1. Group 4: Project Agenda Overview of Business Process Redesign models used in healthcare. Applicability of principles of Business Process redesign related to overall Project Management methodologies. Effectiveness of such models as part of a Healthcare IT initiative. Examples where organizations have used such a model as part of a Healthcare IT initiative. Class exercise and questions.

2. Health Care Challenges that encourage use of BPR: Medical errors and high costs of healthcare Underinsured or uninsured population Increasing number of heterogeneous and older population, Globalization/ medical outsourcing, Maintaining quality for given cost and cost minimization for given quality Shortage of clinical and nursing staff

3. Expectations from BPR models: Increase in efficiency Reduce medical and medication errors Health care cost reduction Better access and quality in healthcare Procedure optimization Time effectiveness Customer and health care provider satisfaction

4. Highlighted solutions: Automating and monitoring processes in healthcare Redesigning or improving clinical processes where necessary and possible Identifying patient expectations and improving patient care processes for better customer services. BPR models: The business process redesign (BPR) models are the processes that target improvisation and optimization of process outputs while maintaining quality.

5. Six Sigma: (Six sigma was invented by Motorola in the 1980s) Analytical approach to indentify the inefficiencies and inadequacies in the process and provide a step by step solution based on analysis of real time data. Process must have < 3.4 defects per million occurrences (Carrigan, 2006) Statistical calculation that suggests customer needs /satisfaction to meet 99.99997% or 6-Sigma level. (Caldwell 2006) Focuses on customer satisfaction, process improvement and cost reduction. (Breyfogle, 2003) Uses structured methodology and powerful statistical tools that provide a scientific approach to process improvement and patient safety. (http://www.medscape.com)http://www.medscape.com)

6. Six Sigma Sub methodologies DMAIC: Define, Measure, Analyze, Improve, and Control; (improve existing processes ) DMADV: Define, Measure, Analyze, Design, Verify; (develop new processes or products at Six Sigma quality levels) (http://www.isixsigma.com/sixsigma/six_sigma.a sp)http://www.isixsigma.com/sixsigma/six_sigma.a sp Implementing 6sigma: “Black Belt” = organize of Six Sigma project “Green belt” = implement and monitor the project.

7. Applications of BPR models: Scheduling appointments Emergency room allotment Diagnostic imaging Patient follow up appointments Cancer screenings Bed allotment systems Minimizing duplication of records, bills, scheduling of follow ups and refills Reduce “off time” of the systems to improve accessibility and promptness Reducing wait times at Dr.’s office and many more.

8. BPR Obstacles: Internal and external challenges such as resistance to change, financial challenges, hierarchical tensions, changing workforce, lack of commitment, lack of implementation Six Sigma requires a clear goal setting, ample training of employees and commitment to implement the projects thoroughly. success is not guaranteed (Corn 2009)

9. Bibliography: Corn, J.B., Six Sigma in Health Care, Radiologic Technology. September/October 2009; 81(1): 92-95 Breyfogle, F.W., Implementing Six Sigma: Smarter Solutions Using Statistical Methods, 2nd ed. 2003, Wiley, New York, NY. http://www.isixsigma.com/sixsigma/six_sigma.asp) http://www.isixsigma.com/sixsigma/six_sigma.asp http://www.medscape.com/viewarticle/449692_6) http://www.medscape.com/viewarticle/449692_6 Carrigan MD, Kujawa D. Six Sigma in health care management and strategy. Health Care Management. 2006;25(2):133-141 Caldwell, C., Lean-Six Sigma tools for rapid cycle cost reduction, Healthcaare Financial Management. Oct 2006, 60 (10) Schweikhart SA, Dembe AE. J Investig Med. 2009 Sep 2 http://www.pqa.net/ProdServices/sixsigma/sixsigma.html