Application of Management Tool for King Abdullah Medical City (KAMC)

This project presents a comprehensive analysis of a management tool implemented at King Abdullah Medical City (KAMC) in Makkah, Saudi Arabia, to address inefficiencies within its referral system. The project begins by outlining four process improvement tools: DMAIC, SIPOC model, Fishbone Diagram, and Plan-Do-Check-Act cycle, and explains their potential benefits. The core problem identified is the delays and disorganization caused by the referral system, impacting patient satisfaction and operational efficiency. The research methodology utilizes lean six sigma tools, particularly DMAIC, to analyze and improve the referral process. The DMAIC phases are customized with the SIPOC model and Fishbone diagrams to identify and visualize issues. The study then details the customization of lean six sigma tools, including the use of the SIPOC model to identify value-added and non-value-added activities, and a fishbone diagram to analyze root causes of the referral system issues. The improving phase incorporates a value stream mapping tool to suggest both short-term and long-term solutions. The project concludes with an overall result of the case study which shows the lean six sigma model helped the medical center KAMC by increasing the response rate of the referral requests by the physicians of the hospital, along with a comparison of improvement tools in manufacturing and service sectors.

Management Tool for King Abdullah Medical City (KAMC) 0
Title: Management Tool for King Abdullah Medical City (KAMC)
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Management Tool for King Abdullah Medical City (KAMC) 1
Contents
Four Process Improvement Tools..............................................................................................2
Problem Statement & Research Methodology...........................................................................3
Problem Statement.................................................................................................................3
Research Methodology...........................................................................................................3
Selection of the Tool..................................................................................................................4
Customization of the Tool..........................................................................................................5
Overall Result of the Case Study.............................................................................................10
Comparison in the Application of Improvement tool between the Manufacturing & Service
Sector........................................................................................................................................11
References................................................................................................................................12
Image References.................................................................................................................12

Management Tool for King Abdullah Medical City (KAMC) 2
Four Process Improvement Tools
There are many tools and techniques that help in improving the process of functioning of
an organization. These tools facilitate an efficient working system and also develops an
environment of continuous improvement in the organization. The four main tools that can be
utilized in King Abdullah Medical City are –
 DMAIC
The methodology of DMAIC is based on five processes, which are define,
measure, analyze, improve, and control. In the healthcare organization, the DMAIC
tool will be most beneficial in departments where the process is mainly driven by data
and information. Also, this tool imposes huge pressure on analysis and measurement,
which is very effective in bringing a structured change improvement.
 SIPOC Model
The SIPOC model can be defined as a graphical representation that facilitates
process management in five crucial phases. The SIPOC stands for supplier, inputs,
process, outputs, and customers. In the healthcare institution, the SIPOC model will
help in identifying the issues in a deeper way, as it provides an in-depth visual display
of the complete process through the graphical presentation.
 Fishbone Diagram
A fishbone diagram is a process improvement tool that is also known as cause
and effect analysis. In the healthcare organization, this tool will be helpful in
identifying the potential issues that are disturbing the process. This graphical
representation is conducted in a fishbone manner that the main reason why it is called
a fishbone diagram. A fishbone analysis consists of 6M’s which are man, method,
machine, material, measurement, and mother nature, when the process is related to

Management Tool for King Abdullah Medical City (KAMC) 3
manufacturing. In case of a service delivering organization like hospitals, the key
elements are people, environment, equipment, policies, and procedures.
 Plan-Do-Check-Act
The PDCA cycle is a continuous improvement tool that identifies and
examines the hypothesis in four steps which are plan, do, check, and act. This process
will help the hospital in implementing strategies on a small scale and through this trial
and error phase, the hospital will be able to make necessary improvements.
Problem Statement & Research Methodology
Problem Statement
The case study is about the medical center, King Abdullah Medical City that functions
in Makkah, which is a popular place in Saudi Arabia. The main problem that the organization
is facing is due to the incorporation of the referral system that has caused a disturbance in the
different departments of the hospital by creating hindrances in different functions. All the
issues have affected the efficiency level at the medical center, ultimately affecting the needs
and wants of the patients, both in the short and long run. The main problems are emerging
due to the late response of the referral system that is disorganizing the documentation
process, which is further creating problems in the process of admitting the patient in the
medical center. Due to this disturbance in the complete process, the patients are getting
dissatisfied with the services offered by the hospital and this is creating further issues for the
King Abdullah Medical City (Alkinaidri & Alsulami, 2018).
Research Methodology
The researchers utilized the DMAIC tool for attaining a better understanding of the
referral system and the problems emerging due to it. Also, the lean six sigma tools were
incorporated as it would provide the researchers with the opportunity to identify various

