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SIX SIGMA QUALITY – BUILT ON A SNOWSTORM By Jerry Rhoads, Founder, All-American Care Nursing homes struggle to convince the public that they really do care. My memory of the biggest challenge in my business life was the realization that in a troubled 207 bed skilled nursing facility that I took over, I had 175 patients that did not want to be there, 175 staff members that didn’t want to work there, and 175 families who did not want to visit there. My approach for the first six months was to try every day to turn those negative attitudes into positive action. It took a snow storm that closed us down for three days with only one half of the staff to realize that we could do a better job with staff. During that time, by focusing on each patient’s list of problems, then matching the list with the appropriate response, positive results began to happen! After the snowstorm, we did not return to the previous approach to patient care. We eliminated departments and continued with the teams that formed during that three day challenge. We had implemented Deming Principles and Six Sigma processes without even knowing it! Six Sigma methodology requires a focus on deductive processes versus reaction to problems. As a result of implementing Six Sigma, problematic programmatic approaches converted despair to hope and reactionary management with waste and mistakes into Quality Controls and Quality of Life. By mapping out how we would restore the patients’ functioning, we eliminated wasteful business practices, measuring progress against the patients’ goals for their recovery, rehabilitation, restoration and reintegration back into a community life style. Almost immediately, the staff turnover diminished, staff showed up for work on schedule and patients started to get better. With better functioning patients, along with more discharges to home, the families began to show up and get involved in the process. We had provided hope of a better way for the patients and their families. Their faith was no longer shattered by the reality of a l ong term care facility. So, my personal experience converts to what is now termed Six Sigma. Focusing on results reduces waste and results in a staff that is:
During this conversion to redefine the service model for a nursing home, improved staff morale served as a means to an end - improved quality and reduced waste - and transformed the air of despair to laissez-faire. In this context, laissez-faire refers to the concept of a free enterprise system and the doctrine of caveat emptor or “let the buyer beware.” Staff attitudes were transformed from uncaring to caring, the staff was made accountable for the patient's welfare, and families' awareness of the process increased. In a business sense, this means higher quality of care at a lower cost, resulting in more beneficial outcomes for both staff and patients. The increase in discharges attracted more referrals as word spread that patients really did return home. More families were assured their loved ones would be the center of staff’s attention. The staff, in turn, thrived on getting patients better. Even patients who could only make small advances or tiny gains were a motivational factor in the lives of the staff. We were making a difference in our patients’ lives! Only then did 195 patients want to be there knowing they had a chance to get better; only then did 175 staff (we increased census and better utilized existing staff) want to show up for work so they could get the personal high of helping another human being get better; only then did the 195 families want to actively participate in the restorative process; and, only then did the culture of our facility become Six Sigma with zero defects, with efficiency and cost effectiveness. In summary, out of the “snow storm epiphany” came the All-American Care mission of promoting wellness and preserving health. Not only can we restore people’s health - we can restore their hope and pride. When you can do that, anything is possible. Sincerely, |
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