Lean Six Sigma Final
Interval scheduling systems schedule multiple patients at the same time to ensure staff are not idle if one or more patients are late or do not show up for their appointment. True False
False
The dependent variable (DV) is the variable expected to predict or cause a change in another variable. True False
False
The goal of the Measure stage is to collect data on customer expectations and system performance. True False
False
The null hypothesis (H0) states the identified cause is related to the desired outcome. True False
False
Validity addresses the question of whether data collected at different times or in different groups will yield the same results i.e., reproducibility. True False
False
When collecting voice of the customer data, Likert data yields superior information than open-ended questions. True False
False
Improvement projects should be selected based on a multitude of factors including frequency of the event and impact on customers, employees, and/or the organization. True False
True
Process capability assesses whether a production system meets customer expectations or technical standards. True False
True
Product process flow maps are used to document total time in a production process and identify time spent in value-adding activities, waiting, and transport. True False
True
Regression reports whether an independent variable is statistically significant in explaining changes in a dependent variable and the amount of change that can be expected by increases or decreases in the independent variable. True False
True
The purpose of the stakeholder management plan is to establish how different stakeholders will be managed based on their importance to the project and whether they are supportive, indifferent, or opposed to the project. True False
True
When benchmarking an improvement team should strive to compare their organization to similar organizations based on total patients served, ownership, and other factors. True False
True
When operating at six sigma the number of defects per million opportunities (DPMO) is -232.6 -3.4 -66,807 -6,210
3.4
On a scatter diagram when the Y variable increases when the X variable decreases the relationship is -A positive or direct relationship -A negative or inverse relationship -A nonlinear relationship -No relationship
A negative or inverse relationship
On a scatter diagram when the Y variable decreases when the X variable decreases the relationship is -A nonlinear relationship -A positive or direct relationship -No relationship -A negative or inverse relationship
A positive or direct relationship
A Kaizen event is -An organization philosophy focusing on continuous improvement -An approach to inventory management -A targeted project focusing on improving the performance of a process -Discrete, independent, and opportunistic problem solving
A targeted project focusing on improving the performance of a process
Performance dashboards include information on -Safety and quality measures -Timeliness -Cost and/or input utilization -All the above
All of above
Which of the following is the goal of Lean 6 sigma? -All of the Above -Reducing waste -Increasing employee satisfaction -Increasing customer satisfaction -Adding value to goods and services produced
All of the Above
Value stream mapping is aimed at determining if -Current steps add or reduce value -Support functions improve the performance of care givers -Additional steps are required -Current steps can be performed more effectively or efficiently -All of the above
All of the above
Value stream mapping is used to -Document the steps in a production process -Surface differences in how team members believe a process operates -All of the above -Identify differences between documented procedures and how work is performed
All of the above
The role of Measure in the DMAIC process is to -Identify methods to enhance performance and outcomes -Identify the causes of lower-than-expected performance -Assess how systems are working -Identify a problem or opportunity to improve -Ensure performance gains are maintained
Assess how systems are working
Process capability -Assesses the timeliness of the production process -Assesses the cost of output -Assesses whether a system's outputs are stable or predictable -Assesses whether a system's outputs meet customer expectations or technical standards
Assesses whether a system's outputs meet customer expectations or technical standards
Flow is noted as in the reading as: -Minimizes defects -Builds continuous movement processes and reduces wasted motion, interruptions, and delays -Produces products when demanded by customers -Is every action taken to design, produce, and deliver a product
Builds continuous movement processes and reduces wasted motion, interruptions, and delays
