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The Institute for Business and Industrial Statistics of the University of Amsterdam is better known as IBIS UvA and celebrates its twentieth anniversary this May. Founder Ronald Does is still in charge of this institute for research and advice based on the Lean Six Sigma approach to quality improvement and quality management.

Ronald Does

Lean Six Sigma is a combination of the Japanese lean methodology, originally developed for industrial processes and aimed at the prevention of waste, and the Six Sigma approach that originated in the United States, focussing on cost reduction and high volumes. Since 1991, Does is also professor of industrial statistics at the University of Amsterdam. His department has recently been renamed Operations Management and added to the Amsterdam Business School as an independent section. 

Since 2000 IBIS UvA supported many service provider customers such as banks, insurance companies and government agencies. More recently there is a growing number of hospitals amongst the clientele. Does: "The manufacturing industry has always been a frontrunner in the field of quality management and improvement. Only since the millennium have other industries been forced to pay more attention to quality and costs. With Lean Six Sigma we can find solutions to solve chronic problems. Our strength as a consultant is that we are an educational institution that teaches employees of the client’s organization to solve problems themselves. As an academic institution, we develop methodology and we model the variation margins in order to achieve predictable and therefore manageable processes." 

"Let's take healthcare as an example: it’s a shame that so often you make an appointment at a clinic in the hospital and then you have to wait. We are very capable of helping hospitals reduce those waiting times. In this case the variation is the time between the appointment and the time that people are actually seen by their physician. We also register how, when a specialist holds clinic hours, his or her other work is organised. And sometimes patients do not show up. How do you deal with that? We put all the variables of the process in a model, which makes it very easy to expose the consequences of certain actions. Lean focuses on the bottleneck in the process, which is often the medical specialist. How can you ensure that the specialist functions optimally? At the very least test results need to be available before the consultation starts and during consultation hours, other doctors should cover emergencies." 

"In this case the statistics are in the comparison of waiting times of numerous specialists based on variance analysis. There is always a best practice, a specialist who doesn’t make patients wait. What is the difference in their practice? The statistics are gathered by our client’s employees. In healthcare, we often work with team leaders. It’s hard work to solve a problem without knowing the solution so medical specialists are seldom available due to their busy schedules. But a good thing about our approach is that we can calculate the impact of solving the problem before we start a project. This immediately justifies the costs of the employees involved." 

"With IBIS UvA we want to raise the quality of processes to a higher level. In healthcare this often involves improving patient pathways. We did a lot of projects dealing with reducing the average hospitalisation time. If this can be reduced by half, twice as many patients can be admitted. And if there aren’t enough patients, the amount of beds can be reduced. In addition to medical and technical progress the length of hospitalisation can also be decreased by comparing surgical techniques and materials. Transparent patches contributed greatly to better wound treatment and control. Previously the patch needed to be removed for check-ups, which often caused new bleeding and extra hospitalisation. It is funny to see that it takes a while before every specialist starts using these transparent patches. But those who don’t at some point attract attention because the stay of their patients doesn’t decrease.” 

"We have completed about six hundred projects in healthcare and therefore we now can identify standard patterns. Those six hundred projects can be reduced to nine generic types. For new projects in healthcare we just have to identify with which generic type we are dealing and then we know exactly what to measure. That's what you may expect from us as an academic institution: that we reflect upon what we are doing and that we contribute to the further development of the field. This is process optimisation in its purest form, applied to healthcare."