Bottom line on 6 Sigma and Healthcare!

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    Mr. Peters

    Focus PDSA is the only way to go.  Why?
    How can you use 6 sigma on clinical indicators?  Maybe you can on healthcare financial but clinical?
    In order to use 6 Sigma you have to come up with specification limits.  This isn’t industry/manufacturing where you can decide what should be the ideal process capability in order to meet the customers’ specification limits.  There are very few examples where processes in healthcare can be assigned specification limits. 
    Another thing wrong with 6 Sigma is it’s assumption of process stability, that is a naughty no no!  Only a control chart can tell you if a process is stable!
    And yet another reason 6 Sigma is unwanted in healthcare is the fact that Motorola developed it.  Ever noticed where they are these days? Youch!
    In summary, 6 Sigma is good if you are a consultant training organizations on it.  Starting it in your HEALTHCARE organization is a great way to be bilked out of thousands if not millions of $$$!!!
    If your saying “yeah but like your saying it’s great for industry”, let me end this rant by stating you can do much better process improvement without the massive bloated overhead of 6 Sigma!
    Black Belts?  What is this Sciencetology?


    Dr. Deborah L. Smith

    Having worked in Healthcare for 30 plus years, I can say that PDSA or PDCA, Quality Advantage, TQM, CQI, Reengineering and multiple other programs have been of value to Healthcare. However, with the introduction of Six Sigma in Healthcare we have raised the bar on how we approach quality improvements and business initiatives. Six Sigma is making significant intellectual investments in our Healthcare Professionals, who make life and death decisions everyday. Six Sigma Methodology is much more than statistics and tools. It is a fundamental critical thinking skill to change the way you approach planning/defining, measuring, analyzing, implementing and sustaining results. Healthcare Professionals are taught to think using a similar approach as the Six Sigma Model, it just wasn’t called that at the University. In Healthcare the collection of data has become a full-time job for managers and those who are giving the daily care. Over and over data collection has been a costly and unnecessary process. Much of the data has no repeatability, nor reproducibility, therefore leading to wrong decisions. Do you want to be that Patient? Not me, I want people knowing what makes up good reliable data, that leads to working on problems that will make a difference in the decision making process of care delivery. I want professionals using data that will reduce the variability in the way care is delivered. And before someone’s decision is implemented I want to know that it has been statistically validated and mechanisms are in place to prevent a medical error or mistake.Healthcare is data rich in Benchmarks and Standards. Benchmarks exist for financial, quality, satisfaction and transactional process. Acquiring Specification Limits is the easy part, the difficult part is scoping all the data to numbers that are manageable In 1997, the Joint Commission’s ORYX  initative integrates outcomes and other performace measurement data into the accreditation process for JCAHO. Then starting in 2002, JCAHO Accredited Hosptials began major data collecting efforts on performance measures. JCAHO identified four clinical areas of core measures: AMI, acute myocardial infarction;  CHF, congestive heart failure; community acquired pneumonia and pregnancy and related conditions.  Many hospitals have applied Six Sigma Methodology in these areas and have obtained sustainable results indicated on a control chart.  JCAHO is constantly developing new measures that address areas such as surgical infection rate prevention, ICU care and pain management, children’s asthma care.  All of these clinical initiatives have specific benchmarks.Some healthcare organizations have been applying Six Sigma for 3-5 years now. These organizations are seeing significant returns on investment to the bottom line, major quality and safety improvements in the way care is being delivered, and higher satisfaction for patients, families, employees and physicians. My concise question for closure is: “Why not Six Sigma in healthcare, since it is working?”

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