Six Sigma Project Progress Report

Date Project Team Timing
13-May-10 Lab 11.00am to 12.00pm

13-May-10 OP 12.00pm to 1.00 pm
13-May-10 Biomedical 2.00pm to 3.00pm
13-May-10 Nursing 3.00 pm to 3.30 pm
13-May-10 Pharmacy 3.30 pm to 4.00pm
13-May-10 Stores 4.00 pm to 5.00 pm
13-May-10 Marketing 5.00 pm to 6.00 pm
13-May-10 Dietition 6.00 pm to 7.00 pm
13-May-10 Human Resource 11.00am to 12.00pm
13-May-10 Ward 12.00pm to 1.00 pm
13-May-10 IP Discharge 2.00pm to 3.00pm
13-May-10 Accounts 3.00pm to 4.00pm
13-May-10 Insurance 4.00pm to 5.00pm
13-May-10 Reception 5.00pm to 6.00pm
13-May-10 Billing 6.00pm to 6.30pm
13-May-10 Maintenance 6.30pm to 7.00pm
20-May-10 Lab 11.00am to 12.00pm
20-May-10 OP 12.00pm to 1.00 pm
20-May-10 Ward 12.00pm to 1.00 pm
28-May-10 Lab 11.00am to 12.00pm
28-May-10 OP 12.00pm to 1.00 pm
28-May-10 Ward 12.00pm to 1.00 pm
Conusultant
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Jayabalan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Rajarajan
Define - Measure - Analyse Analyse -
Project Team Measure Phase Phase Improve Phase
08-May-10, 20-May-10,
Lab 13-May-10 28-May-10
08-May-10, 20-May-10,
OP 13-May-10 28-May-10
08-May-10, 20-May-10,
Biomedical 13-May-10 28-May-10
20-May-10,
Nursing 13-May-10 28-May-10
08-May-10,
Pharmacy 13-May-10
08-May-10, 20-May-10,
Stores 13-May-10 28-May-10
08-May-10, 20-May-10,
Marketing 13-May-10 28-May-10
Dietition
08-May-10, 20-May-10,
Human Resource 13-May-10 28-May-10
20-May-10,
Ward 13-May-10 28-May-10
13-May-10,
IP Discharge 8-May-10 20-May-10
08-May-10, 20-May-10,
Accounts 13-May-10 28-May-10
13-May-10,
Insurance 8-May-10 20-May-10
Reception 8-May-10
Billing
08-May-10,
Maintenance 13-May-10
Note: Nurse and Ward team can take process improvement project
Improve - Control
Phase Control Phase
8-May-10
20-May-10,
28-May-10
8-May-10 13-May-10
8-May-10
28-May-10
28-May-10
13-May-10,
20-May-10 28-May-10
08-May-10, 20-May-10,
13-May-10 28-May-10
20-May-10,
28-May-10
improvement project .
PROJECT PROJECT NAME PRESENT STATE Remarks
Process has improved from 16.6 min to

12.7 min. New improvement initiative
Billing : Inpatient billing process time Improve - has been taken ; circular to collect ward
PROJECT 1
reduction Control phase wise per visit per patient Doctor fee.
Process is STABLE, NORMAL, and Cpk
0.5.
1. One way ANOVA for tests and One

way ANOVA for lab technician is done
and there is a significant difference in
Define -
PROJECT 2 Outpatient Department- Lab delay atleast one test and one technician.
Measure Phase
Need to sort out the same, as some of
the technicians are consistently having
less time difference.
Peak hours have been identified to be