Pull systems where production does not begin until a customer order is received reduces all of the following wastes except -Defects -Overproduction -Excess inventories -Idleness
Defects
Critical success factors such as critical to satisfaction are identified at what stage of the DMAIC process? -Control -Analyze -Improve -Measure -Define
Define
Set-in-place/Set-in-order in 5S is designed to -Ensure all workers use the same procedures -Ensure a clean work area -Simplify the work area and reduce clutter -Define locations for tools and supplies
Define locations for tools and supplies
The goal of establishing performance targets is to -Evaluate the performance of the improvement team -Ensure the improvement project generates higher benefits than its cost -Establish future work standards -Determine when a project should be considered complete
Determine when a project should be considered complete
A t-test -Determines if there is a difference between the means of two or more groups, a categorical variable -Estimates the relationship between two categorical variables -Estimates the relationship between a dependent continuous variable and one or more continuous or categorical independent variables -Determines if there is a difference between the means of two groups, a categorical variable
Determines if there is a difference between the means of two groups, a categorical variable
Which of the following is not a typical means employed to improve performance and outcomes? -Elevate leadership -Purchase better supplies and equipment -Change methods and processes -Discipline employees for avoidable errors -Retrain employees
Discipline employees for avoidable errors
Run charts are used to -Display the change in a variable over time -Highlight major issues by visual comparison of the frequency of issues -Display the distribution of variables that are measured on continuous scale -Collect data
Display the change in a variable over time
The goal of the Measure stage is to -Identify an improvement opportunity, define the parameters of improvement project, and assemble the resources to complete the project. -Develop a plan to improve performance. -Document customer requirements and system performance -Identify the causes of gaps between customer requirements and system performance.
Document customer requirements and system performance
Value stream mapping is -Builds continuous movement processes and reduces wasted motion, interruptions, and delays -Documents every action taken to design, produce, and deliver a product -Minimizes defects -Focuses on the product features that enhance customer satisfaction
Documents every action taken to design, produce, and deliver a product
The purpose of creating a revised or current value stream map (VSM) is to -Document the work of the improvement team -Develop the mapping skills of employees -Highlight changes between existing processes and new processes -All the above
Highlight changes between existing processes and new processes
To improve flow, workers should do all of the following except -Institute batch processes -Ignore artificial boundaries created between departments and authority lines -Focus on the good or service to be provided to the customer -Minimize queues, stoppages, and backflows
Institute batch processes
Which of the following tools is used to document how employees use their time during the workday? -Value stream map -Spaghetti diagram -Operator full work analysis -Product process flow
Operator full work analysis
Ensuring treatment is based on the individual's preferences, needs, and values is the STEEEP goal of -Patient centeredness -Effectiveness -Timeliness -Efficiency
Patient centeredness
A scatter or XY diagram -Plots points in a two dimensional space to determine if one variable is correlated with another variable -Estimates the relationship between a dependent continuous variable and one or more continuous or categorical dependent variables -Estimates the relationship between a continuous independent variable and a categorical variable -Estimates the relationship between two categorical variables
Plots points in a two dimensional space to determine if one variable is correlated with another variable
A spaghetti diagram is used to document -Spaghetti diagram -Operator full work analysis -Value stream map -Product process flow
Product process flow
In the Kano model, increases or decreases in normal or one-dimensional attributes produce -Proportional increases or decreases in customer satisfaction -Exponential increases in customer satisfaction when delivered and exponential increases in dissatisfaction when absent. -Exponential increases in customer satisfaction when delivered but no dissatisfaction when absent. -Exponential increases in customer dissatisfaction when absent but little satisfaction when delivered.
