SVHC Uses Six Sigma to Improve Performance

Six Sigma is a business strategy focused on improving quality of services by driving out waste (defined as defects, unnecessary costs, and inefficient use of time) contained in our work processes.

“Sigma” is a statistical measure that shows how well a produce or process is performing. Higher sigma values indicate better performance.

Six Sigma Reduces Errors

Six Sigma at SVHC has allowed us to redirect time, energy, and resources toward activities that bring real value to patients and staff, improve the quality of care and reduce costs.

Here are some recent improvement projects and results.

Project: Improving Care at End of Life
The problem? Patients don’t always receive care in the most clinically appropriate, cost-effective, and desirable setting at end of life. In surveys, the majority of Americans say they would prefer to die at home. This Sigma team works with patients, families, and providers to make timely hospice care referrals. As a result of the team, 18 percent more people near the end of life have benefited from services provided by VNA & Hospice of SVHC.

Project: Observation Status
The volume of patients admitted under observation status at Southwestern Vermont Medical Center had climbed to an average of 128 per month. Many of these patients were incorrectly assigned observation status when they should have been inpatients, while others stayed in the hospital longer than the 24- or 48-hour guideline from Medicare. Fixing the process so that more patients were correctly assigned resulted in a $761,000 increase in revenue.

Project: Pressure Ulcer Management
At Centers for Living & Rehabilitation, pressure ulcer rates were above national and state quality benchmarks. Pressure ulcers cause considerable harm to patients and residents. They hinder recovery and cause pain and serious infections. This Six Sigma team made many improvements, including replacing mattresses at CLR and SVMC. The new mattresses are designed to prevent pressure ulcers. They also put in place best practices to prevent and treat the wounds. The result: a 50 percent reduction in the percentage of post-hospital care patients with pressure ulcers.

Project: Visiting Nursing Association Productivity
At VNA & Hospice, the average number of adult home nursing visits was above national benchmarks and above the agency’s budget. One problem the team identified was that it took staff up to 3 times longer than best practice standards to complete their paperwork. A solution the team put in place was putting everyone on higher speed Internet connections to use when sending information about the patient visits they made each day. The result was a reduction to several seconds of the time it took to transfer patient information. Using the old method, it took from 15 to 60 minutes.