1. W
hat makes Six Sigma different from other improvement methods
is its structured process for defining, measuring and controlling
an opportunity for improvement. In other words, it’s a disci-
plined effort that closely examines an organization’s repetitive processes
involving areas such as product design, production, supply chains and
service. And this is why it can significantly reduce defects in the service
industry, particularly in patient-oriented services.
In the healthcare industry, Six Sigma has been proven to benefit patients
with its focus on operational efficiency.1
The method helps translate
patients’ needs into separate tasks and define the optimum requirements
for each. The steps that follow this translation and definition can have a
powerful effect on a healthcare organization’s performance, the quality of
patient care and employee development.
Six Sigma and healthcare
Unfortunately, Six Sigma isn’t accepted in many healthcare organiza-
tions, and there’s a misunderstanding of how it can be applied. When
a healthcare practitioner hears the words “Six Sigma,” he or she might
respond with comments such as: “Oh great, another program,” “I have
patients to see and don’t have time for this,” “We do not have repetitive
processes,” or “Every person is different.”
Six Sigma doesn’t take the focus away from patients in search of ways to
cut costs. And it doesn’t sacrifice clinical quality by seeking shortcuts or
cookie-cutter medicine.
There are a number of key elements in successfully implementing Six
Sigma:
• Start by genuinely focusing on patients and identifying their key
requirements for quality care.
• Ensure that your processes are designed and managed to meet these
key requirements.
• Have appropriate measures in place to determine how well you’re
meeting patients’ requirements and to understand their perception
of how well you are meeting those requirements.
• Involve staff members and make sure they are appropriately equipped
to challenge their processes and improve the way they work.
• Approach improvement by using a systematic problem solving and
process-improvement approach.
Senior support
Gaining senior management support is the most critical step in implement-
ing a successful Six Sigma initiative. Improvement must be driven from
the top down. If the individuals who determine your organization’s future
C A S E S T U D Y
Not Another Program
SIX SIGMA IMPROVES
HEALTHCARE
OPERATIONS, NEW
TECHNOLOGY
INTEGRATION
By William
H. LaFollette,
Accumen
28 I F E B R U A R Y 2 0 1 6 I W W W . A S Q . O R G
2. and direction are not on board, the initiative will not
succeed.
Many organizations have the idea of bringing
Six Sigma into their operations without leadership
support, and they fail miserably. This is a mistake
that’s not just financially costly, but it’s also costly
for an organization’s culture, especially if it wants
employees to accept other improvement programs
in the future.
After management agrees that Six Sigma is the
right approach for the organization, it takes time and
research to ensure the right people are aligned to
the right processes. This can mean getting assistance
from someone who has significant experience in
applying Six Sigma.
There are many healthcare professionals who
successfully transitioned to operational quality. But
in many cases, healthcare systems don’t have the
resources or ability to stay inside their organizations
and must look outside for help—at least when ini-
tially launching a Six Sigma program.
A healthcare system in the Midwest created a
department focused on operational excellence that
was staffed completely with engineers from outside
healthcare. Rather than focus its improvements on
the clinical side of the organization, the approach
was to focus them on the operational side. Finding
these types of experts can require nontraditional
recruitment methods. ASQ’s Career Center (careers.
asq.org) is a job-posting board that can be a valuable
resource in finding quality professionals who can
serve in healthcare.
Finding opportunities
With support from senior management and right
staff in place, your next step is to understand what
Six Sigma will look like in application. Defining
the opportunity for improvement is the first step in
launching a Six Sigma project. To kick off this phase,
I like to quote Albert Einstein: “The significant prob-
lems we face cannot be solved by the same level of
thinking which caused them.”2
Opportunities for improvement could be issues
such as:
• Flaws in complex interactions among individuals:
These could involve multiple handoffs between
providers and staff members, or between depart-
ments. For example: Orthopedics sends a patient
to the X-ray area. The patient arrives and says
he’s there for an X-ray on his shoulder and ends
up getting an X-ray on a foot. In this situation,
there was a lack of documented process steps
and some type of process control. Had it been
a more serious procedure, the results could
have been catastrophic.
• When there is a change in a process or opera-
tional flow: A process-control point must be
established to ensure the consistency of care
and workflow.
• Problems using new, sophisticated technology
with people: When people must interact with
evolving technologies, there is a large opportu-
nity for errors. This is where our subject matter
experts—whether they are in Six Sigma or IT—
face their greatest challenge.
Improvement with IT and Six Sigma
Getting healthcare practitioners to use new technol-
ogy is nearly an impossible task. The first hurdle to
overcome is defining the technology, and this is fol-
lowed by explaining how that technology will benefit
the organization. Moving practitioners out of the
“that’s the way we’ve always done it” mindset is never
easy, but with the right focus and methods, new tech-
nologies with proper controls can have a significant
effect on an organization.
A physician-owned healthcare system in the
Midwest improved its technology and followed Six
Sigma’s define, measure, analyze, improve and con-
trol process to provide major improvements to its
overall operational health.
The healthcare system identified an opportunity to
improve its patient service by reducing the amount of
paper charts used by staff members. Giving providers
the information they needed to consult with patients
involved a courier pulling paper charts and deliver-
ing them to a provider’s department.
This process required the transfer of thousands
of records across many floors in a 150,000-square-
foot facility. It also caused a one-day delay in the
process. After delivery, medical staff was required to
sort through information and prep for the next day’s
patients, creating additional delays.
After a patient arrived for his or her appointment,
a provider reviewed the paperwork and began treat-
ment. The provider then sent handwritten notes
to be transcribed, and the transcribed notes were
added to the patient’s record. Each of these steps
compound delays in the process of treating patients.
The health system’s opportunity for improvement,
S I X S I G M A F O R U M M A G A Z I N E I F E B R U A R Y 2 0 1 6 I 29
Not Another Program
