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six sigma in healthcare

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  • #25275

    Louise Schwartz
    Participant

    I am a graduate student writing a thesis on six sigma in healthcare. Do you know of any studies that compare six-sigma with CQI, TQM or other quality methodologies in a healthcare setting? Also I would appreciate any ideas for original study concerning six sigma and healthcare-thanks   

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    #60797

    Louise Schwartz
    Participant

    Okay- so I now read the threads on former thesis searchers and know I have to do my own homework- but would still be interested in help pinpointing characteristics of “quality cultures in healthcare” that adopted six sigma successfully and those that six sigma project ultimately failed. I was considering a questionnaire to both to try to find common links. I would also appreciate it if someone could share their knowledge about six sigma and patient or member satisfaction in healthplans and hospitals. Again- I am in the process of doing “hours, weeks, months, of research on my own- thanks-louise

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    #60804

    Arora
    Member

    “Addressing Variation in Hospital Quality :is Six Sigma the answer?” —- Tanisha D Woodard,
    Journal of Health Care Mgt, July-Aug 2005 v50 i4 p226(11)
     
     

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    #60806

    LJ
    Participant

    Thanks, Louise

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    #60815

    Brit
    Participant

    LJ:
    You’re tackling a big subject.  I would like to be a resource for you as you move forward.  I can give you a few ideas of what to include in your research regarding the quality movement in Healthcare.

    Much of the first quality efforts started not by choice but by “request” from the Joint Commission on Accredited Healthcare (JCAHO).  This body certifies hospitals so that they can more easily access Medicare/Medicaid funding. Without the cert, state requirements can be grueling for reimbursement.  More than likely, this grew out of the enormous growth in healthcare costs and quality/patient safety issues- but that is supposition on my part.
    Around 1994, JCAHO started emphasizing quality measurement requirements, more so than previously.  It was similar to ISO9000, where you had to do something and document it, but not really sure of what was to be done.
    TQM was big at the time and the Health Care Advisory Board, a large data/guidance resource for hospitals published the Total Quality Management Volume series II (1992 – The Advosry Board Company) where they presented TQM tools and rated them on a A+ to F scale.  Hospitals could use this as a resource for developing their own TQM/CQI programs. 
    Consultants grew to accommodate healthcare CQI.
    CQI/TQM continued in healthcare to today.  The most common form of process improvement model is FOCUS-PDCA.   FOCUS is used to find an opportuinity and PDCA is the Deming Cycle.  My experience is that this model has fostered some poor practices – in particular, trial and error before data shows what needs to be done. However, many hopsitals have been successful with it.  I do not know who was the first to use ths model.
    Six Sigma in healthcare grew from manufacturing and GE is generally credited with starting it in healthcare.
    No formal number exists, but proponents of Six Sigma estimate that 5 – 10% of hospitals use Six Sigma (I think it’s closer to 5% based on presentations I give at Six Sigma Healthcare conferences).
    Thats’ some stuff in a nutshell.  Feel free to contact me at [email protected]

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    #60816

    LJ
    Participant

    Thanks for a great foundation- as usual, my thesis advisor wants me to “focus” and also come up with some original research- I now manage the disease and case management dept of a medicaid managed care co. The hardest part of initiating any improvements is the “culture of change” for a lack of better terminology. I would like to do some research- maybe a questionnaire to hospital staff (possibly QA nurses) to see whether six sigma has been successful in changing that culture over x period of time. The second possibility would be to see if success in 6S projects coorelates to patient satisfaction.
    I would appreciate input on either of these ideas or another direction that might be better to go in.
    thanks to all, LJ   

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    #60817

    Brit
    Participant

    The culture change would be easiest to address in my mind via a questionnaire. In our case, it would be harder to pinpoint general patient satisfaction because of the other efforts going on to address that specifically.  One area that all hospitals deal with is patient waiting time/throughput, which Six Sigma has been used successfully to address. you could correlate between wait time satisfaction for hospitals who have 6sig and ones who do not (as long as those that do have it have had proejcts dealing with patient throughput).  As far as culture chnage, the biggest 2 are making data-based decisions compared to emotional ones and the teaming aspect.  Good luck and again, consider me a resource. I all for research inthis area!

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    #60818

    Michael Marx
    Participant

    The iSixSigma Blogosphere is a good source for information on Six Sigma in healthcare.  One of the bloggers, Andrew Hillig, writes about Six Sigma from a healthcare perspective.  He has insight into the “culture of change” that you mention.  Good luck with the thesis.

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    #60827

    LJ
    Participant

    I was thinking of adapting the Baldrige National Quality Program assessment tool (Are we Making Progress?)as the basis for determining the success of a change in quality culture in a healthcare organization. Has anyone used this tool or know of a better one? I haven’t found any prior research specifically in this are although the blogs of Andre Hilliq have been helpful to my understanding. Thanks for your help.

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    #60836

    Brit
    Participant

    Baldridge has a healthcare section – by the way

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    #60837

    LJ
    Participant

    I know- I have the Baldrige healthcare section- I also have the Alliance for Healthcare Research’s “Organizational Change Processes in High Performing Organziations: In- Depth Case Studies with Health Care Facilities”- which shows that the studergroup is a change agent for the hospitals and why and how it was successful or not successful- the criteria would be increases in patient satisfaction, increases in employee satisfaction, improvements on quality indicators, financial growth indicators, and reduction in employee turnover… what I am trying to research is the same study premise( similar)  but with six sigma-I would appreciate help from blackbelt/greenbelts who are with healthcare organizations that have implemented six sigma to assist me in the study…Are there similar studies already done on six sigma? Thank you for your time and help…LJ     

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    #60838

    Brit
    Participant

    I think your efforts would be valuable to a number of organizations – particularly ones like ASQ.  I haven’t seen anything comprehensive on how many Healthcare organizations are using six sigma and the effectiveness of the process.  I know I hear 10% of hospitals a lot, but haven’t seen studies done as of yet.  I hear alot while speaking at conferences, but don’t really kow for sure how it is working globally.  It works great for me and my hospital, but more could be learned.  Feel free to use me as a resource – I will help if I can.

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