Cardiac catheterization labs are one of the most significant capital investments for hospitals. However, in recent years, due to various changes in health care with regard to changes in Medicare reimbursement, it has become increasingly difficult for hospitals to maximize their cardiac cath lab’s potential economic return. In order to tackle the patient flow quandaries of delayed start times, physician unavailability, improper staffing, and excessive non-productive time in the cardiac catheterization lab, the implementation of the use of a combined Six Sigma and Lean System quality improvement methodology is suggested. Six Sigma’s focus on customers (in this case, patients) and quality improvement will be beneficial in identifying areas of concern and will provide a structure for the identification of and changes to poor patient flow in a cardiac catheterization lab. The call center on the other hand is an important operational center for management of an organization which calls for increased efficiency. The most important process in the call center, which needs most improvement, is an agent handling inbound or outbound call. Six-sigma methodologies can produce major breakthroughs in call handling providing improved results for employees, customers, and shareholders.
The five step DMAIC project for both cases:
Define. Defining the issues and their importance is not difficult. Since starting the first case of the day plays such an important role in the flow for the rest of the day, a quality and process improvement plan must address this issue. Cases need to begin on time to maximize unit staff, physician resources, and area hours of operation. Patients expect their procedures to begin at the scheduled time. Thus, first case start time is clearly a quality initiative. Hence, a charter was established by the senior leadership and a goal of 80 percent on-time starts was established.
-While competitors were growing their levels of satisfaction with support customers by growing businesses through reducing support costs per call, the call center in the case was experiencing an increase in support costs. The customer satisfaction level was also average or below average. This situation could drive the call center out of business unless the management took decision to come back on track.
Measurement. The measurement phase of DMAIC should consist of various collections of data pertaining to the beginning of the first cardiac catheterization procedure of the day. Through brainstorming, contributors to late start were identified. Some of these factors were Patients arriving on time, registration, transportation, timeliness of patient preparation, and completion of assessments by cardiologist, anesthesiologist, etc. Data was collected to identify factors having most significant impact on delay of first case.
-Measures of customer satisfaction were identified-follow-up surveys, in-call escalations, etc. all of which lead to the same conclusion that the agent controlled audio files improve customer satisfaction. For improving customer satisfaction, measures such as wait time, transfers, service time, support time, days to close, etc. were identified as most important measures to improve call center productivity.
Analyze. The analyze phase is the time to determine where the delays are originating. Through regression analysis it was figured out that the time within which the cardiologist completed his assessment was the key driver in deciding whether the first case would be started on time.
-In the call center setting, the information which is conveyed to clients is important for improving the overall efficiency of the call center.
Improve. The fourth phase of the DMAIC project is the improve phase. Improvements in the cardiologist assessment were analyzed. As a part of developing revised process, the team also completed a new process map which had target of in what time each process has to be completed.
-The call center team looked for sentences, phrases, and words that could be eliminated while still clearly communicating the message. Reduction in the word count led to overall improvement in the call center operation.
Control. The last phase of the DMAIC project is the control phase. This phase was tasked with examining whether changes made were sustainable as well as outlined procedure for monitoring the critical factors which had impact on the start time.
-The final outcome of the call center was evaluated after all waste eliminating techniques were adopted and control measures were finalized to make sure that the efficiency was maintained in the operations.
By comparing the two cases, we can make out that six-sigma was successfully utilized by both hospital and call center in improving efficiency of their respective systems. The main difference between both case studies is that call centers need to build a standardized process the agents would follow and which allows for process improvement. In hospitals, the process needs to be revised according to the existing situation and the need of the process. In call center, employees need to be motivated as happier and motivated employees would be able to deliver a vastly improved customer experience and the management would be able to implement productivity improvements and cost reductions for shareholders.
Reference Page:
Wrobel Sylvia, Milliar Margaret, O’Brien Bernadette, Weissman Marie (2010),” Reducing Delays in the Cardiac Cath Lab with Six Sigma: An iSixSigma Case Study”, Retrieved August 27, 2013 http://www.isixsigma.com/new-to-six-sigma/dmaic/reducing-delays-cardiac-cath-lab-six-sigma/

Williams, Tim (2010),” Salvaging a Call Center’s Big Software Investment”, Retrieved August 27, 2013 http://www.isixsigma.com/new-to-six-sigma/dmaic/salvaging-call-center-software-investment/