Valley Baptist Health System (VBHS) is a pioneer in implementing Six Sigma in Healthcare. Now completing its 7th year of Six Sigma methodology execution, VBHS has realized tremendous success in all aspects of hospital operations, with particular achievements in the clinical arena. VBHS has reduced ventilator associated pneumonia rates in ICU patients by 85, decreased mortality rates for patients with acute myocardial infarctions by 60, reduced complication rates in patients with congestive heart failure by 72, and reduced the average length of stay in patients undergoing coronary artery bypass graft surgery by 19. Even with such stellar results, VBHS�s journey has not been without its struggles. While Six Sigma is a methodology designed for the manufacturing industry, successfully applying it to healthcare, an enterprise supported by centuries of artistic interpretation of standards, has been both challenging and rewarding. Dr. Gonzalez will share VBHS�s Six Sigma successes and failures, highlighting physician involvement, human resources and budgetary implications, patient care impact, and other rites of passage of its seven year relationship with Six Sigma.
Tomas Gonzalez
VP, Quality Initiatives
VALLEY BAPTIST HEALTH SYSTEM

With the numerous day to day operations that executive leaders have on their plate, how do you keep them engaged in performance improvement? It seems that new regulatory requirements are forced upon on us on a regular basis. So how do we keep up with the changes in a systematic manner? I will share ideas how Thibodaux Regional Medical Center �grows� their leaders to be accommodating to the ongoing changes and also achieve high quality performance at the lowest cost. Quarterly leadership sessions, a strong foundation of performance improvement and ensuring accountability are just some examples we use to sustain engagement amongst our leaders.

Greg Stock
CEO
THIBODAUX MEDICAL CENTER

- importance of leading Lean efforts internally
- providing adequate resources
- aligning projects with strategic goals
- holding people accountable for project completion and results

Robin Wilson
Vice President of Medical Affairs
THEDACARE

Richard C. Vinci
Rear Admiral, Senior Healthcare Executive
UNITED STATES NAVY

TRACK A: BEGINNERS
TRACK B: INTERMEDIATE/ADVANCED
TRACK C: MANAGING CHANGE IN THE ORGANIZATION
TRACK D: PEOPLE MANAGEMENT FOR EFFECTIVE IMPLEMENTATION

This presentation will provide with an overview of the structured problem solving methodology used in improving quality, safety, service, capacity and/or cost in clinical and non clinical settings at Mayo Clinic. An introduction to six sigma DMAIC framework and integrated lean tools and techniques used will be provided. Goals, deliverables and tools commonly used for each of the five phases in the DMAIC framework will be discussed, using healthcare examples. The concept of tollgate review and team composition to ensure successful implementation will be reviewed.

Anantha Kollengode
Quality Improvement Advisor
MAYO CLINIC

A balanced scorecard can be an effective tool to monitor work unit performance and drive organizational strategic objectives. The objective of this presentation is to demonstrate the process for deploying and utilizing the Balanced Scorecard (BSC) at the Nebraska Medical Center. Some of the major topics will include The Nebraska Medical Center�s method for: developing and deploying its BSC, aligning BSC metrics to strategic objectives, measuring metric performance, holding leadership accountable, and incorporating the BSC with process improvement.
John List
MBB
NEBRASKA MEDICAL CENTER

Banner Health, a regional healthcare provider with 22 hospitals in seven western states, has developed a �game plan� for delivering consistently excellent care at all its facilities. Its Care Management Division leads this effort and in this presentation, Vice President Twila Burdick describes their approach and results they are achieving. She will describe Banner�s Care Management �Game Plan� that includes:
- Engaging clinical leaders in clinical improvement
- Taking advantage of innovative technologies and tools
- Applying operational science to healthcare processes

Twila Burdick
VP Organizational Performance
BANNER HEALTH

Bob Costello
Director, Process Improvement
NORTHWESTERN MEMORIAL HOSPITAL

In this session, you will learn how to determine when to use DMAIC, Lean, and Work-Out to address a specific process issue. You will also learn how to integrate these methodologies and tools together to affectively drive process improvement in the Healthcare environment. You will be able to know when to apply the right tool for the problem you are facing.
Daniel Walker
Master Black Belt
BAYCARE HEALTH SYSTEM

