MGMT 676 Factory Physics & Six Sigma Concepts for Healthcare Engineering & Management

1. MGMT 676 Factory Physics & Six Sigma Concepts for Healthcare Engineering & Management Research Solutions in Healthcare: Successes, Challenges, & Lessons Learned 2008 Spring Conference April 22, 2008 Herbert Moskowitz Suresh Chand Steve Shade

2. Perspectives History / Evolution Details: Overview, Focus, Content, & Topics Appendices Tools Team Projects Table of Contents 2

3. Uniqueness, Objectives Linking Students with Current Healthcare Practice Skills Obtained Enhancing & Expanding the Course Perspective 3

4. Industry Juran Center for Quality… University of Minnesota Healthcare Applications… IUMG & Regenstrief Center Development of Healthcare Course History / Evolution 4

5. Issue Improve Product Quality (TV’s) Using Six Sigma Concepts Lessons Learned Need to Change Habits On Building a Successful Team for Change IT Essential for Six Sigma Implementation Six Sigma Training Expensive Humans Poor Statisticians Industry (Thomson Consumer Electronics) 5

6. Research Byproduct IT Brings Data to Process Owner / Decision Maker With Data, Potentially Everything Can be Modeled Improve Decision Making by Letting Humans & Machines Do What They Do Best… Humans: Creativity… Define, Measure Machines: Model… Analyze, Improve, Control Led to Use of Machine Learning Algorithms… Validation of Concept in Practice (Eli Lilly) Industry (Thomson Consumer Electronics) 6

7. Six Sigma Course for MBA’s Product Focused Replicate Reality Animated Simulation of Manufacturing Process for Process Improvement Team-based Competition vs. Machine Learning Algorithm Industry (Thomson Consumer Electronics) 7

8. Major Focus on Healthcare Issues Annual Meetings Criticality of Healthcare to Economy & Industry (Paul O’Neil… Former Secretary of Treasury) Need for Operations Professionals to Improve Healthcare Processes (Denis Cortese… CEO Mayo Clinic) Juran Center for Quality - University of Minnesota 8

9. IUMG / Krannert Collaboration Improve Patient Flow at Grassy Creek Clinic Approach Used TCE Team Model… Champion (Dr. Deanna Willis), Grassy Creek / Purdue Team Developed Animated Simulation of Patient Flow as Experimental Platform Integrated Six Sigma & Factory Physics Concepts / Tools Results Successful Healthcare Applications: IUMG & Regenstrief Center 9

10. Birth of Regenstrief Center Same Laws Govern Behavior of Healthcare & Manufacturing Systems Need for Healthcare Course Using Manufacturing Science to Healthcare System Operational Effectiveness & Efficiency Emulate Model of Product-focused Six Sigma Course Healthcare Applications: IUMG & Regenstrief Center 10

11. Overview Factory Physics (FP) and Six Sigma (SS) Complementary Concepts Hot Button Issues in Industry to Improve Processes & Product Quality Healthcare a High Priority National Issue with Direct Impact on Manufacturing Costs ($1,500 of GM Car Due to Cost of Employee Healthcare) Need to Transfer FP & SS Technology to Healthcare Systems… Spawn Demand for Operational Professionals Details: Overview, Content, & Topics 11

12. Focus Tools, Applications, Research Focused Multidisciplinary Graduate Course Details: Overview, Content, & Topics 12

13. Content Part I: Overview, Fundamentals, & Tools Concept & Tools Case Studies Guest Speakers Active Learning Exercises (Minitab Data Files, Patient Flow Simulation) Part II: Advanced Concepts, Applications, & Research to Healthcare Delivery Details: Overview, Content, & Topics 13

14. Six Sigma Concepts & Tools On Habits Micro and Macro Economics of Quality Measurement Capability Statistical Process Control Process Capability Design of Experiments Full Factorial Designs Fractional Factorial Designs Response Surface Design Single & Multiple Response Optimization Topics 14

15. Factory Physics Concepts & Principles Tools & Applications Case Studies Applicability of Management Models from Production Industries to Healthcare Delivery (Toyota Production System) Physician Order Entry (Electronic Medical Records) Topics 15

16. Guest Speakers Application of Lean Systems in the Healthcare Industry Improving Efficiency & Operational Effectiveness of an Eye Clinic About the Regenstrief Center for Healthcare Engineering Topics 16

17. Uniqueness Mulitdisciplinary Integrate Factory Physics and Six Sigma, Transfer Technology from Manufacturing to Healthcare Active Learning Physical & Computer Simulations Live Team Projects in Healthcare Practice Perspectives 17

18. Objectives Identify Research Opportunities in Healthcare… Theses, Dissertations, Research Funding Concepts/Tools for Improving Healthcare System Performance from Manufacturing Multidisciplinary Project Teams Perspectives 18

19. Linking Academics & Practice Case Studies Guest Speakers Active Learning Animated Simulations Live Healthcare Team Projects Skills Learned Manufacturing Science Technology is Transferrable to Healthcare Systems Concepts / Tools of Factory Physics & Six Sigma to Improve Performance Perspectives 19

20. Enhancing / Expanding Course University-wide Course Orientation Professionals Researchers Executive Education Course for Healthcare Professionals Virtualization… Develop More Animated Simulations of Real Processes for Active Learning & Experimentation Perspectives 20

21. Appendix 1: Course Content 21

22. Factory Physics is study of laws governing behavior of manufacturing systems. Both Factory Physics and Six Sigma focus on process variation reduction, and thus are highly complementary. The authors of the book Factory Physics state, “Factory Physics is a systematic description of the underlying behavior of manufacturing systems. Understanding it enables managers and engineers to work with the natural tendencies of manufacturing systems to: (1) Identify opportunities for improving existing systems, (2) Design effective new systems, and (3) Make the tradeoffs needed to coordinate policies from disparate areas.” In this course, we will see that the manufacturing and healthcare systems are similar in many ways, and the same laws govern the behavior of healthcare systems also. Some specific concepts/tools covered are: 1. Effect of process time variability on performance 2. Sources of variability in process time 3. How variability propagates from one stage to the next 4. Pooling of resources to reduce effect of variability Reference: Wallace J. Hopp and Mark L. Spearman, Factory Physics, Irwin McGraw-Hill, 2001 Factory Physics Concepts 22

23. Six Sigma Concepts and Tools 23

24. Six Sigma Concepts and Tools 24

25. Six Sigma Concepts and Tools 25

26. Six Sigma Concepts and Tools 26

27. Appendix 2: Team Healthcare Projects 27

28. Scheduling to Improve Patient Flow at IUMG Outpatient Clinic Simulation Design of Experiments: Scattered Appointments, Overflow Call Routing to PSA’s, Batching of Patient Records, Pooled Registration Queues Call Center Volume Management Time Series Forecasting, Staffing Operational Effectiveness & Efficiency… Process Improvement Projects 28

29. Modeling & Optimizing Multitasking Administrative Operations Check-in and Phone Calls Modeling Patient Attendance at Outpatient Clinics Logistic Regression, Machine Learning Algorithms Operational Effectiveness & Efficiency… Process Improvement Projects 29

30. Modeling Patient Flow in a Centralized Registration Process Simulation Evaluating Scheduling Policies in a Colorectal Cancer Care Center Agent-based Simulation Operational Effectiveness & Efficiency… Process Improvement Projects 30

31. Medical Diagnosis Computational Intelligence / Machine Learning Algorithms for Diagnosing Breast Cancer Information Technology Electronic Medical Records Additional Projects 31