Objective

In this article, I will show how improvement and its approach can be made simple and effective. However, this does not mean that we should not use the proven methods and principles of Six Sigma, Lean, Model for Improvement, and others. We must be adaptable. At the same time, I will also show how improvement can lead to cheaper, faster, and better processes and products.

Back to the Year 2000

I stepped into my new job as a Financial Process Engineer from a Product Engineer in manufacturing. I shared with the interviewer I do not know debit and credit. But I can re-engineer the processes in the Financial Shared Services Centre (FSSC) to make them more efficient and effective. My worst fear happened when I made a manual journal entry to debit revenue. This article will tell you why I made this error.

To set up an in-house finance team to do support accounting, I must learn from our vendor how it is done. There was this reconciliation process where they will open a PDF report generated by a system, search for a value inside, copy it, and paste it into a MS Excel file. They will do this every day for every business unit in every country. The objective is to look for differences in the values to zero them in the general ledger. This is not an efficient process. They had four headcounts to do this activity and other tasks.

What were my thoughts? If the system can generate a PDF report, then the data must be in the database. Hence, I can automate this activity with a MS Excel Macro using MS Query and an ODBC driver to connect to the database, extract the values, and paste them into the MS Excel file. After doing so, and with other improvements made, we employed two instead of four headcounts to run the same operations. As you can see, the simple approach to improvement has made the process cheaper and faster.

Fast Forward to the Year 2017

This time, I was in a public hospital as a Quality Improvement Specialist. The long waiting time is always the bugbear of every patient, caregiver, and visitor. This annoyance is even more intense in the emergency department.

My manager assigned me and others to collaborate with the doctors and nurses there to reduce the consultation waiting time. The team suggested the usual approach of problem definition, root cause analysis, and solutions brainstorming as detailed in the methods and principles of Six Sigma, Lean, and Model for Improvement.

I shared with the team that we need a simpler approach. Little did I know that I have unconsciously used the Mental Model (simplified explanation of how something works) of supply and demand to solve this problem. If more patients come into the system than doctors can discharge them out of the system per unit time, the cumulative backlog will increase over the unit time, and so will the waiting time. Hence, I engineered the “cumulative backlog” feature (machine learning) to let the Head of Department know the critical hour to get more doctors into the system. Following that, I asked the question, “If the doctors are not seeing patients, what are they doing?” This led to data being collected on their activities. Opportunities were found to reduce their time not seeing patients.

At the end of the project, the waiting time was reduced by 28 minutes for a period of one year. Additionally, the sick leave rate of the doctors was also reduced significantly in the same period. All of these were achieved with the same patient load and doctor headcount. Once again, you can see that the simple approach to improvement has made the service (product) better for the patients. In fact, with fewer sick leave taken by the doctors, the business cost was also reduced, making the process cheaper.

With the above, connect with me to share your thoughts. I am always eager to learn from them.