Change Equation: 1 + ALL = EVERY 1
The task of managing a change initiative can be arduous if the people involved in the change do not have the necessary tools to engage their staff in the movement. People view change as something that is being taken away as opposed to something that may be given to make the process better. People fall into 4 categories when dealing with change 1) Risk Takers, 2) Early Adopters, 3) Late Adopters, and 4) Over My Dead Body Group (OMDBG). Failure to recognize and work with the resistance is the recipe for a failed effort. There are 7 steps to change that need to be addressed when trying to move people from place to another.
1. Who is Leading the Way?
2. How do we Create a Shared Sense of Urgency?
3. What does the Future look like?
4. Have I built the necessary Coalitions and Commitments?
5. How can I Measure this change effort?
6. Are the Systems and Structured Aligned?
7. How do we Sustain the Moment?
Using the tools of change to engage staff does not mean the change won�t happen. What it does mean is the change is coming and what does the change agent need to do to help you get prepared.

Guy Johnson
MBB
BJC Healthcare

Six Sigma use in process improvement allows you to present data with confidence and the ability to determine statistical significance and relevance of data. With the tools of Six Sigma, data can be displayed showing descriptive graphs and process capability analysis. You know when to alert the team members as to when there is a measurable problem and whether it is significant to warrant further action.

Questions to ask before you begin:
Is data readily available?
What are the possible cost benefits?
What are the time constraints?
Who will provide commitment/support?

When should DMAIC (Define, Measure, Analysis, Improve and Control) versus PDCA be used for process improvement?

Are we just doing projects or is this a culture change?

Barbara Sutch
Six Sigma Black Belt
LAKE HOSPITAL SYSTEM

The role of the Six Sigma professional is expanding from a resource that simply works on process improvements to a project manager of continuous process excellence aligned with a business strategy. As Peter Drucker stated: �you can�t manage what you can�t measure�. Productivity is an effective measure of efficiency and Six Sigma methods are well-suited to drive it.

To be fully effective, the Six Sigma professional must work closely with senior management to establish and set future productivity goals as well as to identify those process improvement opportunities that drive toward those goals. We are finding that the six sigma professional is perfectly placed to drive those metrics that drive higher productivity.

Mike Bullock
Master Black Belt
QUEST DIAGNOSTICS

- implementation challenges
- driving and tracking results
- special role that MBBs play in maintaining momentum
- importance of leadership support
- creating cross-functional teams
- providing ongoing communication and ensuring accountability

Donna Powers
Six Sigma Master Black Belt
NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM

Nationwide Children's Hospital has a Business Process Improvement team that uses various tools in their projects to produce quality outcomes. We have used:
� Six sigma statistical analysis
� DMAIC project structure
� Lean tools
� Simulation modeling
� Change Acceptance Tools

Sometimes all in the same project to produce the best outcome for a problem or opportunity.

In this talk, we will present when we have used which tools and how we have integrated them together on some projects. This presentation will give hospitals clues as to when to pick certain tools and where we have found them to be most valuable.

Maribeth Quinn
Director, Business Process Improvement
NATIONWIDE CHILDREN'S HOSPITAL

Saint Vincent Health System in Erie, PA is in its 4th year of LSS deployment. It has developed methods for measuring project success using traditional quality metrics and defect rates, as well as measuring financial returns. A total return measure is using, counting hard dollar ROI, soft ROI, and community benefit, less LSS costs. In three years, Saint Vincent has achieved over $1.0 million in hard and soft dollar returns, and an overall net benefit of $0.5 million. Methods for selecting and approving projects will also be discussed showing a balance between improving customer quality and achieving overall ROI to justify the LSS program.

