What is DMAIC? What are the tools of DMAIC?

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1 What is DMAIC? DMAIC is an acronym for a series of steps used to measure defects in business processes and improve profitability. It is one of two key methods used to implement Six Sigma. DMAIC stands for: Define Analyze Improve Control What are the tools of DMAIC? 1: Brainstorming Identifying the problem you want solved.

2 2: Cause and effect diagrams: known as fish diagrams Sample of Patient Satisfaction Fish Diagram What are the tools of DMAIC? 3: Flow Charting Looking at the current process and identifying redundancies. EXAMPLE: How does a patient access nursing / needs after clinic visit or before? er to OHSU Three Ways to Contact Clinic Scheduling line Provider Admin Assist Primary Phone Contact Nursing Direct line on business cards

3 er to OHSU Nursing Line Scheduling Line Primary Line Admin Line Schedulers Process RN Paged (Not common) Schedulers pull up call and triage as: Clinic goes to queue Schedulers look up patient, gather brief message, decide whether to in basket or page (voic not an option) Schedulers create inbasket message or telephone encounter; send to RN Schedulers (50%) 90% calls are not Admin Triage call for schedulers, clinic or admin Admin (10%) Process er connected w/ RN (RARE) er leaves message RN checks VM Clinic (40%) Transfer to RN direct line goes to VM VM full or er decides not to leave message, calls back later Consults Finishes phone call Whenever you look at a Flow Chart that comes across as messy; rather than Flowing, you know there is redundancy and room for improving efficiencies So Where Do You Start? 1: Brainstorming Identifying the problem you want solved.

4 Scheduling line er to OHSU Schedulers (100%) Admin Line Nursing Line Schedulers pull up call and triage as: goes to queue Triage call for schedulers, clinic or admin Admin (10%) Clinic (40%) Schedulers Clinic Process Transfer to RN direct line Process RN Paged (Not common) Schedulers look up patient, gather brief message, decide whether to in basket or page (voic not an option) Most of the time schedulers create in basket message or telephone encounter; send to RN er connected w/ RN (RARE) er leaves message RN checks VM goes to VM VM full or er decides not to leave message, calls back later Consults need to Finishes phone call Scheduling line er to OHSU Schedulers Process RN Paged (Not common) Consults Schedulers pull up call and triage as: need to Clinic Schedulers look up patient, gather brief message, decide whether to in basket or page (voic not an option) Most of the time schedulers create in basket message or telephone encounter; send to RN Admin Patient can do all this via e mail on their computer at home By centralizing the calls to one number (the schedulers) we have: Eliminated an unnecessary transfer from admin to schedulers (where the call then waits in queue) Standardized how calls are handled Removed the possibility of routing calls incorrectly to RN voic . Schedulers are more EPIC savvy and more in tune with how to triage the patient phone calls. Regulated the message process: Voic not an option. Nurses Direct line to RN / Provider Using technological solution called MyChart don t spend time checking voic . Shifted the work of gathering MRN, phone, brief message from RN to PAS. RN can spend more time doing clinical work Removed the possibility of patient not leaving a voic , only to call back later and restart the process

5 4: Scatter Diagrams 5: Pareto Diagram Shows the amount of correlation between two variables I.E. What number of defects result from an increase speed of production? What is the ultimate speed of production that results in the least number of defects? Particularly effective tool that allows one to focus on the primary problem as an order of its greatest effect on the business. In the flow chart example above, voice mail resulted in the greatest number of call backs and patient dissatisfaction What are the tools of DMAIC? 6: Histogram: Defines above normal, average and below average results Pts with abnormal QRS intervals

6 Pt No Shows Abnormals 6: Histogram: Defines above normal, average and below average results Abnormals: What abnormals do you work on? Pareto Diagram What is the cause of the primary Abnormals? Cause and effect / Flow Charts What solutions do you develop? Brain Storm: The importance of Why How do you keep the abnormals from reoccurring? Controls

7 KEEP IT SIMPLE: WHEN WORKING ON A PROBLEM, BE SURE TO ASK THE QUESTION WHY A MINIMUM OF 5 TIMES