Six Sigma and CMMI

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Six Sigma and CMMI

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DMAIC

• Define Define and scope the problem, identify
  potential benefits and critical to quality
  factors
• Measure Identify the key internal processes
  that influence the critical to quality factors
  and measure the defects generated relative to the
  identified CTQs. Confirm the measurement
  reliability and know the voice of the customer.
  End result Team can successfully measure the
  defects generated for a key process affecting the
  CTQ.
• Analyze Identify the root causes of the
  defects. Use statistical data tools to identify
  key process inputs that affect process outputs.
  End result Explain variables that are likely to
  drive process variation the most.

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DMAIC

• Improve Determine and confirm optimal solution.
  Identify the maximum acceptable ranges of key
  variables. End result Modify the process to
  stay within the acceptable ranges.
• Control Ensure the modified process now enables
  the key variables to stay within the maximum
  acceptable ranges using tools such as metric
  dashboards.

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Six Sigma
Process performance

• Six Sigma is a level of process capability such
  that less than 3.4 defects are produced for
  every million opportunities.

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Example Emergency Room Wait Time

• Project description reduce and consistently
  maintain patient wait times from triage start to
  first physician interaction at established
  thresholds.
• Expected benefits
• Customer CTQ Reduced wait time
• Internal CTQ
• Improve patient / staff satisfaction
• Enhance patient outcomes
• Increase Emergency Room operational efficiency

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Example Emergency Room Wait Time

• Emergency Room Process
• Arrival ? Triage ? Register ? Lobby ? Nurse ? MD

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Example Emergency Room Wait Time

• What is the Voice of the Customer
• Patient Survey N 30 patient survey, random
  with all days and all shifts
• Patient wait time expectations
• 10 20 minutes 43
• 20 30 minutes 23
• Lobby wait satisfaction rating
• Very satisfied - 11
• Somewhat satisfied - 3
• Neutral - 2
• Somewhat dissatisfied - 3
• Very dissatisfied - 11

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Example Emergency Room Wait Time

• Baseline An observational study yielded
  baseline measurements for the total wait time.
• Mean 62.5 minutes
• Standard deviation 39.66
• Specification limit 37 minutes

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Example Emergency Room Wait Time

• Measurements included
• Y number of minutes from triage start to first
  physician interaction
• Specification Limit 37 minutes
• Specification Validation Internal experts and
  data external benchmarks
• Defect Wait time greater than 37 minutes
• Unit One patient visit with one defect
  opportunity each.
• Measurement System Patient survey, manual data
  collection, chart review, quality reports,
  registration and staffing reports
• Impact on Business
• Capacity opportunity
• Improved patient satisfaction
• Enhanced outcomes
• Improve staff satisfaction

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Example Emergency Room Wait Time

• What critical xs were tested as being root
  causes of the problem?

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Example Emergency Room Wait Time

• What critical xs were tested as being root
  causes of the problem?
• 23 variables were selected and analyzed
• Census related 10
• Staffing related 10
• Miscellaneous 3
• What root causes were confirmed and tested in the
  pilot?
• Patient flow
• Direct to bed flow and bedside registration
• Flow facilitator
• Streamlined order entry and results retrieval
  process

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Example Emergency Room Wait Time

• Pilot based upon critical xs
• For n 158
• Mean wait time 12.6 minutes
• Standard deviation 11.6
• Percent defect 22.8

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Example Emergency Room Wait Time

• What are the building blocks of control?
• Guidelines and assigned responsibility
• Data review, reporting and accountability
• Communication and recognition

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General Electric The Broader Context of Six
Sigma

• General Electric Major Initiatives
• Early 1980s
• 1 or 2, Fix, Sell or Close
• Downsized
• Lessened hierarchy and replaced strategic
  planning system with real time planning system
  (What are current market dynamics, competitors
  key recent activities, GE business response,
  greatest competitive threat over next three
  years, planned GE response.
• Modified budgeting system to focus on competitive
  criteria.

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General Electric The Broader Context of Six
Sigma

• General Electric Major Initiatives
• Late 1980s
• Workout
• Best Practices chose Ford, HP, Xerox, Toshiba
  best practices including developing more
  effective processes rather than focusing on
  individual activities, developing pipeline of new
  products, focus on customer satisfaction,
  considering suppliers as partners.
• Move to a global company
• Emphasis on leadership development.
• Modified budgeting system to focus on competitive
  criteria.

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General Electric The Broader Context of Six
Sigma

• General Electric Major Initiatives
• 1990s
• Boundaryless company
• Stretch Goals
• Increasing emphasis on services
• Six Sigma

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Capability Maturity Model

• How can a firm project the benefit of being
  assessed at a CMMI level or operating at a CMMI
  level?

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Process Areas
Level
Focus
Quality Productivity
Organizational Innovation and Deployment Causal
Analysis and Resolution
5 Optimizing
4 Quantitatively Managed
Organizational Process Performance Quantitative
Project Management
Quantitative Management
Requirements Development Technical
Solution Product Integration Verification Validati
on Organizational Process Focus Organizational
Process Definition Organizational Training
Integrated Project Management for IPPD Risk
Management Integrated Teaming Integrated Supplier
Management Decision Analysis and
Resolution Organizational Environment for
Integration
Process Standardization
3 Defined
Requirements Management Project Planning Project
Monitoring and Control Supplier Agreement
Management Measurement and Analysis Process and
Product Quality Assurance Configuration Management
Basic Project Management
Risk Rework
1 Initial
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CMMI Process Areas
CAR OID
Level 5
Optimizing
OPP QPM
Level 4
Quantitatively Managed
DAR IPM OPD OPF OT PI RD RKM TS VAL VER
Level 3
Organizationally Managed
PMC PP RM CM SAM MA PPQA
Level 2
Project Institutionalized
Generic Practices
Specific Goals
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