1. Process Improvement Through
Use of Lean/Six Sigma Methods
Amanda Duling, MS Kendall Cobb
Team Leader, Quality Area Business Manager
Saint Luke’s Hospital Missouri Enterprise

2. Introductions
 Amanda Duling
 Kendall Cobb
 You!

3. Saint Luke’s Hospital
 Flagship hospital in 11 hospital system
 629 beds
 3,996 employees
 Not for profit
 Tertiary care referral
 Protestant Episcopal Church
 Primary teaching hospital – UMKC School of Medicine
 Level I Trauma Center
 Level III Neonatal Care
 Centers of Excellence

4. Missouri Enterprise
 More than 25 years of experience in process
improvement training and implementation.
 Specific areas of expertise in Quality
Management, Lean, Six Sigma, business
growth and product development.
 Six offices throughout the state
 Part of the one of the largest consulting
organizations in America.
 Not for profit

5. How We Began
 Missouri Enterprise AMSTP Program
 301 students
 97 companies
 Part of NIST Network
 Saint Luke’s Participation
 Over 10 Participants from Quality, Administration, Surgery, Home Care, etc.
 At least 8 Projects
 Blood Management
 Admit to Bed Placement
 Specimen Labeling
 Operation First Starts
 Lean Lab

6. Baldrige Award Criteria
Category Six – Process Management
“The process management category examines
how your organization determines its core
competencies and work systems and how it
designs, manages and improves key
processes for implementing those work
systems to deliver customer value and achieve
organization success and sustainability
(Blazey, 2007, p. 185).”
Blazey, Mark L. (2007). Insights to Performance Excellence 2008: An Inside Look at the 2008 Baldrige Award Criteria. Milwaukee, WI: ASQ.

7. Waste Overview
Lean Added
Value = Removing Waste
Non-Value Added
• Waiting
• Adding extra steps (Overprocessing)
• Incorrect Action (Defect)
• Too much… Too soon…(Overproduction)
• Transportation
• Inventory or Supplies (Excess)
• Motion
• Employee utilization
7

8. Waste Exercise
What kind of waste, non-value added activities, do
you see in your organization?
List potential waste in small groups for the following
topics:
1. Waiting
2. Adding extra steps (Overprocessing)
3. Incorrect Action (Defect)
4. Too much… Too soon…(Overproduction)
5. Transportation
6. Inventory or Supplies (Excess)
7. Motion
8. Employee utilization

9. Lean Six Sigma Overview
Lean manufacturing or lean production, which is often known
simply as "Lean", is the practice of a theory of production that
considers the expenditure of resources for any means other
than the creation of value for the presumed customer to be
wasteful, and thus a target for elimination.
 Rid a process of NON VALUE ADDED ACTIVITIES.
 Uses systematic tools such as TPM, Poke Yoke, Kanban, 5S,
Kaizen etc.
Six Sigma is a systematic, scientific, fact based, customer
driven, data driven problem solving process.
 The term “six sigma” defines an optimum measurement of
quality: 3.4 defects per million opportunities.
 Uses a systematic methodology called DMAIC.

10. SLHS Applications of Tools
 Reduced the number of inappropriate blood transfusions by
80% and increased patient safety
 Reduced the number of duplicate HNE/CPI patient accounts
from an average of 78 per month to 30
 Reduced SLH overall printing costs without compromising
patient privacy and regulatory standards by $74,000
 Reduced 50% of the cost associated with fall prevention tools
(Hi/Low Beds, Patient Sitters) while sustaining patient safety
 Standardized the cleaning process in Environmental Services
 Increased cross-functional awareness/understanding
 Opened up lines of communication
 Increased Leadership’s awareness of staff activities
 Educated Leadership/Staff on systematic process
improvement tools

11. SIPOCR Overview
 SIPOCR stands for…
 Suppliers
 Inputs
 Processes
 Outputs
 Customers
 Requirements
 Typicallydone at the beginning and end
of project (current vs. future)

12. SIPOCR Example

13. SIPOCR Exercise
 Select a process
 In the following order complete…
1. 5-10 high level process steps
2. Inputs
3. Outputs
4. Supplier
5. Customers
6. Customer Requirements

14. Questions

15. Contact Information
Amanda Duling, MS Kendall Cobb
• Team Leader Quality • Area Business Manager
Saint Luke’s Hospital Missouri Enterprise
• (816) 932-8151 • (417) 350-2119
• aduling@saint-lukes.org • kcobb@missourienterprise.org