Proportional increases or decreases in customer satisfaction
Queueing methods recommend cross-training and pooling resources, triaging, building backup systems, and standardizing processes to reduce congestion and delays, standardizing processes is designed to -Complete more important work is completed first and lesser work as time permits -Ensure resources can be rapidly shifted from low to high demand areas -Increase system capacity -Reduce variation
Reduce variation
The STEEEP goal of effectiveness -Minimizes the cost of treatment -Correct! Restores patient health or reduces their pain -Reduces harmful delays to patients -Ensures that treatment does not vary based on race, gender, or age
Restores patient health or reduces their pain
The internal cost of poor quality (COPQ) include the costs of -Rework and scrap -Inspection -Warranties, lost goodwill, and lost sales -Product and process design and orientation and training of employees
Rework and scrap
The tool to use to display the change in a variable over time is a -Defect factor check sheet -Pareto chart -Histogram -Run chart
Run chart
Sort in 5S is designed to -Define locations for tools and supplies -Ensure all workers use the same procedures -Ensure a clean work area -Simplify the work area and reduce clutter
Simplify the work area and reduce clutter
The purpose of an affinity diagram is to -Monitor the data collection process -Collect data -Identify the most important themes or issues. -Sort data collected into themes or categories
Sort data collected into themes or categories
Which tool should be used to document the movement of people, supplies, or information to identify unneeded movement? -Product process flow maps -Operator full work analyses -Spaghetti diagrams -Value stream maps
Spaghetti diagrams
The goal of the internal processes level of a balanced scorecard is to assess whether -Goods and/or services are satisfying customers -The organization is creating value -Systems and methods are effective and efficient -Employees have skills, tools, and motivation to meet organizational goals
Systems and methods are effective and efficient
The tool that identifies major causes and sub-causes under each of the identified major causes before selecting the most likely cause(s) is -The why-why diagram -The is/is not matrix -The five whys -The cause and effect diagram
The cause and effect diagram
Correlation reports -The degree to which two variables move together and the degree of correlation ranges from -1.0 to +1.0. -Whether one variable causes a change in another and the degree of correlation ranges from -1.0 to +1.0. -Whether one variable causes a change in another and the degree of correlation ranges from 0% to 100%. -The degree to which two variables move together and the degree of correlation ranges from 0% to 100%.
The degree to which two variables move together and the degree of correlation ranges from -1.0 to +1.0.
Regression calculates the intercept and slope of a line, Y = a + bX + e, the slope b, reports the -The probability of randomly observing the calculated relationship between the DV and IV -The percentage of change in the DV that is explained by changes in the IV -The expected change in the DV for every one unit increase in an IV -The expected value of the DV when the IV(s) is zero
The expected change in the DV for every one unit increase in an IV The expected value of the DV when the IV(s) is zero
Regression calculates the intercept and slope of a line, Y = a + bX + e, the intercept, a, reports the -The probability of randomly observing the calculated relationship between the DV and IV -The expected value of the DV when the IV(s) is zero -The expected change in the DV for every one unit increase in an IV -The percentage of change in the DV that is explained by changes in the IV
The expected value of the DV when the IV(s) is zero
The tool that identifies a single cause for lower-than-desired performance is -The five whys -The is/is not matrix -The cause and effect diagram -The why-why diagram
The five whys
A product process flow map is used to document -The movement of inputs in a production process until an output is produced -How employee time is used -The steps taken by employees in completing an action -The steps in a production process
The movement of inputs in a production process until an output is produced
Takt time defines the -Amount of idle time in a process -The pace at which work must be completed to meet demand -Amount of productive time in a process -Amount of time to complete a process
The pace at which work must be completed to meet demand
The coefficient of determination, R2, reports the -The probability of randomly observing the calculated relationship between the DV and IV -The expected change in the DV for every one unit increase in an IV -The expected value of the DV when the IV(s) is zero -The percentage of change in the DV that is explained by changes in the IV
The percentage of change in the DV that is explained by changes in the IV
The p-value reports the -The expected change in the DV for every one unit increase in an IV -The percentage of change in the DV that is explained by changes in the IV -The expected value of the DV when the IV(s) is zero -The probability of randomly observing the calculated the relationship between the DV and IV
The probability of randomly observing the calculated the relationship between the DV and IV
A process distribution check sheet is designed to document -The type of defect or problem occurring -The variability of the output from a process that can be measured on a continuous scale like time, weight, temperature, height, and width -The inputs and/or conditions present when an error or defect occurred -Where a defect or problem occurred or was observed
The variability of the output from a process that can be measured on a continuous scale like time, weight, temperature, height, and width
The goal of the end of the Define stage questions (or a Tollgate Review Checklist) is to -To check overall progress and that most work is completed or near completion in the Define phase. This is to assure that every member of the performance improvement team are clear on goals and working towards the same outcome to move onto the next phase. -Provide a performance contract the project team can share with upper management -Ensure every step in the Define stage was completed -Complete the project charter
To check overall progress and that most work is completed or near completion in the Define phase. This is to assure that every member of the performance improvement team are clear on goals and working towards the same outcome to move onto the next phase.