10hrs to 20hrs. Process Capability has
Analyse - improved from 0.6 Cpk to 1.6 Cpk, due
PROJECT 3 Patient registration time reduction
Improve Phase to an improvement initiative of Direct
Registration in computer without using
registration form.
Not able to get special cause with

reason for Receiving billing card by
Discharge Delay Reduction for cash Measure -
PROJECT 4 billing department. Inititative taken to
patients Analyse Phase
send billing card directly to billing
department.
Investigation document, Details of
management, Previous consultation,
Past history, Cause of illness, Final
diagnosis are the fital few cause for
delay in insurance approval. Remedy
steps such as sending preauthol twice a
Reducing the time of Cashless Insurance Analyse -
PROJECT 5 day, FIRST at 11 hrs to 12 hrs for the
approval Improve Phase
patient admited previous day after 13
hrs. and Second at 18hrs to 19 hrs for
the patient admited on the same day
before 13 hrs. Mayor insurance cause
delay was TTK,Star (gen),
VIPUL,Medicare, MD india.
Define - Shameem absent, Shiva kumar is not

PROJECT 6 Employee's satisfaction
Measure Phase aware of 6sigma.
Identified 367.369,370,368 as the major

To reduce the breakdown time of Measure - power consuming services. A/C outdoor
PROJECT 7
maintenance equipments Analyse Phase unit, All Rooms as the power consuming
division of 367 services.
Measure - Analyse 1. ABC inventory analysis and Profitability

PROJECT 8 Pharmacy
Phase Analysis of all goods in stock is done.
To provide timely, tasty hygienic dietary Analyse -
PROJECT 9 Not visited
care Improve Phase
1. Actual process of Gauge R & R is

clearly explained to Mr. Hari. 2.
PROJECT 10 Increasing the reliability of the test results Measure Need to create 5-S system in
consumables and other racks in lab
3. Need to implement the action plan
To provide reduce the billing card time given to

PROJECT 11 Define New project
billing department
Improve -
PROJECT 12 Improve Nursing care satisfaction Not visited
Control phase
1. Process owner has completed getting

25 data points and the performance is
still dipping. He has some reasons like
off season for special cause in control
Define - chart of actual/targeted number of
PROJECT 13 Increase No. of Referral Cases
Measure Phase patients. 2. Have mooted the idea of
wearing corporate uniform for brand
identity and improving the consultant
feedback forms for business
development
1. Could not meet, as the process
owner is out on an exigency purchase.
PROJECT 14 Improving quality of purchase process Measure Phase He has to continue with previous
suggestions and still improve his
volume utilization.
Medicare TPA, TTK, Star health, MD India

Measure - Analyse are the Vital few insurance causing 50% of
PROJECT 15 To improve account receivable of insurance
Phase delay in insurance sum to 70% of insurance
value.
ACTION PLAN
1.Improvement initiative; fee for medical consultant has to be

freezed.
1. Control chart's special causes needs to be addressed properly

to improve process stability.
1.Standardized schedule 2. Queue formation. 3. Swapping of

billing and reception team. 4. Introducing notificaiton period as
2month 5. Implementation of 5S
1. Check the One way anova B/W ward Vs Total discharge time,
Total temprory bill, total final summary, Total final bill , Receive
billing card by pharmacy, take final summary, receive written
summary. 2.Doctors Vs total final summary.
1. Modify check list including the vital few delay caused
document. 2. Identify the causes for the vital few authoriz-
delaying insurance.3.Identify the average delay time for all the
vital few insurance.
To Make the ratings as 4 3 0 and plot individual moving range

chart and look for special cause.
1. Basement Consultant A/C Usage during the break monitor

chart ( 14,15,16,17 hrs).2. Rooms extra bulb no. 3.Rooms A/C
temperature at 9, 12,17.20.30 hrs 4. Understanding Operation
theater A/C usage during non operation period 5. Operation
theater data ( Date, Operation, Doctor, opertaion time, duration)
1. He has to identify both ABC class inventory items and fast

