CMSA Today - Issue 4, 2014 - (Page 16)

DMAIC Six Sigma Approach The DMAIC Six Sigma Approach In the Value of Case Management By Tina Kowlsen, RN, BS, CCM O ver the last two decades, case management services have spread into many areas of the health care industry. Because of this expansion, there is a demand for proven quality and value of these services, as well as compliance with new rules and regulations in health care which have had a major economic impact on the health care industry. Because of this impact, health care leaders have responded with quality management strategies such as total quality management (TQM) and lean management methodologies. Among these methodologies, Six Sigma is the newest approach to quality improvement that is currently creating a paradigm in the health care industry. In this article, I will discuss the Six Sigma application of the DMAIC (Define-Measure-Analyze-Improve-Control) methodology and assess its use to measure the value of case management services in health care organizations. Over the last three to five years, health care companies have begun to implement the Six Sigma strategy and tools for project improvement initiatives. According to Bryan Carey, "DMAIC is a process unto itself that can be - should be - improved in each organization that uses Six Sigma as a critical component of continuous improvement and quality initiatives" (Carey, 2010, p. 1). Recently, the Six Sigma strategic approach has demonstrated a transformation in the culture, vision, goals and process improvement methodologies of several health care organizations where it has been implemented. The DMAIC is a problem-solving course of action that involves defining the problems of a process, measuring the available data involved in the process, analyzing the process's performance and identifying associated issues, selecting solutions to the root cause of the problem, and implementing a control plan that demonstrates how standards and improvements can be sustained and risks managed. This method is primarily based on the application of statistical process 16 CMSA TODAY Issue 4 * 2014 control, quality tools, and capability analysis, and is used to help design and redesign a process improvement. As case management services continue to evolve with the transformation of the health care industry, the DMAIC methodology is a proactive approach that can establish industry standards and measurements for quality, as well as cost-effective process and performance improvements of case management services in health care. One important step in estimating the value of DMAIC methodology is scoping the DMAIC project. According to D. Lynch, S. Bertolino and E. Cloutier, "This step is a vital part of the define phase and can have a long-term impact on a Six Sigma program's ultimate success. Six Sigma projects should contain quantifiable metrics intrinsic to organizational performance. The metrics are used to track the progress of the project. Thus, one of the most critical aspects of a Six Sigma project is to provide a measurable benefit in terms of cost, quality and timing" (Lynch, P., Bertolino, S., and Cloutier, E., 2003, p. 1-2). Additionally, the DMAIC process provides the highest benefit-to-cost ratios in the shortest period of time through analyses of data, process, and root-cause. The use of process maps, pareto charts, histograms, and brainstorming techniques also provides opportunities to reduce variations, yet gain higher predictability in the case management process. According to Donald Lighter, "Because sigma represents the standard deviation, it provides a measure of variation in the process that leads to nonconforming output." (Lighter, 2011, p. 292) Thus, the DMAIC approach has tremendous value for measuring case management productivity, financials and quality outcomes in health care organizations. Another benefit of the DMAIC Six Sigma approach is the ability of company executives operating in this approach to generate considerable cost savings. This benefit further justifies the use of DMAIC methodology and Six Sigma calculations to assess the value of case management services. Case management programs have always held value based on cost savings and return on investment. With the DMAIC Six Sigma approach, case managers can showcase their value through highlighting the timing of specific processes, cost benefit/savings analyses, return on investment (ROI) calculations, and customer satisfaction reporting. According to Tushar Desai and Dr. R. L. Shrivastava, "Six Sigma propagates that all-round quality performance is bound to result in the attainment of the desired business excellence in terms of reduction,

Table of Contents for the Digital Edition of CMSA Today - Issue 4, 2014

President’s Letter
President-Elect’s Letter
Cmsa Corporate Partners
Association News
Value-Driven Health Care
The Dmaic Six Sigma Approach
Motivational Interviewing
Q & A
Medication Non-Adherence
Index of Advertisers

CMSA Today - Issue 4, 2014