A Gantt chart is used to visually display an improvement project timeline and the interdependencies between steps. True False
True
A t-test assesses whether the means of two groups are difference while ANOVA can assess differences in means between two or more groups. True False
True
The Pareto rule highlights the law of diminishing returns i.e., improvements will decline when improvement efforts move beyond the "vital 20%". True False
True
The alternative hypothesis (HA) states the identified cause is related to the desired outcome. True False
True
The goal of the Measure stage is identify gaps between customer expectations and system performance and the expected monetary benefit of improvement. True False
True
Before advancing to the Analyze stage, an improvement team should be able to answer all of the following questions except -How are throughput process performing? -What is the cause or causes of performance gaps? -What level of performance is possible? -What are the critical outcomes and how is the organization performing on each measure? -What is the cost of performance gaps?
What is the cause or causes of performance gaps?
In a Voice of the Process (VOP) matrix, the operational definition identifies -The performance goal or target -Where data will be obtained to assess performance -Current performance -How performance will be measured i.e., the formula -The "critical to..." factor being assessed
Where data will be obtained to assess performance
Cost benefit analysis is used to determine -if an activity will create greater benefits than its cost -the lowest cost approach to achieving a goal -whether an existing activity is running according to plan and/or achieving the desired goals -whether a capital investment will generate more revenue than its cost
if an activity will create greater benefits than its cost
The goal of Lean Six Sigma is to reduce errors, cost, performance time, space requirements, and/or employee turnover by: -75% -50% -25% -87%
87%
Process capability is determined at what stage of the DMAIC process? -Define -Control -Analyze -Measure -Improve
Analyze
Chi-square analysis is the appropriate statistical test to determine whether cholesterol levels are different between females and males. True False
False
Load leveling is -Proactively seeking out and capitalizing on opportunities -Distributing work to ensure all workers are fully employed, neither over- or underworked -Standardizing inputs and processes to ensure consistent output -Striving for prevention of rather than correction of defect
Distributing work to ensure all workers are fully employed, neither over- or underworked
All are the types of Waste except: -Duplication -Overproduction -Inventory -Defects -Idle -Extra Processing -Motion -Not utilizing human potential -Transportation -Waiting
Duplication & Idle
Ensuring treatment is delivered using the minimum amount of resources is the STEEEP goal of -Efficiency -Patient centeredness -Equity -Effectiveness
Efficiency
Correlation measures the degree to which one variable causes a change in another. True False
False
According to the author the most fertile source for improvement ideas comes from -Data anaylsis -Employee/Customer suggestions -Malpractice suits -Patient comments and complaints only
Employee/Customer suggestions
Which of the following cannot be considered an external customer of a hospital? -Employees -Patients -Third party payers -Suppliers
Employees
Queueing methods recommend cross training and pooling resources, triaging, building backup systems, and standardizing processes to reduce congestion and delays, triaging is designed to -Reduce variation -Ensure resources can be rapidly shifted from low to high demand areas -Ensure more important work is completed first and lesser work as time permits -Increase system capacity
Ensure more important work is completed first and lesser work as time permits
The role of Control in the DMAIC process is to -Identify the causes of lower-than-expected performance -Assess how systems are working -Identify methods to enhance performance and outcomes -Ensure performance gains are maintained -Identify a problem or opportunity to improve
Ensure performance gains are maintained
The STEEEP goal of equity -Ensures that treatment does not vary based on race, gender, or age -Restores patient health or reduces their pain -Restores patient health or reduces their pain -Seeks treatment that does not injure a patient
Ensures that treatment does not vary based on race, gender, or age
Chi-square analysis -Estimates the relationship between a continuous independent variable and a categorical variable -Estimates the relationship between two categorical variables -Estimates the relationship between a dependent continuous variable and one or more continuous or categorical dependent variables -Plots points in a two-dimensional space to determine if one variable is correlated with another variable
Estimates the relationship between two categorical variables
In the Kano model, increases or decreases in exciting quality or delight attributes produce -Exponential increases in customer satisfaction when delivered and exponential increases in dissatisfaction when absent. -Proportional increases or decreases in customer satisfaction. -Exponential increases in customer dissatisfaction when absent but little satisfaction when delivered. -Exponential increases in customer satisfaction when delivered but no dissatisfaction when absent.
