Informatics and Six Sigma
Driven by a need for better quality operations and patient safety, many healthcare organizations are using process improvement methodology to optimize their clinical and administrative processes. The methodology of PDSA (Plan, Do, Study, Act) is often the foundation for many hospitals' improvement efforts.
More recently, Lean Six Sigma has been introduced, after widespread use and success in business and industrial settings worldwide. Healthcare Informatics - the knowledge, skills and tools that facilitate the recording and communication of information - has a role to play in process improvement efforts.
Informatics professionals develop systems to improve the functioning and efficiency of all hospital processes. While healthcare organizations may not have an informatics department per se, many have IT/IM (Information Technology/Information Management) personnel who perform informatics tasks. These professionals create electronic systems to replace paper-based ones, allowing clinicians to spend more time treating patients. They improve the efficiency and effectiveness of vital services, such as lab test results, radiology and drug dispensing. They develop systems to cut wait times and ensure hospital beds are available when and where they are needed. And they work with researchers to plan and implement studies that expand medical knowledge.
Often informatics personnel help select software solutions that provide a base functionality, and then integrate them with existing information systems. They also find appropriate software solutions to replace a highly manual, paper-based system.
To determine the appropriate solution, informatics personnel must first understand the existing work processes in the area they wish to optimize or automate, such as scheduling or billing, computerized physician order entry or electronic patient records. In the past, some healthcare organizations simply threw technology at a problem without first understanding the underlying process, which only automated a bad process.
To get a thorough understanding of a work process, informatics personnel can map it out using process mapping tools found in the PDSA and Six Sigma Toolbox. Six Sigma also has a VSM (Value Stream Map) tool, a counterpart to process mapping.
These tools will identify staff roles and the flow of information or data, such as the flow of patient information between providers. Additionally, the tools can reveal wasteful rework loops, bottlenecks, constraints, over-processing and other areas of waste and inefficiency. It's important for informatics personnel to master these process mapping and VSM tools to be able to produce optimal technology solutions.
Process improvement methodologies such as PDSA and Six Sigma are heavily dependent on measurement data and analysis. Six Sigma projects use the DMAIC (Define-Measure-Analyze-Improve-Control) method.
Informatics plays a key role in supporting process improvement initiatives in two major ways: First, it can provide data to help measure the effectiveness and efficiency of the current state. (assuming that the data is accurate.) Second, in many cases, part of the process improvement requires an informatics or an IT solution. This makes the informatics group a key player on any process improvement team.
Healthcare informatics groups are often so busy delivering projects or providing support to clinical and administrative areas that they don't have time to consider how to optimize their own functions or delivery of services. Assuming a good project management methodology is in place, one can apply Lean Six Sigma to informatics or IT departments, as it's about eliminating waste and reducing variation.
Lean Six Sigma projects could encompass areas such as: network administration (especially around speed and reliability), software defect reduction (for departments that do coding or some development), support or help desk reliability, hardware and software testing, and training effectiveness.
Informatics plays a significant role in process improvement initiatives. Sometimes, it's a supporting role: providing critical process measurement data. Other times, it's a lead role: as part of a team that determines an informatics or technology solution required for a particular process problem. The more familiar informatics or IT professionals are with process improvement tools and methodologies, the better their technology solutions will be.