Steve Osborn
VP, Quality Compliance & Improvement
SAINT VINCENT HEALTH CENTER

This presentation will explore the pitfalls in implementing Lean Six Sigma in three organizations without the use of full time process improvement resources. Several critical factors to the success of a low resource implementation will be discussed. These factors include:
� Creating a performance improvement culture
� Delegating improvement accountability
� Executive oversight
� Limiting the scope of implementation
� Delegating management responsibilities
� Time management and team leadership for Hospital Directors
� Choosing the right tools and techniques
� Keeping projects on track

Charles DeBusk
Vice President, Performance & Process Improvement
UNIVERSAL HEALTH SERVICES, INC.

Mr. King will plot the path for improvement of healthcare and the road to putting your hospital on the cutting edge of quality and innovation whether you are beginning, intermediate or advanced. Some key points of keynote presentation that will help your organization prosper in tough and changing times include:
� How to get doctors and hospital administration and staff aligned.
� How to get staff involved in strategic planning when the key plan is developed by an outside consultant.
� How to improve Lean Six Sigma with innovation tools.
� How to pick the improvement tools best suited for your problems and your improvement experience.
� How to help employees use effective time management to accomplish lean six sigma projects in addition to their regular job. These are just some of themes that will help you prosper in tough and changing times?
Bob King
Founder and CEO
GOAL/QPC

Presentation objectives: employing a high-energy presentation, including video clips and humor participants will understand that:

 Why do some Lean/Six Sigma initiatives falter? Improving organizational performance requires more than choosing a method such as Lean/Six Sigma. In hospitals, the leadership triad of executives, trustees and physician leaders must act with purpose to embrace system thinking which cultivates process excellence in which consideration is given to human factors aspects of performance. Dr. Mayfield�s presentation will describe how better performing organizations create a culture of expectations where executive leaders engage in system thinking and communicate with content leaders who have process responsibility. Lean/Six Sigma methods support the four main improvement principles used by high-performing organizations (managing organization variability, removing waste, eliminating defects and reducing process variation) combine to deliver performance excellence.

Stephen R. Mayfield, Dr. H.A., MBA, MBB
Senior Vice President, Director AHA Quality Center
AMERICAN HOSPITAL ASSOCIATION

TRACK E: Focus on Lean
TRACK F: Clinical Case Studies
TRACK G: Strategic Process Improvement

Every area consists of Value Added and Non-Value Added steps that make up the entire Value Stream. Lean is a methodology that focuses on reducing non-value added steps by using a variety of tools and concepts. In this presentation, you will see how these tools can be implemented and also understand the timing of implementing them. You will gain an understanding of how to get started in the waste reduction business and see what you need up front to make sure you capture the rewards for your efforts. You will learn how to select areas to focus on and hear tips that ensure successful events. Quantifying savings from Lean events is often challenging but you will see different ideas and tools that you could use to show the gains from your Lean events.

Lance Privett
Director of Process Improvement
BLESSING HOSPITAL

Surgery department is usually the highest cost department in healthcare. So how to make surgery department work more efficiently and effectively becomes very important in VA hospital. In this presentation, we will discuss the pros and cons of currently used popular metrics in surgery operation, such as rate of first cases starts on time, mean first case delays, surgery cancellation rate, operating room utilization, surgery block utilization, turn around time per surgery specialty and so on. By analyzing the relevance of these metrics to real surgery operation efficiency, we will derive what are the most relevant and powerful surgery operation performance metrics. Based on this deep understanding of performance metrics, we developed an effective computerized tool kits that can capture and analyze surgery operation data, report operation efficiency and pin point the current performance problems. A real case study will be presented.
Kai Yang
Professor, Department of Industrial and Manufacturing Engineering
WAYNE STATE UNIVERSITY

Ochsner Health System embarked on implementing lean process improvement on April of 2008. We are already reaping the benefits from an efficiency, productivity, qualiyt/compliance, and awareness of our processes standpoint. In addition, we are currently rolling out lean to each manager and above to begin using the tools to drive process improvement. We have several lessons learned and "ah-ha" moments that we would like to share. In addition, we have developed a tool to ensure sustainablity and accountability for the projects.