moving/slow moving inventory items.
2. He has to set reorder levels and max inventory levels for
the items. 3. Take Visual pictures to demonstrate the
improvement. 4. Have an
arrangement of medicines facilitating FIFO movement. 5. High cost
non moving items and low profitability non moving items SKUs to be
taken out immediately. Find alternate methods of procurement for
non-returnable narcotics drug.
1. Twenty One Point Lessons for visual management.
2. Including visual pictures such as training and feedback
collection of all the phases of improvement
3. Create a Dash board with photos and charts. Include only
recent and penultimate data/six-packs.
4. Document all the improvements made in the recent past to
demonstrate the sudden improvement in CpK from .53 to 1.53.
5. Make a presentation in the model given by Mr. Jayabalan for
preparation towards ANQ meet discussed with C.O.O
6. Clock idea for knowing the locality of the
department head to be discussed with C.O.O
1. Investigate the special causes and take necessary corrective

and preventive actions 2. Do one Gauge R& R
in biochemist or hepatology departmental machines.
3. Create a quarantine zone for disposing hazardous waste.
1. Project charter 2. Project Milestone chart 3. Data 4.Control chart

with special cause.
1. Start 5-S as a starting point for Voice of Business.
3. Including visual pictures such as training and feedback
collection of all the phases of improvement
4. Create a Dash board with photos and
charts. Include only recent and penultimate data/six-packs.
5. Make a presentation in the model given by Mr. Jayabalan for
preparation towards ANQ meet discussed with C.O.O
6. Create a documentation(either in soft or hard format)
in chronological order for the project for project replication.
7. Toyota type shoe cleaner to be installed in the
visitor area. Initiate the feasibility talks of buying such an
instrument with C.O.O
Two control charts. 1. X-MR chart for both patients per week / no
of doctors 2. Actual/Targeted number of patients per week.
Both the control charts are explained to Ms. Banu Rekha. The
control charts plotted shows definitive dip in the performance of
the marketing in the last two months. The process owner needs
to investigate the reasons and take counter measures.
1. Identification & Traceability of stores is found to be OK.
Checked the Fevi gum SKU in R7 C13 Rack 4 .
2. Reorder levels and max inventory level of
the stores is also checked. 3. He has to
put a pareto to identify A class items contributing to 80% of
stock value. 4. Volume is still not effectively utilized in
the storage areas of stationery rack.
1.Find the average delay time for the insurance company. 2. Implement
improve intiative, such as consistent reminder well in advance. Daily
phone call and mail 20 days before for TTK and Medicare and 14 days
before for Star health and MD india.
PRESENT
PROJECT PROJECT NAME
STATE
Improve -
Billing : Inpatient billing process time
PROJECT 1 Control
reduction
phase
Define -
PROJECT 2 Outpatient Department- Lab delay Measure
Phase
Analyse -
PROJECT 3 Patient registration time reduction Improve
Phase
Measure -
Discharge Delay Reduction for cash
PROJECT 4 Analyse
patients
Phase
Measure -
Reducing the time of Cashless Insurance
PROJECT 5 Analyse
approval
Phase
Define -
PROJECT 6 Employee's satisfaction Measure
Phase
Measure -
To reduce the breakdown time of
PROJECT 7 Analyse
maintenance equipments
Phase
Measure -
PROJECT 8 Pharmacy Analyse
Phase
Analyse -
To provide timely, tasty hygienic dietary
PROJECT 9 Improve
care
Phase
PROJECT 10 Increasing the reliability of the test results Measure
Define
PROJECT 11 Effective record maintenance
Phase
Improve -
PROJECT 12 Improve Nursing care satisfaction Control
phase
Define -
PROJECT 13 Increase No. of Referral Cases Measure
Phase
Measure
PROJECT 14 Improving quality of purchase process
Phase
Define -
PROJECT 15 To improve account receivable of insurance Measure
Phase
REMARKS
Process was unstable and had ppk less than zero till
march 23rd. Pareto on special cause have taken.
Found the following vial few special cause responsible
for billing process delay Doctor phone not pick
up(DPNP)55% ,Unable to find a doctor due to busy in
surgery (UCD-A) 15%, Discussion with internal staff
(DIS) 10% . Management has helped billing team to
take the following action, a) Update the billing amount
in billing card from doctor before discharge b) Give
prior intimation to doctor for collecting the doctor fee.
This action has resulted changes from 26 th march
2010.The process is stable with Mean = 16.6 minutes,
ppk = 0.39, ppm =130560 . By this process , billing
department were able to bring process from 36 min to
16.6 min, and save Rs.36 per hour.
Refinement in data collection and monitoring needed
Phone call interruption, New staff and Direct enquiry

