Published: 03/06/2004, Volume II4, No. 5908 Page 31
A year ago, I was trained in the Six Sigma improvement methodology at Motorola Corporate University in the US. Six Sigma is a rigorous, statistically based approach which is becoming the predominant improvement strategy in organisations worldwide. It aims to create 'defect-free' products and services.
I returned from the training determined to apply the tools to my own internal work processes, but urgent tasks always seemed to take precedence over important tasks. I had a constant backlog of work.
The Six Sigma project was my first attempt to apply a comprehensive change methodology to my work systems. The administrative team that I work with became the project team.We looked at core processes such as initial response and follow-up to e-mail requests, appointment scheduling and use of my time. Internal analysis demonstrated that, despite the best efforts of the team, my work systems were unreliable and out of control.We aimed to reduce the time lag for initial e-mail response and to ensure follow-up to every single request. A further goal was to provide speedy access to my diary for everyone who needed to see or speak to me.
Early on, we conducted 20 interviews with stakeholders of my work processes - from the Modernisation Agency, the NHS and the international improvement community. Finding out what really matters to my 'customers' gave me an insight into priorities.Our team used a number of techniques to analyse our performance against customer requirements.We used process mapping, demand and capacity analysis, cause and effect analysis and other tools.
I learnt that I had similar problems to many of the trusts taking part in the Modernisation Agency's Improvement Partnership for Hospitals programme. I used to think I was swamped with work, and demand far outweighed my capacity to respond. As a result of the Six Sigma project, I understood that my fundamental problem was one of a mismatch between variations in demand and capacity. It was within my power to improve the situation enormously by changing the patterns of my own capacity and that of my team to meet the predicable patterns of demand.
Changes were made to the whole team's processes to smooth the flow of work.
Roles and responsibilities changed, operational definitions were clarified.My time-scheduling system was transformed from multiple queues of work to a single one. The amount of variation and the mean e-mail response time has halved. The capability of the system in meeting the target response time, as defined by our customers, has increased from 54 per cent to 84 per cent.
The project has also reinforced the importance of analysis and reflection before making changes.We need to understand the root causes of problems and which changes will make the most impact.
'Modernisers' like me should be prepared to apply improvement methodology as rigorously to ourselves as we do to the NHS.We should aspire to be the change that we want the NHS teams to adopt.
Helen Bevan is director of knowledge and innovation, Modernisation Agency.