The talking points of this presentation are:
- Leadership involvement and strategic alignment
- Linkage to management teams
- Examples of performance improvement outcomes
- How to implement lean in < 1 year and see results
- Portal overview - driving accountability

DeAnna Davis
VP of Operations - West Bank and System Lean Initiative Facilitator
OCHSNER HEALTH SYSTEM

Many healthcare leaders struggle to determine appropriate staffing for various areas of the hospital. Lean and basic statistical analysis concepts can be used to provide data for leaders to use while making informed decisions about staffing patterns and ultimately FTEs requirements. The �pattern� of ED arrivals is fairly predictable across the country, although volumes vary from hospital to hospital. Analyzing ED arrival data by hour of the day and day of the week provides the basis for understanding the quantity of work required of Registration staff in the Emergency Department. Calculation of takt time provides additional information about the amount of time needed to complete the required work. After removing waste from the process, this team combined arrival pattern data and takt time calculations to make informed decisions about staffing patterns and FTE�s required. They were able to eliminate nearly 4 FTEs while improving staff satisfaction.
Beth Lanham
Director Lean Six Sigma
FROEDTERT HOSPITAL MILWAUKEE

US Oncology is the nation�s leading healthcare services network dedicated exclusively to cancer treatment and research. US Oncology is affiliated with more than 1,200 physicians in approximately 480 sites in 39 states. We started our Lean Six Sigma journey in 2006 and have quickly gained momentum to deliver results throughout our network. In this session, we will focus on the revenue cycle from the point of scheduling the appointment to the time that the balance is collected. Our main topics will include:
 Using DMAIC to tell the story without the Six Sigma jargon
 Engaging physicians & leaders in the process
 Developing the solutions into best practices
 Disseminating the best practices to obtain optimize results
Wilma (Willie) Diefenbach-Jones
Practice Quality & Efficiency Director
US ONCOLOGY

Solaris Health System, like many hospitals throughout the U.S., are transitioning from excess capacity to capacity constraints in terms of surgical volume. To address their new reality, Solaris selected Perioperative Services as part of their 2008 strategic initiatives. In preparation for 2008, Solaris began to implement Lean techniques in the fall of 2007 with a value stream mapping (VSM) session. This action-based event produced a roadmap to improve processes within the Perioperative services. The VSM highlighted Pre-admission Testing Kaizen for a focus area.

The talking points of this Perioperative presentation are:
� Lean methodology and techniques that the Kaizen team utilized to increase patient volume and reimbursement to the department/hospital.
� Engaging Surgeons, Anesthesiologists and referring physician offices in the Lean process.
� Defining strategies such as appropriate use of Anesthesia Guidelines, scheduling policies and under-utilization of human talent.
� Lesson learned from implementing the Kaizen 30-day plan.

Vinnie Brigandi
Director of Process Improvement
SOLARIS HEALTH SYSTEM

Thomas Decker
Manager
GE HEALTHCARE

The healthcare industry is expected to double its spending towards hospital construction in the next decade. Chasing the Quality Chasm [Institute of Medicine, 1999] emphasized the need to look at healthcare as a system and that errors resulted due to the failure of systems. Conventional architecture techniques are insufficient for accurately factoring these system failures into consideration. A comprehensive, quantitative and qualitative design process is required if organizations are to build facilities that enhance patient safety and create a patient-safe culture.

While the lean concept isn't new, its application in health care is. Lean design, originally championed by Toyota, has been popular in the manufacturing arena for decades. Only recently, however, has it migrated into the services sector and health care. As such also, healthcare facilities are looking for ways to breathe new financial life into a historically tight-margin industry.

Virtua Health, NJ recently completed planning & design work for a new Greenfield 376 bed hospital and regional ambulatory center. The hospital is expected to open during the first half of 2011. Lean thinking was the guiding design philosophy. Through this design effort, upto 15 reduction is square feet and 12 reduction in travel distances for clinicians, families and patients was achieved between original and final design plans. This will helps clinicians more face time with their patient that in turn is expected to improve outcomes and staff moral as suggested by several researches.