where found to be the vital few special cause. Phone
instrument has been shifted from registration spot.
But still reception team were distracted by phone
call.
IP discharge process has been expressed in equation

as below, Total temporary bill (60min) = Receiving
discharge slip (15 min) + Receiving billing card by
ward secretary (5min) + Receiving billing card by
pharmacy(20 min)+Receiving billing card by billing (5
min) +Generate temporary bill (15min). Total
discharge summary (45 min) = Receive written
summary(20 min)+ Take final summary (20 min)+
Hand over summary to ward (5 min).Pareto was drawn
on frequency of target failed incidence on the above
activity. It was found the vital few cause for delay in
Total temporary bill was Receiving billing card by
billing department, Receiving billing card by
pharmacy. Also the vital few cause for delay in Total
discharge summary was Take final summary and
receiving written summary.
Data collection process have got refined with No. of query,
Reason for query, % of approval and Query type by the
team.GOPINATH CAN ALSO SHARE THE PROJECT OWNERSHIP
OF THIS PROJECT WITH VIJAYALAKSHMI.
Plotting and interpretation of chart has to be

improved.
Control chart for all the nine services data show they
are stable. Major power consuming services was
identified to be 367,369, 337 and 368.
Needs to do 5-S in stores. Could see a marked

improvement in the arrangement of the items in the
pharmacy.
Find out special causes in the recent control charts for

further improvement. Please enumerate all the
hypothesis testing and ANOVA used to improve
/identify the problem points.
Plot the control charts and bring in stability and

histogram for normality.
Project owner not available

Sustain achieved 6 sigma level of quality. Please
enumerate all the hypothesis testing and ANOVA used
to improve /identify the problem points. Enumerate
the turning point of your project. What did you do to
achieve six sigma quality. In specific, how the
variation has gone down. Please create a campaign
among all the hospital employees.
Understanding of the chart is yet not clear. Team

Leader has the responsibility of making him
understand the importance of drawing control charts
and their interpretations.
Communication of the time of request should be

standardized and authorized by C.O.O to effectively
monitor the time of issue. Control chart
understanding is not very clear. The inventory records
and reorder level should be automated by the
software alarms. The location of the stock is not yet
updated in the system.
Operational definition on the delay date on receivable

of insurance.
ACTION PLAN
1) Draw Pareto with inference for medical case.

2) Brainstorm
actions for the vital few.
1.Plot difference(target time to actual time) with

XMR chart. 2.Pareto on types of test.
1) Identify the peak hours using pareto.

2) Refine schedule with one receptionist dedicated
for attending phone call and enquiry during peak
hour. 3) Implement 5S to
arrange the most needed item near to your hand.
1) Draw control chart with special cause for

Receiving billing card by billing department,
Receiving billing card by pharmacy, Take final
summary and Receiving written summary. 2) Pareto
for the special cause and find the vital few special
cause.
1) Redefine query type 2) Pareto based on query type 3)
Pareto on the frequency of delay on insurance company.
To Make the ratings as 4 3 0 and plot individual

moving range chart and look for special cause.
1) Identify major power consuming devices in each

identified services. 2) Brainstorm on methods to
reduce power consumption on these identified
devices.
1. He has to identify both ABC class inventory items and

fast moving/slow moving inventory items.
2. He has to set reorder levels
and max inventory levels for the items. 3.
Take Visual pictures to demonstrate the improvement.
4. Have an arrangement
of medicines facilitating FIFO movement.

