Lean Six Sigma in Healthcare

The Need for Efficiency in Healthcare

Healthcare Reform: The National Problem

It is no secret that the cost of US healthcare has been spiraling out of control for a long time. Whatever source data and projections are cited, accepted, debated, or debunked — the status quo was unsustainable and the US will be in the process of healthcare reform (of one form or another) for years to come. Some reference data:

  • The United States spends far more on healthcare expenditure per capita than other industrialized nations (including those countries that provide health insurance to all their citizens). [1]
  • From 2002 – 2012, employment-based health insurance premiums have increased 97%, compared to cumulative inflation of 28% and cumulative wage growth of 33% during the same period. [2]
  • An estimated thirty to forty cents of every dollar spent on healthcare, or more than a half-trillion dollars per year, is spent on costs associated with unnecessary, inefficient and even unsafe care. [3]


Finding a Solution for Healthcare Organizations

There’s no doubt that many of the healthcare problems we face as a nation can only be addressed at the macro-level (i.e., government and large consortiums). However, by working with a number of healthcare organizations to implement Lean and/or Six Sigma improvement programs, Pivotal Resources has demonstrated that enormous gains can also be made at the micro-level (i.e., individual organizations and facilities). Most individual health plans, hospitals and medical centers can significantly reduce costs (and improve quality) by removing waste and eliminating errors that exist in their day-to-day operations, especially in those activities that support the actual delivery of healthcare services. For example, some of the process improvements our clients have made affect the following areas:

  • Processing invoices and insurance claims
  • Providing customer service to health plan members
  • Admitting patients to a medical center
  • Cleaning and preparing hospital examination rooms
  • Scheduling patient appointments
  • Hiring doctors, nurses and administration staff
  • Transporting specimens and lab results

Identifying Waste in Healthcare Organizations – Perhaps Not As Easy As It Seems

For many healthcare organizations, trying to implement process improvement programs can be difficult. Apart from perhaps not having internal Lean or Six Sigma expertise, a huge challenge comes when employees and staff members are asked to identify waste in the work in which they are so closely involved. Recognizing that much about their daily jobs is wasteful and unnecessary can be difficult for anyone, but it may be especially hard for healthcare professionals who so directly link their work activities to patient health.

Pivotal Resources – Your Partner in Driving Efficiency and Enhancing Value

Pivotal Resources is an expert in helping healthcare organizations identify and eliminate waste, and measure and reduce the impact of errors and variation. Additionally, and most importantly perhaps, Pivotal can support the creation of a Culture of Quality, whereby all staff and employees begin to proactively examine the effectiveness and efficiency of their work processes. It is when such a Culture of Quality takes root that healthcare organizations begin to see real change that leads to significant financial results and gains in customer satisfaction, which includes the satisfaction of patients, of members and of providers.


Lean Six Sigma Improvement: Getting Started / Planning a Strategy

For most healthcare organizations who are considering a process improvement effort, Pivotal Resources recommends beginning with a simple two-day workshop that explains the basics of Lean and Six Sigma, and helps the team recognize if and how the methodologies can help them drive efficiency and enhance value. Following this two-day program, the organization will be well prepared to build its improvement strategy and plan the appropriate next steps.

NOTE: While Pivotal has a great deal of experience with healthcare organizations, no two process improvement programs are identical. The details of each organization’s strategy must be decided upon based on that organization’s unique situation, needs and cultural characteristics. In some cases, training select staff members as Lean Six Sigma “Black Belts” might be the best next step. In other cases, identifying and executing some “quick hit” projects might be a more effective approach. The two-day program outlined below is designed specifically to give an organization exactly the knowledge and skills they need to decide which approach is the right approach for them.

Core Concepts of Lean Six Sigma (2-day workshop)

During this two-day program, healthcare examples will be used to illustrate Six Sigma and Lean concepts and tools, such as value adding/non value adding work, Voice of the Customer, process maps, types of waste, 5S, poke-yoke, cycle time, takt time, cell design, data display and analysis, and process control. Examples will come from various healthcare organizations, including hospitals, clinics, laboratories and pharmacies. On day one of the program, participants will learn about the most fundamental tools, techniques and concepts of the Lean and Six Sigma improvement methodologies. Throughout the day, the group will participate in an interactive process simulation activity that will give people a direct connection to what innovative, customer-driven process improvement is all about. Playing roles in a “real-life” company, participants will be challenged to:

  • Use Lean and Six Sigma tools and metrics to identify and eliminate the causes of waste, errors, customer dissatisfaction and poor process performance
  • Collect Voice of Customer data to identify process requirements
  • Develop, test and implement solutions
  • Work as a team to execute effective improvement

On day two of the program, participants will use their newfound knowledge of Lean and Six Sigma to assess the opportunities for improvement in their organization, and to build a vision and strategy for driving a Culture of Quality.


This program is not just about training – it is about helping you decide if and how to proceed. After completing the two-day workshop, your organization will be able to confidently plan the best strategy for driving efficiency and enhancing value.



  1. [Source 1: OECD Health Data 2013.]
  2. [Source 2: The Henry J. Kaiser Family Foundation. Employee Health Benefits: 2012 Annual Survey. September 2012.]
  3. [Source 3: Building a Better Delivery System: A New Engineering/Health Care Partnership, a joint effort between the National Academy of Engineering and the Institute of Medicine. 2005.]

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