Six Sigma to reduce claims processing errors in a healthcare payer firm

Abstract

As a continuous improvement practice, Six Sigma has been accepted globally across the service industry. In the past decade, the application and success of Six Sigma in healthcare services has been remarkable. Despite the fact that several papers on Six Sigma have appeared in the erstwhile literature related to healthcare operations, there is a dearth of field studies highlighting the application of Six Sigma in healthcare outsourced firms, in specific to healthcare payers that engage in a non-clinical setup. The aim of this paper is to explore the role of Six Sigma within the healthcare payer outsourced firms, where error-free delivery becomes critical. The article contributes to the literature of Six Sigma in healthcare outsourcing highlighting how ‘Six Sigma as a methodology’ could help reduce claims adjudication errors in a healthcare payer firm. The Six Sigma DMAIC project case study presented as part of the paper delivered a saving of USD 0.53 million and is a classic example of how Six Sigma can bring bottom-line impact to healthcare outsourced organizations. Managerial implications and lessons learned are discussed alongside the concluding notes.     

Improving the efficiency of IT help-desk service by Six Sigma management methodology (DMAIC) – a case study of C company

Six Sigma concept depicts a ‘Triangle Relationship’ that integrates three attributes such as customer quality, science manners and team work. By employing this concept with the required survey and data collection to carry out the continuous improvement, a company can truly take advantage of the minimum set of operational variables and the lowest cost procedures, and hence, result in an increasing competitive value for/to the company. This research is conducted based on the Six Sigma methodology, DMAIC (definition, measurement, analysis, improvement and control) principle, and it deals with project-related issues to improve the efficiency of information technology (IT) help-desk service through an eHelp-desk system. It is the authors’ belief that the use of eHelp-desk system can help case company to improve its service quality and efficiency. In addition, managerial implications and research limitations are discussed at the end of this article.     

Six Sigma implementation: a qualitative case study using grounded theory

Many organisations have implemented Six Sigma, but successful Six Sigma implementation has not been fully investigated. The purpose of this study is to explore the process of implementing Six Sigma in a manufacturing plant using qualitative case study methodology. Data were collected through in-depth interviews and analysed using grounded theory to identify the main factors that emerged from the interview data and the relationships between them. Consistent with previous studies, the findings emphasise the role of executive commitment, Six Sigma Champions, and training in successful implementation of Six Sigma projects. Furthermore, the study underlines the role of effective project selection and the coexistence of other management initiatives (e.g. lean manufacturing and continuous improvement) on successful implementations of Six Sigma projects. Our findings also suggest that Six Sigma implementation leads to higher levels of customer focus. The study contributes to the existing body of knowledge in effective implementation of Six Sigma. The results include a coding paradigm for the implementation process and implications for managers and practitioners.     

Six-sigma for improving Top-Box Customer Satisfaction score for a banking call centre

Six Sigma process improvement methodology has been accepted globally across the service industry. In past one decade, the application and success of Six Sigma in Services is remarkable across Information Technology organisations, Hospitality firms, Government, Healthcare firms and Banking & Financial Sector. The aim of this paper is to explore the role of Six Sigma within call centres where the metric based environment complements the application of Six Sigma for process improvements. The article establishes the literature for the need for Six Sigma in call centre environment elaborating on customer facing metrics in addition to internal performance measures and highlighting the advantages of Six Sigma. A case study is presented in the second part of the article to study the DMAIC project management approach of Six Sigma for improving the Top Box Customer Satisfaction score of a Banking call centre. The literature identifies the possible opportunities for improving the performance of call centre metrics using Six Sigma. The project case study presented as part of the paper delivered a saving of USD 0.27 million to the bank, and is a classic example of how Six Sigma can bring bottom-line impact to an organisation. The article is limited to elaborate the advantages of Six Sigma in call centre environment, emphasising on its need and its compatibility to go along successfully with change acceleration and project management processes. Managerial implications and lessons learned are discussed alongside the concluding notes.     

Improving patients’ satisfaction in a mobile hospital using Lean Six Sigma – a design-thinking intervention

Abstract

Lean Six Sigma (LSS) that offers a unique integration of Lean and Six Sigma has been accepted globally across services sectors. Previous studies that examined the application of LSS in healthcare were steered in traditional hospital settings. Apparently, there are no studies that highlight the application of LSS in mobile hospitals, an emerging trend in the healthcare sector. The aim of this article is to explore the applicability of LSS in a mobile hospital. The authors present a case study of improving patients’ satisfaction in a mobile hospital, through reducing turnaround time. Design-thinking intervention to LSS helped resolve a real-time problem using Define-Measure-Analyze-Design-Verify roadmap. This article contributes to the ‘healthcare quality” body of knowledge and is novel as it is the first of its kind of LSS application in a mobile hospital underpinning Design thinking. This study is unique as it demonstrates academia–industry collaboration in solving an organizational problem.     

