Tools, Technologies and Training for Healthcare Laboratories

Interview with a Black Belt

An interview with a Six Sigma Black Belt from Quest Diagnostics.

Kathleen Truitt, Quest Diagnostics Black Belt

Interview by Sten Westgard, MS

I first met Kathleen Truitt when she attended our Six Sigma Quality Design and Control in June of 2001. We had been hearing about Six Sigma at Quest Diagnostics from many people, but Kathleen was the first true Black Belt that we had met. Her insight and experiences helped make the seminar a great success. We felt that her wealth of knowledge should be shared with more than just the workshop audience. Luckily, with the gracious consent of Quest Diagnostics, we're able to present an interview with her.

Kathleen holds an MLT Degree from Triton College in River Grove, Illinois, a B.S. Degree from Northern Illinois University in DeKalb, IL, and a M.S. in Microbiology from the Illinois Institute of Technology in Chicago. In 1988 she joined the company formerly known as SmithKline Beecham Clinical Laboratories, now known as Quest Diagnostics, Incorporated. Over the next 13 years, she was given the responsibilities of a supervisor in the Hematology, Toxicology, Chemistry and Specimen Processing departments. During that time, she also participated in several TQM initiatives that focused on improving processes within the laboratory. Since 1998, she has been enrolled in the MBA program at DePaul University and will graduate next year. In April of 2000, she was chosen to apply for the position of Black Belt. Four months later, she began her career in Six Sigma.

How did Six Sigma come to Quest Diagnostics?

Ken Freeman, chairman of Quest Diagnostics, initiated Six Sigma in a deliberate attempt to raise the bar on quality in healthcare services. In late 1999, a report produced by the National Academy of Sciences' Institute of Medicine documented tens of thousands unnecessary deaths caused annually by hospital errors. Before joining Quest Diagnostics in 1995, Ken spent much of his career in the manufacturing field. Having seen the outstanding results that Six Sigma produced for companies such as Motorola, Sony, and GE, Ken saw an opportunity for Quest Diagnostics to lead healthcare services to a new level of quality.

How many Six Sigma projects are ongoing in Quest Diagnostics?

There are approximately 150 Six Sigma projects that are ongoing within the company at this time. We are now beginning to implement proven Six Sigma solutions across all business units in an effort to standardize many business processes.

How many people are involved in Six Sigma at Quest Diagnostics?

Currently, Quest Diagnostics has 11 Master Black Belts and 105 trained Black Belts whose full-time job is managing Six Sigma projects.

What's the typical goal of a Six Sigma project at Quest Diagnostics?

The typical goal of a Six Sigma project is a 50% reduction in the number of defects as defined by each project.

What kind of impact has Six Sigma had on Quest Diagnostics? Financial and otherwise?

Six Sigma has made a cultural impact on how everyone in the company performs their jobs. Quest Diagnostics has successfully trained 24,000 employees on the basic concepts of Six Sigma and has integrated these concepts into the daily work life of every employee. We expect that Six Sigma will start to realize cost savings and volume growth starting in 2002.

Has Quest Diagnostics begun Six Sigma projects in the analytical testing area?

Yes, currently there are approximately 20 Six Sigma projects in the area of
"Test Specimen", one of nine core processes of our organization.

Could you describe your introduction to and training in Six Sigma?

My first introduction to Six Sigma was as a topic in one of my classes at DePaul University. There I learned that the Six Sigma approach was being used by manufacturers to meet customers'expectations, monitor and improve process capabilities and reduce defects. With that in mind, I was very interested to learn that Quest Diagnostics was going to use Six Sigma tools to improve the quality of healthcare.

My career as a Six Sigma Black Belt began with four weeks of training over a five-month period. The five phases of the Six Sigma initiatives, Define, Measure, Analyze, Improve and Control, were taught in such a way that after each week's training, each Black Belt was instructed to apply what they learned in their own Six Sigma project.

What is your current Six Sigma project? What is its goal?

I am currently leading a Six Sigma project that deals with how Quest Diagnostics receives billing information from our customers. As anyone in healthcare knows, the processes for a successful billing transaction are very complex. This project focuses on improving the timeliness by which we receive patient demographics and insurance information in order to collect payment for services rendered. The goal is to decrease the cycle time by 50%.

What are the hardest obstacles to overcome in a Six Sigma project?

The Six Sigma strategy is very rigorous and challenges a Black Belt in many ways. All pathways toward improvement are validated by statistical analysis in an effort to insure that the time and energy spent on each project adds value to the project and to the organization.

Have you already completed a Six Sigma project(s)? What were they and what were their results?

I have just completed my first Six Sigma project, which focused on reducing defects related to specimen collection. The project concentrated on the processes by which blood specimens are collected in a hospital environment. Special attention was placed on improving the phlebotomy processes performed in the Emergency Department and the Neonatal Intensive Care Unit and Nursery, where most defects occur. Focus was placed on improved education and training provided to nurses in these areas. A continuous improvement program was designed to share specimen quality issues with certain hospital units, which has, in turn, enhanced the understanding of the laboratory's function within the hospital network and improved communication. Overall, the project has 1) improved specimen quality and integrity 2) reduced the number of cancelled test requests 3) decreased re-work 4) improved the timeliness by which physicians receive test results and, in turn, the timeliness to diagnose and treat patients and 5) improved the patient's experience with the laboratory. The project has been successful in reducing the number of defective specimens related to clotting, hemolysis and "quantity not sufficient" by 50%.

If there's one thing about Six Sigma you think people should know, what is it?|

One of the most important aspects of Six Sigma is its goal of virtual perfection. Achieving Six Sigma quality means that there are only 3.4 defects in every million opportunities. Certainly, that is a stretch goal, but I can't think of a better place to strive toward such a goal than in healthcare, where even the smallest defect or medical error directly affects the well-being of a patient.

Once again, we thank Kathleen Truitt and Quest Diagnostics for letting us present this interview.