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Six Sigma, a management tool which has made significant impact in private sector companies worldwide such as Hewlett-Packard, General Electric, Motorola and 3M, is now being applied in the Singapore Public Sector. The use of Six Sigma by public sector organisations has started to offer significant improvements in service quality and reductions in cost.

2 Six Sigma is a highly disciplined approach that helps an organisation focus on the critical processes that need improvement. Together with the rigorous analysis of facts and statistics brings about breakthrough process improvements to the organisation.

3 In January 2002, seven public sector organisations, viz. Subordinate Courts, Alexandra Hospital, Urban Redevelopment Authority, Insolvency & Public Trustee's Office, Board of Commissioners of Currency, Defence Science Technology Agency and Ministry of Defence, participated in a pilot programme to apply Six Sigma in their organisations.

4 A number of these organisations have already achieved significant service improvements. Alexandra Hospital's Specialist Outpatient Clinic measures the time taken to turn-around patients. It targets to complete the entire process from seeing the specialist to having the medication dispensed within 60 minutes. After Six Sigma was used to streamline work processes, a 20 % improvement has been recorded. Alexandra Hospital is working to improve this further.

5 Staff at Alexandra Hospital also used the process mapping concept in Six Sigma to scenario map a patient's entry and exit from the hospital system, and ensure that they "wow!" patients at every point of contact. For example, a "break fast corner" has been installed in the hospital. Here, patients, starving after pre-blood-test fasts, can help themselves to snacks. "Cupboards of delight" have been installed in wards containing items like toiletries, instant noodles, snacks and even back-scratchers for patients' use. Six Sigma process mapping helps Alexandra Hospital to pay attention to these details, and to minimise the unpleasantness of a hospital visit. For example, when a patient comes in during late night admission and is hungry; the staff would offer him a cup of steaming hot noodles from the delight cupboard to relieve him of the hunger pang.

6 Alexandra Hospital staff are constantly developing ways to improve services for patients and to WOW! them. All these are displayed in a room called the Idea Lab where staff can visit for inspiration to come up with more creative ideas that will ultimately benefit our patients. More details of Alexandra Hospital's experience with Six Sigma can be found at Annex A.

7 Another pilot agency, Urban Redevelopment Authority, achieved a reduction of processing time for development applications submitted through URA's Electronic Development Application (EDA) system from 28 to 21 days. URA has used Six Sigma statistical analysis to better understand the processes involved in approving these applications, identify the major delays and problems, and then concentrate on solving them. The contact details of officers from Alexandra Hospital and Urban Redevelopment Authority are at Annex B.

8 Building on these initial successes, more public sector agencies will be adopting Six Sigma. The Managing for Excellence Office of the Ministry of Finance will be holding a forum on Organisational Excellence, with a special focus on Six Sigma at the Institute of Public Administration and Management Auditorium on Thursday, 29 August 2002 at 9.00am. The pilot agencies' will share their success stories with other public officers. The top management of public agencies, viz. Permanent Secretaries and CEOs of statutory boards, will also be at the forum. Head, Civil Service, will be giving a keynote address focusing on Six Sigma and why the public sector is embarking on it.

Annex A

SIX SIGMA IN ALEXANDRA HOSPITAL

At Alexandra Hospital, we are deeply committed to provide quality healthcare for all our patients. This is why we embarked on the Six Sigma journey in March 2001 with one mission in mind. That is: "To provide patient-centred quality healthcare, that is accessible and seamless, comprehensive, appropriate and cost-effective".

2 The Six Sigma methodology is aimed at improving key processes in terms of improving efficiency, reducing defects and cost and enhancing patients' satisfaction. Alexandra Hospital has formed project teams to look into the various areas that require systems improvement. One of these projects is about reducing the Patient Turnaround Time at the hospital's Specialist Outpatient Clinic (SOC).

Six Sigma at the Specialist Outpatient Clinic

3 The Six-Sigma project of the Specialist Outpatient Clinic was in response to the problem of long turnaround time for patients at the clinic. Patients, who come to the clinic for medical follow-up with their specialists, expect to spend less than one hour at the clinic but this expectation is often not met. Therefore, the hospital's management decided that the old workflow and process need to be re-looked and streamlined, so that the patient turnaround time can be improved.

4 Following the streamlining of the SOC process, an increasing percentage of our patient's experience a shorter turnaround time based on the high performance standard set by the hospital's management (to enter and leave the clinic within 60 minutes). By continuously using the DMAIC methodologies of Six Sigma, work processes in the SOC were streamlined, and made more efficient. With improved staff morale, patients also experienced a higher level of service quality. The process capability of the SOC is monitored closely using the data collected on a monthly basis. The SOC will be working closely with clinicians to try to improve the turnaround time further so as to bring about more customers' satisfaction.

WOW initiatives

5 Following the six-sigma project implementations, the staff at AH realise the value of the process mapping that is integral in all six sigma processes. They adopted the process mapping concept to scenario map patient entry and exit from the hospital system and ensure that they "wow!" patients at every point of contact. For example, a "break fast corner" has been installed in the hospital. Here, patients, starving after pre-blood-test fasts, can help themselves to snacks. "Cupboards of delight" have been installed in wards containing items like toiletries, instant noodles, snacks and even back-scratchers for patients' use. They have paid attention to details so as to make hospital visit as less traumatic as possible.A case in point is when patient came in during late night admission and was hungry; the staff would offer the patient a cup of steaming hot noodles from the delight cupboard to relieve him of the hunger pang!

6 Our hospital staff are constantly developi

MINISTRY OF FINANCE