A Knowledge Framework Underlying Process Management*

Organizations are increasingly implementing process‐improvement techniques like Six Sigma, total quality management, lean, and business process re‐engineering to improve organizational performance. These techniques are part of a process management system that includes the organizational infrastructure to support the improvement techniques. The knowledge‐based view of a firm argues that organizational knowledge is the source of competitive advantage. To the extent that the process management system enables knowledge creation it should be a source of competitive advantage. This study investigates the underlying framework and factors of a process management system that lead to organizational knowledge creation. Prior studies have considered knowledge creation in process improvement, but none have considered the role of the process management system. Specifically, the study uses the case study method to investigate multiple levels (organization level and project level) of two firms using Six Sigma as their chosen process management system. Analysis of the cases reveals that the leadership creates a supportive infrastructure enabling process‐improvement techniques to effectively create organizational knowledge. Interestingly, focusing on decision‐making tools and methods may not be effective without developing a supportive infrastructure. The proposed framework provides a basis for organizational leaders to think about how to design and implement a process management system to better enable knowledge creation in organizations.     

Using Lean Six Sigma to improve mobile order fulfilment process in a telecom service sector

This study proposes and follows a specific and systematic framework for implementing Lean Six Sigma (LSS) methodology in a telecom company in order to improve customer satisfaction by minimizing the company’s response time to customer requirements. The goal of this study was achieved by utilizing several LSS tools under five phases of the DMAIC methodology. Unlike previous studies in the telecom sector that used only qualitative method, in this study, both qualitative and quantitative methods were utilized to draw meaningful conclusions. As a result of the implementation of the LSS methodology, the average order fulfilment lead time for sales orders (SO) and value-added service (VAS) orders was reduced from 10.3 to 5.9 days and from 1.5 to 0.5 days, respectively. The reduction in lead time resulted in an increase in the sigma level for SO and VAS orders from 0.44 to 1.26 and from 0.73 to 2.66, respectively. These improvements were expected to lead to a financial benefit in savings of over $600,000 per year in operational costs, enhancements to customer experience and an increase in revenue generating opportunities. Moreover, this article enriches the existing literature on the application of LSS concept in the service industry, and helps the company to speed up the response to customer requirements.     

Lean Six Sigma applied to process performance and improvement model for the development of electric scooter water-cooling green motor assembly

Abstract

In response to the environmental issues triggered by global warming, worldwide companies gradually put the factor of carbon emission into the process of product lifecycle, developing green technology or adopting cleaner production aimed at sustainable development. Lean Six Sigma has advantages of cutting waste and facilitating process improvements as well as system analysis, helping enterprises create the overall business benefits in the value chain. Used in the renewable energy industry, it can promote the triple bottom line (TBL), the performance of sustainable production for corporate profit, social responsibility and environmental responsibility. Therefore, this work took the process performance of the electric scooter water-cooling green motor manufactured in Taiwan with the world’s highest density of scooters as a case study. The developed performance evaluation and improvement model for manufacturing scheduling and process quality achieved the goal of economic benefits of enhancing process quality performance by shortening manufacturing scheduling and reducing process variations with Lean Six Sigma. Besides, they could respond to the policy of energy saving and carbon reduction – replacing the traditional scooters of high-carbon emissions with the electric scooters of low emissions. Furthermore, they could bring enterprises into harmony with economic benefits, ecological benefits and social benefits.     

Quality management and performance: a comparison between the UK and Turkey

Purpose: The aim of this article is to detail the correlation between quality management, specifically its tools and critical success factors, and performance in terms of primary operational and secondary organisational performances.

Design/methodology/approach: Survey data from the UK and Turkey were analysed using exploratory factor analyses, structural equation modelling and regression analysis.

Findings: The results show that quality management has a significant and positive impact on both primary and secondary performances; that Turkish and UK attitudes to quality management are similar; and that quality management is widely practised in manufacturing and service industries but has more statistical emphasis in the manufacturing sector. The main challenge for making quality management practice more effective lies in an appropriate balanced use of the different sorts of the tools and critical success factors.

Originality/value: This study takes a novel approach by: (i) exploring the relationship between primary operational and secondary organisational performances, (ii) using service and manufacturing data and (iii) making a cross-country comparison between the UK (a developed economy) and Turkey (a developing economy).