Management Tool for King Abdullah Medical City (KAMC) 4
different aspects, which could be utilized to reduce the delay in responding to the referral
system. The various different stages of DMAIC will help in understanding the complete
operating system of the hospital in a better way.
The methodology has a distinctive approach, as the focus is different at each stage of
the DMAIC model. During the define phase, the main focus of the methodology is on
recognizing the various parameters that are most crucial to hospitals like the needs and
desires of the patients. In the second phase of measuring, the current referral system is
evaluated on the basis of the documentation process and the complete process is compared
with the standard figures. In the third phase of analyzing, the main issue which the hospital is
facing and it is conducted in accordance with the datasets available. In the fourth phase of
improving, a brainstorming session is conducted for evaluating different ideas that may help
the hospital by solving the various issues it is facing. In the final phase of control, the main
focus of the model is on facilitating continuous improvement in the hospital for the long run
and managing the potential contingencies (A. Shaikh & Kazi, 2015).
Selection of the Tool
The author has selected the lean six sigma tools to help the hospital by solving the
problem due to the referral system at the KAMC. This tool has been selected as it will
facilitate the researchers with the opportunity to analyze the main needs of the patients and
the tool will help the researchers the main driving forces that the hospital can utilize to fulfill
the various needs of the patients. Also, the tool will help the researchers in identifying
different aspects that can help in reducing the delay of response to the referral system. The
lean six sigma tools enhance the level of efficiency and speed in any organization and it also
helps in improving the level of service quality offered by the organization to the customers.
Thus, these two aspects require rectification at KAMC and thus, the selection by the
researchers is appropriate (Sehgala, Kaushisha & Rathia, 2015).

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Customization of the Tool
In the medical center KAMC, a customized lean six sigma tool has been incorporated
and the same has been exhibited in the various phases of the DMAIC model. The main issue
was highlighted in the defining phase that the delay in the response to the referral system was
happening due to the different categories of physicians that are employed in the medical
center. The main objective that was decided was to attain the response rate of 95 percent for
the urgent requests to the referral system and attain a response rate of 90 percent for normal
requests. During the measuring phase, the SIPOC model was utilized to recognize the
different activities as value added and non-value added, associated with various entities that
include suppliers, processes, inputs, outputs, and lastly the customers (K. Modi & A. Desai,
2017). The incorporation of the SIPOC model –

Management Tool for King Abdullah Medical City (KAMC) 6
Image source: (file.scirp.org)
Through customization of lean six sigma tools and the incorporation of the SIPOC
model, valuable information was attained at the measuring phase that highlighted that the
response rate of the physicians is 68% and 79% for normal and urgent cases respectively.
After the huge difference in the response rate of the referral system, in comparison to the
decided objectives, another customization was required in the analyzing phase. During the

Management Tool for King Abdullah Medical City (KAMC) 7
analyzing phase, the fishbone diagram was incorporated to examine the cause and effects in a
deeper manner (Abdelhadi, 2016). The fishbone diagram analyzed the various issues
associated with the referral system, communication, availability, and contact, which has been
illustrated in the following presentation –
Image source: (file.scirp.org)
During the fourth phase of improving, the value stream mapping tool was
incorporated that exhibited different ideas, which should be implemented in the hospital to
increase the service quality and to increase the response rate of the referral system. The plans
that were incorporated were both short and long term. The short-term plans for the hospital
are designating a specific referral number for each department of the hospital, notifying the

Management Tool for King Abdullah Medical City (KAMC) 8
physicians through SMS as soon as the incorporation of referral is conducted in the system,
directly calling for emergency cases, the head of the system should be notified about any
delay and also the reason behind the delay should be informed (Kumar & Sharma, 2012). For
the long-term plans, creating an efficient procedure for accepting the referrals, informing the
authorities about the execution of the plan, developing and utilizing a mobile application to
manage the referral requests more conveniently, and formulating an escalation system in case
of any delays.
Image source: (file.scirp.org)

Management Tool for King Abdullah Medical City (KAMC) 9
Image source: (file.scirp.org)
In the last stage that is the controlling phase, the PDCA cycle was utilized, especially
to monitor the functions of the coordination office, which has to be developed for the purpose
of reducing the delay in response to the referral system. The performance of the referral
system was regularly evaluated and was also presented to the board members of the hospital.
The PDCA cycle also facilitated with the opportunity to analyze the different trends related to
the concerned department and with this trial and error approach, appropriate solutions were
formulated (Mandal, 2012).

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Image source: (logisticsmgepsupv.files.wordpress.com)
Overall Result of the Case Study
From the complete case study, this can be concluded that the lean six sigma model
helped the medical center KAMC by increasing the response rate of the referral requests by
the physicians of the hospital. The hospital witnessed a reduction in the delay by 2 percent in
the urgent cases and by 5 percent in the normal cases. Also, with the implementation of the
decided long-term goals, the hospital will be able to create an environment of continuous
improvement and with the hospital mobile application, the main issue of delay in response
will be tackled effectively.

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Comparison in the Application of Improvement tool between the
Manufacturing & Service Sector
Though the lean six sigma tools will be effective in all the organizations associated
with manufacturing or delivering any services, there is a slight difference that lies in the
application process. In the manufacturing organization, there are a number of more different
aspects that have to be taken into consideration like in the fishbone diagram, the 6M’s have to
be analyzed which are a man, mother nature, machine, materials, measurement, and method.
Also, in the supply chain, there are various aspects that have to be analyzed for facilitating
continuous improvements like distribution, various channels of distribution and many more.
In the service sector, all the aspects that have been mentioned above will be analyzed by the
continuous improvement tool (Nadia, Lamia & Benchekroun, 2014).