Exponential increases in customer satisfaction when delivered but no dissatisfaction when absent.
The costs of warranties, lost goodwill, and lost sales are -External failure costs -Internal failure costs -Appraisal costs -Prevention costs
External failure costs
The role of the team leader on a performance improvement team is to -Facilitate meetings, mentor team members, and monitor project progress -Transfer Lean Six Sigma knowledge and skills, apply Lean 6σ tools, and provide statistical support -Collect data, supply subject matter expertise, and apply Lean Six Sigma tools -Approve the project and remove obstacles
Facilitate meetings, mentor team members, and monitor project progress
A value stream map identifies who a patient interacts with during a visits and hand-offs between employees. True False
False
Which of the following events should be selected for an improvement project i.e., which will produce the greatest benefit for the organization? -Low frequency of occurrence, high impact on patients, and expected completion time greater than 6 months. -High frequency of occurrence, low impact on patients, and expected completion time less than 6 months. -Low frequency of occurrence, high impact on patients, and expected completion time greater than 6 months. -High frequency of occurrence, high impact on patients, and expected completion time less than 6 months.
High frequency of occurrence, high impact on patients, and expected completion time less than 6 months.
Pareto charts are used to -Highlight major issues by visual comparison of the frequency of events -Display the distribution of variables that are measured on continuous scale -Display the change in a variable over time -Collect data
Highlight major issues by visual comparison of the frequency of events
The tool to use to display the distribution of variables measured on a continuous scale is a -Histogram -Run Chart -Defect factor check sheet -Pareto chart
Histogram
The question that the Measure stage of the DMAIC process seeks to answer is -What is the solution(s) to the problem? -How can improvements be sustained? -What is the problem? -What is the cause(s) of the problem? -How big is the problem?
How big is the problem?
The question that the Control stage of the DMAIC process seeks to answer is -What is the solution(s) to the problem? -How can improvements be sustained? -How big is the problem? -What is the cause(s) of the problem? -What is the problem?
How can improvements be sustained?
The role of sensitivity analysis in cost benefit analysis is to determine -How the desirability of an intervention changes when key variables change. -If the correct objective was selected. -Whether the monetary benefit of an intervention exceeds its cost -If all alternatives for achieving the chosen objective were reviewed.
How the desirability of an intervention changes when key variables change.
Before advancing to the Control stage, an improvement team should be able to answer all of the following questions except -How will improvements be sustained? -How will improvements be achieved? -What are the expected costs and benefits of improvement? -How will current processes be altered?
How will improvements be sustained?
The role of Define in the DMAIC process is to -Ensure performance gains are maintained -Identify methods to enhance performance and outcomes -Assess how systems are working -Identify a problem or opportunity to improve
Identify a problem or opportunity to improve
The goal of the Improve stage is to -Identify the root cause or causes of less-than-desired performance. -Identify and implement a solution to improve performance. Identify an improvement opportunity, define the parameters of improvement project, and assemble the resources to complete the project. -Determine whether improvements produced the desired effect and ensure improvements are not lost over time. -Document customer requirements and system performance.
Identify and implement a solution to improve performance.