Limitations: Detailed contrast provided between only two countries.     

Defining Problems Fast and Slow: The U‐shaped Effect of Problem Definition Time on Project Duration

This study examines how time spent in problem definition affects problem solving in projects such as Six Sigma projects. Our hypotheses are tested using data collected from 1558 Six Sigma projects in a company. The results show evidence of a U‐shaped relationship between the amount of time spent in the Define phase and project duration. This finding suggests that spending too little time on problem definition potentially causes poor problem formulation, which leads to deficient problem solving and lengthens overall project time. On the other hand, too much time spent on problem definition can lead to unneeded delays in project completion due to diminishing returns on problem definition efforts. Furthermore, the optimal balance between spending too little and too much time depends on prior project experience and project complexity. Prior project experience reduced project completion time and weakened the U‐shaped effect. Conversely, complex projects took longer and appeared to show some evidence of a stronger U‐shaped effect; this suggests balancing the time spent in the Define phase was more challenging for complex projects. Our study also underscores the importance of managing project duration, as projects that were completed faster tended to be associated with higher project savings.     

Towards sustainability by aligning operational programmes and sustainable performance measures

Abstract

In the last decades, sustainable concerns have increasingly gained importance to organizational survival, and Lean/Six Sigma approaches are becoming more and more outstanding in order to improve sustainability performance. This article aims to evaluate the degree of importance of sustainable performance measures of Brazilian organizations and to propose guidelines to achieve sustainability by aligning these measures with operational improvement programmes. Multiple data collection methods were applied as theoretical literature review, questionnaire survey and semi-structured interviews with industry professionals and academic researchers. The findings show that it is the corporate responsibility to focus their efforts on both operational improvement programmes and sustainable initiatives in order to achieve better environmental protection, corporate reputation, quality management, cost performance and suppliers relations, as they are considered to be more important on organizational sustainability.     

A conceptual hybrid framework for industrial process improvement: integrating Taguchi methods,Shainin System and Six Sigma

Design of Experiments (DoE) has evolved as powerful industrial statistics tool for managing and improving processes in diverse industries. The three broad approaches of DoE in practice: classical or traditional methods, Taguchi methods and Shainin System (SS), have their merits and demerits for a extensive industrial experimentation. Nonetheless, the power of these DoE approach is not fully harnessed in established process improvement frameworks in industries. On the other side, Six Sigma DMAIC is a well-accepted methodology for improving process capability through focus on customer’s requirement (CTQ). The use of DoE in traditional DMAIC framework is limited to quantification of influence factors on CTQ. To offer a contribution to this paucity, this paper proposed a conceptual Six Sigma/DOE hybrid framework aiming to integrate SS, Taguchi methods and Six Sigma DMAIC for process improvement in complex industry environment. A case on improving DF generation process in shock absorber assembly was developed to validate the effectiveness of the framework for intricate problem-solving.     

Leadership and Six Sigma project success: the role of member cohesiveness and resource management

The primary purpose of this study was to determine whether the effect of leadership on Six Sigma project success (PS) may be mediated by member cohesiveness (MC). The second objective was to examine whether the impact of MC on PS was moderated by resource management. The effects of the project manager's leadership styles and MC on PS were also investigated in this research. To address the primary aims, a survey was used to measure the project manager's leadership styles, MC and the overall success of Six Sigma projects. The analyses suggest that MC may serve as a mediator between leadership and PS. The results also indicate that resource allocation has a moderating effect on the relationship between MC and PS.     

Implementation of Lean Six Sigma framework with environmental considerations in an Indian automotive component manufacturing firm: a case study

Lean Six Sigma is a systematic data driven methodology that integrates two powerful business improvement strategies Lean Manufacturing and Six Sigma with the goal of removing wastes and reducing process variation. Lean Six Sigma has a positive effect on environmental performance as defect reduction and reducing process variation leads to reduction in raw material consumption, energy consumption and reduced scrap which in turn reduces the overall environmental impacts. In this context, this study uses a Lean Six Sigma framework with environmental considerations to reduce overall defects and environmental impacts concurrently to improve the firm’s operational and environmental performance. The framework is based on Define Measure Analyze Improve Control methodology where traditional Lean Six Sigma and environmental impact assessment tools are integrated to systematically deploy LSS strategies with environmental considerations. The framework is validated with an industrial case study conducted in an Indian automotive component manufacturing organisation and the inferences are derived. On successful deployment of the framework, the internal defects was brought down to 6000 ppm from 16,000 ppm and environmental impacts was reduced to 33 Pt from 42 Pt. Deployment of the developed framework helped in improving the firm’s sigma level and also reduced the overall environmental impacts.     