2. Including visual pictures such as training and
feedback collection of all the phases of improvement
3. Create a Dash board with photos and charts.

Include only recent and penultimate data/six-packs.
4. Document all the improvements made in the
recent past to demonstrate the sudden improvement
in CpK from .53 to 1.53.
5. Make a presentation in the model given by Mr.
Jayabalan for preparation towards ANQ meet
discussed with C.O.O 6. Clock
idea for knowing the locality of the department head
to be discussed with C.O.O
1. Investigate the special causes and take necessary

corrective and preventive actions
2. Do one Gauge R& R in biochemist or hepatology
departmental machines. 3. Create a
quarantine zone for disposing hazardous waste.
Management need to take call on this project

1. Start 5-S as a starting point for Voice of Business.
3. Including visual pictures such as training and
feedback collection of all the phases of improvement
4. Create a
Dash board with photos and charts. Include only
recent and penultimate data/six-packs.
5. Make a presentation in the model given by Mr.
Jayabalan for preparation towards ANQ meet
discussed with C.O.O 6. Create a
documentation(either in soft or hard format) in
chronological order for the project for project
replication. 7. Toyota type shoe
cleaner to be installed in the visitor area. Initiate the
feasibility talks of buying such an instrument with
C.O.O
Two control charts. 1. X-MR chart for both patients

per week / no of doctors 2. Actual/Targeted
number of patients per week. Both the control
charts are explained to Ms. Banu Rekha. The control
charts plotted shows definitive dip in the
performance of the marketing in the last two months.
The process owner needs to investigate the reasons
and take counter measures.
1. Identification & Traceability of stores is found to

be OK. Checked the Fevi gum SKU in R7 C13 Rack 4 .
2. Reorder
levels and max inventory level of the stores is also
checked. 3. He has to put a
pareto to identify A class items contributing to 80%
of stock value. 4. Volume is still not
effectively utilized in the storage areas of stationery
rack.
1.Pareto on frequency of delay from insurance
company. 2. Stratify Insurance company based on the
pending amount.
PRESENT
PROJECT PROJECT NAME
STATE
Billing : Inpatient billing process time Measure
PROJECT 1
reduction Phase
Define -
PROJECT 2 Outpatient Department- Lab delay Measure
Phase
Analyse -
PROJECT 3 Patient registration time reduction Improve
Phase
Measure -
Discharge Delay Reduction for cash
PROJECT 4 Analyse
patients
Phase
Reducing the time of Cashless Insurance Measure

PROJECT 5
approval Phase
Define -
PROJECT 6 Employee's satisfaction Measure
Phase
Measure -
To reduce the breakdown time of
PROJECT 7 Analyse
maintenance equipments
Phase
Define -
PROJECT 8 Pharmacy Measure
Phase
Analyse -
To provide timely, tasty hygienic dietary
PROJECT 9 Improve
care
Phase
PROJECT 10 Increasing the reliability of the test results Measure
Define
PROJECT 11 Effective record maintenance
Phase
Improve -
PROJECT 12 Improve Nursing care satisfaction Control
phase
Define -
PROJECT 13 Increase No. of Referral Cases Measure
Phase
Measure
PROJECT 14 Improving quality of purchase process
Phase
Define -
PROJECT 15 To improve account receivable of insurance Measure
Phase
REMARKS
Too many special cause, Not clear

stratification of special cause.
Refinement in data collection and monitoring

needed
Vital few special cause have been identified

using Pareto. Counter measure need to be
refined.
Countable non value adding activity. Need

good Co-ordination among Ward secretory,
Nursing, Billing and Pharmacy
Data collection need to be improved
Plotting and interpretation of chart has to be

improved.
Understanding of chart need to be clear.
Need to find areas of improvements
Project owner not available
Sustain achieved 6 sigma level of quality.
Control chart plotting and interpretation.

