Six Sigma at Academic Medical Hospital Harvard Case Solution & Analysis

Six Sigma at Academic Medical Hospital Case Study Solution

Six Sigma had been now implemented at the Academic Medical Hospital using the DMAIC approach methodology. The results of the pilot study had been surprising however, the project champion, Dr. Elbridge and McCrea, the black belt of the project were still facing a number of the issues. This was because they considered the results of the pilot study to be biased as a result of the Hawthorne Effect. The current environment at the Academic Medical Hospital was in the need of significant changes in the emergency department (ED) of the hospital with regard to the wait times over the past 10 years.

The Six Sigma had been implemented by the advocates of this program such as the part time project leaders and the main project leader, McCrea who acted as the black belt of the project. Dr. Elbridge was the champion of the project and all of the advocates strived hard to fund the project, design it, implement and incorporate the results of the pilot study within the system of the Academic Medical Hospital. There were a number of issues now present ahead of McCrea such as a number of doctors and physicians did not welcome the six sigma changes as it changes the ways in which they worked.

Another issue was that; Dr. Hamilton was appointed as the project sponsor who had to fund the entire project but he himself was not convinced about Six Sigma because he considered it as another effort of reducing the ED wait times that would be soon shelved. The main issue faced by McCrea was the communication of the benefits and the final results to all the stakeholders of the Academic Medical Hospital. The acceptance by all the stakeholders was a primary obstacle for the successful ED management at Academic Medical Hospital. This has been clearly explained by the Q X A = E equation for Six Sigma within the case.

Overall, these all were the main issues encountered by McCrea and the Foundation Team. Changes need to be made not only to the system of the ED but also within the minds of the stakeholders. A number of statistical limitations had been identified with the pilot study and now McCrea needed to start the control phase and to work cooperatively with the stakeholders for influencing the sustainability of the project on her mind.

Six Sigma at Academic Medical Hospital Harvard Case Solution & Analysis

Question 2

What critical opportunities should the team consider at this stage of the project?

The improvement opportunities identified by the Six Sigma pilot study was providing the right improvement curves and opportunities to improve to Dr. Elbridge and Dr. Hamilton. The project had focused on the two different waiting times within the ED that are the Lobby waiting time and the MD waiting time. After conducting the pilot study, the results had shown dramatic decreases in the waiting time within both of these areas. Thus it introduced many critical opportunities for the team to consider at this stage of the project.

The project team could not focus on the Xs or the factors that cause the long waiting times and control those factors that are controllable such as the status changes and the time wasted within the IS related code changes. The patients should be able to focus on the core patient facilities and all the clerical work should be performed by the clerks that would be hired. Moreover, the physicians are not the employees of the Academic Medical Hospital but they are the independent contractors from a medical school therefore, Dr. Elbridge can also not comply them with the programs of the hospital and this was because of the complex reporting relationship. Therefore, McCrea, Hamilton and Dr. Elbridge need to work on increasing the acceptance level of all the stakeholders.

Opportunities to introduce the improvements through Six Sigma can involve working with the emergency medicine department chair, Dr. George Calhoun. He had remained an arm’s length throughout the entire program. As he was responsible for overseeing the work of the residents and the faculty therefore, he was in a strong position to influence the various faculty members and implementing the long term changes resulting from the ED Wait time Project. Another way to influence the attending physicians was to leverage the support of the clinical staff of the ED at Academic Medical Hospital. When they realize the importance of the Six Sigma initiatives, then they would be able to influence the residents and the attendants.

Question 3

Assess the pilot results in terms of the statistical significance of the improvement seen via the implemented changes. What should the team say to Project Sponsor Dr. Hamilton and to Project Champion Dr. Elbridge, about the results?

According to the results of the pilot study, the wait time for the Lobby had come under the acceptable wait time target of 15 minutes and the wait time for the MD was improving. Although the MD wait time under the pilot was 8.9 minutes compared to the target of 8 minutes but it had shown significant improvement in the MD wait time when compared with the study 1 and study 2 MD wait times of 16.1 and 11.2 minutes. The defect rate had dropped overall and the 95% confidence interval test for the study 1 vs study 2 vs the pilot study had shown statistical significance of the improvement in the waiting time of the process and the reduction in the waste from the process. The coefficient of variation under the pilot study had also increased for the variation per unit of waiting time for the lobby and the MD waiting times...............

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