A Lean Six Sigma framework for the reduction of ship loading commercial time in the iron ore pelletising industry

Evidence suggests that specifically designed frameworks to implement Lean Six Sigma (LSS) projects to tackle particular problems are more effective than ‘generic’ versions. This paper proposes an implementation framework to effectively deploy LSS to improve a key operation and performance indicator, i.e. ship loading commercial time, of one of the largest world producer of iron ore. This article therefore contributes with a refined framework to effectively implement LSS, and documents its successful application and effectiveness within the context of the case organisation. The LSS framework and project contributed in helping the studied organisation to improve both the capability of its ship loading process and commercial time by more than 30%, resulting in operational savings in the range of $300,000 USD per year. The systematic nature of the framework proposed also helped the organisation to establish a standardised routine to improve its operations. Managerial implications exposing the challenges faced during the implementation of LSS are also discussed to serve as lessons learnt to be considered in other LSS projects. Managers and engineers incharge of improving operations and processes can benefit from this paper as it can be used as a guide to direct the conduction of LSS projects and the empirical application of its principles and tools.     

Mathematical modelling to improve Rolled Throughput Yield in a supply chain

The outspread of supply chains competition entails inevitable application of quality improvement methods, such as Six Sigma. It is less than a decade that Six Sigma methodology has entered the supply chain scope; however, researches undertaken in this field have massively increased. Most of these research works have been done towards the application of the Six Sigma method for supply chain improvement, yet nothing has been done about suitable entity selection in supply chain for improvement. The purpose of this article is to propose a method for individual entity selection in the supply chain. Accordingly, a mixed integer non-linear programming model is presented that shows which supply chain entity should be selected, and how much to improve, in order to maximise financial benefit. This article also presents new comprehensive criteria based on the previous approach, which can measure the performance of the supply chain. Moreover, the ability of the proposed criteria is shown through a numerical example. Finally, the optimisation model was applied for selecting individual entity in tweedy supply chain in order to illustrate the capability of the model. In addition, sensitivity analysis is carried out on the parameters of the model.     

Case study in Six Sigma methodology: manufacturing quality improvement and guidance for managers

This article discusses the successful implementation of Six Sigma methodology in a high precision and critical process in the manufacture of automotive products. The Six Sigma define–measure–analyse–improve–control approach resulted in a reduction of tolerance-related problems and improved the first pass yield from 85% to 99.4%. Data were collected on all possible causes and regression analysis, hypothesis testing, Taguchi methods, classification and regression tree, etc. were used to analyse the data and draw conclusions. Implementation of Six Sigma methodology had a significant financial impact on the profitability of the company. An approximate saving of US$70,000 per annum was reported, which is in addition to the customer-facing benefits of improved quality on returns and sales. The project also had the benefit of allowing the company to learn useful messages that will guide future Six Sigma activities.     

Rejects reduction in a retail bank using Lean Six Sigma

Lean Six Sigma (LSS) is a majestic process improvement methodology that has been proved to be a powerful management strategy across services. The influential synergy of Six Sigma and Lean aims at improving the processes, focusing on both rapid and robust improvements, reducing waste and variation in the process. LSS generates successful results in key performance indicators (KPIs) based environments, where process data gets measured and leveraged for making essential management decisions. The aim of this paper is to highlight the importance of LSS in banking industry through a real-time process improvement study. The article establishes the literature for the need for LSS in banks detailing on customer facing metrics and process KPIs. An action-research study conducted in a retail bank is presented in LSS DMAIC methodology which reaped a benefit of INR 1.6 million and is a classic example of how LSS can bring bottom-line impact to an organisation, alongside contributing to the process improvement mind-set in employees.     

Using Shainin DOE for Six Sigma: an Indian case study

Shainin design of experiments (DOE) offers a powerful and effective experimental design approach for solving the chronic quality problems that plague manufacturers worldwide. However, the academic literature still contains a few empirical studies on the use of non-statistical Shainin DOE tools to simplify the quality improvement initiatives. In order to overcome this deficiency, this case describes framework for incorporating Shainin experimental design within Six Sigma define–measure–analyse–improve–control and tests its effectiveness in an Indian automotive gear manufacturing unit. Shainin tools such as Paired Comparison, Product/Process search, Concentration chart, B vs. C analysis, Pre-control chart were employed to analyse, improve and control the gear manufacturing process. The study provides stimulus for the wider application of Shainin experimental design approach for industrial experimentation.