Tejas Gandhi
Assistant Vice President: Management Engineering
VIRTUA HEALTH

The strategic impact and breadth of the Lean Six Sigma methodology can be improved markedly by including value to the customer along with cost and speed as the set of metrics used to compare process improvement alternatives. The reason is that value, cost, and speed (measured as the pace of innovation) represent the three fundamental financial metrics that drive the bottom-line metrics of demand, price, and cash flow delivered by the product or service. With this approach, process improvement begins by considering system level needs which unfolds into the set of requirements for the supporting subsystems. Several tools are presented for quantifying customer value in dollars for comparison to costs.
Harry Cook
Professor Emeritus
UNIVERSITY OF ILLINOIS AT URBANA-CAMPAIGN

The health care work environment is very hazardous for all employees � lifting, pushing, pulling, slips, trips, falls, needle sticks, etc�. While there is a general perception that the health care industry is a safe place to work, the recordable incident rate for hospitals is 7.7 and nursing homes and residential care facilities is 8.8. The West Georgia Health System has achieved more than a 50% reduction in recordable incident rate since 2004.

Participants will learn through a case study presentation which explains how the West Georgia Health System implemented a sustainable safety system by partnering with Milliken & Company. This world-class safety and health case study will demonstrate:

� Employee engagement and empowerment
� Teamwork
� Coaching and mentoring
� Systematic operating systems
� Continuous improvement
� Real, tangible performance
Gerald N. (Jerry) Fulks, CHE
President/CEO
WEST GEORGIA HEALTH SYSTEM

Tommy Britt
Director of Human Resources
WEST GEORGIA HEALTH SYSTEM

Six Sigma methodology and teams achieved results in the care of patients with septicemia, a blood stream infection that affects multiple organ systems, has high risk of mortality and has increased cost of care. Being able to define and reduce defect rates for patients with severe sepsis has resulted in a decrease in actual mortality rates of 17%, resulting in 66 lives saved in less than a year, as well as cost reduction of $2,400 per patient and length of stay reductions. This presentation will demonstrate how our workforce and medical staff have used Six Sigma to create new processes and procedures for the management of sepsis in our institution, including mechanisms to recognize sepsis earlier in the Emergency Department and begin the aggressive care for these patients in the ED.
Glenn Crotty MD
Chief Operating Officer
CHARLESTON AREA MEDICAL CENTER

The healthcare industry in this country is in a major revolution. Burgeoning technology advancements, cost increases that are outpacing inflation, and the public demand for better quality and safety at a lower cost are pressuring healthcare executives to focus on strategic growth, quantifiable clinical effectiveness, and improved operational efficiency. All the while, they must also be concerned with attracting and retaining top clinical talent, exploring new and innovative revenue streams, and maintaining compliance with ever changing regulatory standards. To sum it up, today�s healthcare executive is always focused on attaining sustainable performance improvement (PI).

Lean Six Sigma embraces key business philosophies and methodologies that help organizations develop performance improvement competencies, however, the cost can be daunting. More than ever before, every resource investment must produce demonstrable strategic return. Whether just at the beginning of your Lean Six Sigma deployment or years into the journey, incorporating Lean 6 Sigma into your overall business strategic is imperative for maximum financial and strategic return. At this session, participants will be introduced to a Strategy Management model that fully incorporates the power of Lean Six Sigma to achieve strategic objectives.

Jody Thompson
Director Strategic Planning
OSF SAINT FRANCIS MEDICAL CENTER

The Provincial Health Services Authority (PHSA) started implementing lean in 2006 initially as a tool and over the past two years as a core organizational strategy. This session will provide an overview of the approach used to integrate lean thinking into an organization and create a cultural change in addition to a process change. Topics to be covered include: the change in culture and the culture of change; the organizational and leadership support; case studies and lessons learned.
Jennifer MacKenzie
Vice President, Strategic Planning, Transformation Support and Innovation
PROVINCIAL HEALTH SERVICES AUTHORITY