ACTION PLAN
Month wise Control chart with special cause and

Month wise Pareto on Special cause
1.Plot difference(target time to actual time) with

XMR chart. 2.Pareto on types of test.
Implementation of counter measure. Assess process

improvement due to counter measure change using
control chart and Pareto .
Pareto on IP discharge delay based on support team

wise. Control chart with special cause on IP
discharge and support team.
Number of queries before approval, categories the

queries, and draw pareto for the same. X MR chart
for time taken for pre authorization form filling.
Enhancemennt queries categorisation and pareto.
To Make the ratings as 4 3 0 and plot individual

moving range chart and look for special cause.
1.To use multiline chart. 2.To record benefits due to

change lift operation. 3.To record data on a) IP per
day, b) No. of OT1 and OT2 operation per day, c) No.
x-rays per day. 4. To explore possibilities of motion
sensor light in basement on trail basis.
To send complete data start to end time in excel.
Application of Analitical tools to statisticaly highlight

the process state.
Control chart with special cause. Pareto chart based

on special cause
Management need to take call on this project
Project on reducing defects and rework in Discharge

card.
Month wise data - a) No. of doctors refered b) No. of

IP refered data.
Control chart with special cause.
Pareto on insurance company based on no. of patient

refered. Control chart for Insurance claim time.

Six Sigma Project Progress Report

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Date Project Team Timing

13-May-10 Lab 11.00am to 12.00pm

Process has improved from 16.6 min to

1. One way ANOVA for tests and One

Peak hours have been identified to be

Not able to get special cause with

Define - Shameem absent, Shiva kumar is not

Identified 367.369,370,368 as the major

Measure - Analyse 1. ABC inventory analysis and Profitability

1. Actual process of Gauge R & R is

To provide reduce the billing card time given to

1. Process owner has completed getting

Medicare TPA, TTK, Star health, MD India

1.Improvement initiative; fee for medical consultant has to be

1. Control chart's special causes needs to be addressed properly

1.Standardized schedule 2. Queue formation. 3. Swapping of

To Make the ratings as 4 3 0 and plot individual moving range

1. Basement Consultant A/C Usage during the break monitor

1. He has to identify both ABC class inventory items and fast

1. Investigate the special causes and take necessary corrective

1. Project charter 2. Project Milestone chart 3. Data 4.Control chart

PROJECT 10 Increasing the reliability of the test results Measure

Refinement in data collection and monitoring needed

Phone call interruption, New staff and Direct enquiry

IP discharge process has been expressed in equation

Plotting and interpretation of chart has to be

Needs to do 5-S in stores. Could see a marked

Find out special causes in the recent control charts for

Plot the control charts and bring in stability and

Project owner not available

Understanding of the chart is yet not clear. Team

Communication of the time of request should be

Operational definition on the delay date on receivable

1) Draw Pareto with inference for medical case.

1.Plot difference(target time to actual time) with

1) Identify the peak hours using pareto.

1) Draw control chart with special cause for

To Make the ratings as 4 3 0 and plot individual

1) Identify major power consuming devices in each

1. He has to identify both ABC class inventory items and

1. Twenty One Point Lessons for visual management.

3. Create a Dash board with photos and charts.

1. Investigate the special causes and take necessary

Management need to take call on this project

Two control charts. 1. X-MR chart for both patients

1. Identification & Traceability of stores is found to

Reducing the time of Cashless Insurance Measure

PROJECT 10 Increasing the reliability of the test results Measure

Too many special cause, Not clear

Refinement in data collection and monitoring

Vital few special cause have been identified

Countable non value adding activity. Need

Data collection need to be improved

Plotting and interpretation of chart has to be

Understanding of chart need to be clear.

Need to find areas of improvements

Understanding of chart need to be clear.

Project owner not available

Sustain achieved 6 sigma level of quality.

Understanding of chart need to be clear.

Understanding of chart need to be clear.

Control chart plotting and interpretation.

Month wise Control chart with special cause and

1.Plot difference(target time to actual time) with