Which of the following is not a goal of collecting voice of the customer (VOC) data? -Ensure compliance with regulatory and reporting requirements -Identify current system performance -Provide basis for evaluating project success -Identify improvement opportunities -Gauge upper management support for project
Identify current system performance
The role of Improve in the DMAIC process is to -Identify a problem or opportunity to improve -Identify the causes of lower-than-expected performance -Identify methods to enhance performance and outcomes -Ensure performance gains are maintained -Assess how systems are working
Identify methods to enhance performance and outcomes
The role of Analyze in the DMAIC process is to -Identify a problem or opportunity to improve -Identify methods to enhance performance and outcomes -Identify the causes of lower-than-expected performance -Ensure performance gains are maintained -Assess how systems are working
Identify the causes of lower-than-expected performance
The goal of the stakeholder identification table is to -Identify the level of attention and effort that should be given to different stakeholders. -Identify members for the performance improvement team. -Identify the communication medium, frequency of communication, and responsible party who will interact with different stakeholder groups. -Identify the importance of stakeholders to the success of an improvement project.
Identify the importance of stakeholders to the success of an improvement project.
The goal of the stakeholder management plan is to -Identify the level of attention and effort that should be given to different stakeholders. -Identify members for the performance improvement team. -Identify the communication medium, frequency of communication, and responsible party who will interact with different stakeholder groups. -Identify the importance of stakeholders to the success of an improvement project.
Identify the level of attention and effort that should be given to different stakeholders.
The goal of the Analyze stage is to -Identify the root cause or causes of less-than-desired performance -Document customer requirements and system performance -Identify an improvement opportunity, define the parameters of improvement project, and assemble the resources to complete the project -Identify and implement a solution to improve performance
Identify the root cause or causes of less-than-desired performance
Which of the following is not part of a project charter? -Implementation plan -Process start and end points -Problem statement -Team members -Project start and end dates
Implementation plan
When prioritizing action based on voice of the customer data, the first issues that should be addressed are those identified by -Large, profitable customers -Minor, unprofitable customers -Minor, profitable customers -Large, unprofitable customers
Large, profitable customers
A meaningful voice of the process (VOP) measure should -Measure characteristics of a good or service that are likely to meet customer expectations and organization goals -Point to potential causes of deviation from desired performance -Signal when action should be taken -Supply information that can be used prior to the completion of a production cycle
Measure characteristics of a good or service that are likely to meet customer expectations and organization goals
Chi-square analysis is the appropriate statistical test to determine whether the number of hospital-acquired infections are different between the medical and surgical nursing units. True False
True
The role of the Lean Six Sigma expert on a performance improvement team is to -Transfer Lean Six Sigma knowledge and skills, apply Lean 6σ tools, and provide statistical support -Facilitate meetings, mentor team members, and monitor project progress -Supply subject matter expertise and implement improvements -Approve the project and remove obstacles
Transfer Lean Six Sigma knowledge and skills, apply Lean 6σ tools, and provide statistical support
A primary problem with load leveling, ensuring employees are neither over-worked nor idle, in health care is the inability to anticipate the degree of complexity and the amount of attention each patient will require. True False
True
An independent variable (IV) is the variable expected to predict or cause a change in another variable. True False
True
Benchmarking is used to compare the performance of an organization against the industry average or the performance of competitors. True False
True
Which of the following is not a tool to collect voice of the customer data? -Focus groups -Value stream maps -Complaints -Interviews and Surveys
Value stream maps
Which tools should be used to identify unnecessary steps and wasted time in a production process? -Product process flow maps and operator fall work analyses -Spaghetti diagrams and value stream maps -Operator full work analyses and spaghetti diagrams -Value stream maps and product process flow maps
Value stream maps and product process flow maps
The five principles of Lean 6 sigma are -Value, timeliness, pull, flow, and price -Value, timeliness, pull, flow, and perfection -Value, value stream mapping, pull, flow, and perfection -Value, value stream mapping, pull, flow, and price
Value, value stream mapping, pull, flow, and perfection
