly, August 4, 2010

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I recently spoke with a hospital customer who was trying to improve processes in the case management and utilization review (UR) departments at a large teaching hospital. The facility recently instituted 24/7 case management in the ED and hopes to create process improvement in a culture reluctant to change.

One of my favorite quotes is attributed to Albert Einstein who said, “Insanity is doing the same thing over and over again and expecting different results.” I fear hospitals, providers, and payers are applying business-as-usual methods to a vastly changing industry. Hospitals and physicians who are willing to explore process change and embrace what other industries have used successfully will prosper.

“The core idea in Lean Six Sigma is to maximize customer value while minimizing waste,” according to the Lean Enterprise Institute.

Sigma is a term used to represent levels of excellence or quality. Six Sigma seeks to achieve a ratio of 3.4 defects per one million opportunities. The process began in manufacturing as a defect-reduction effort and has spread to other industries, most notably air transportation.

Lean makes an organization more nimble, which allows it to react to changes in the market and customer preference. A Lean organization can create products and services with more variety, higher quality, and lower cost. It can also manage information and data used to generate services more efficiently because the information is simpler and more accurate.

The six process elements also known as DMAIC(T) include:

  • Define opportunity
  • Measure performance
  • Analyze opportunity
  • Improve performance
  • Control performance and optionally
  • Transfer best practice to spread learning to other areas of an organization

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