NHS Staffing Improved

A Case Study of a Lean Six Sigma Implementation in the NHS

Define
This case study concerns a National Health Service operation that has responsibility for arranging for nurses to be allocated to vacant shifts on London hospital wards using NHS and contract staff. Key metrics for the operation are

Fill rate i.e. percentage of shifts requested and fulfilled
Percentage of agency nurses used
Measure

The process for taking requests through the call centre, determining nurses’ availability and arranging for nurses to be allocated to vacant shifts was mapped and baseline performance measured.

Analyse
Wards that had lowest fill rates were identified and the causes of low fill rates were determined. Failure modes of the call centre fulfilment process were identified. This included the fact that call centre operators would have no criteria to select nurses to contact other than their qualifications to work on a particular ward.

Improve
Nurses’ monthly shift allocation and uptake were made available to call centre operators so that they could identify nurses that were most probable to fill a vacant shift instead of selecting nurses to contact based on no criteria.

Control
Call centre operators provided with training in use of data concerning nurses’ shift uptake. Control chart of numbers of nurses per vacancy called is used to ensure process remains under control.

Benefits
Fill rate was increased and therefore fewer wards were understaffed leading to greater patient care. Percentage of agency nurses was reduced saving costs.

You provided valuable mentorship for two Black Belt projects that I completed successfully with impressive results within the National Health Service. Your knowledge and expertise was exceptional being able to apply the methodology to a services environment. – Darren Perera (EMEA Director of Client Services and Global Head of Operations, Dealogic)