Six Sigma in psychological services

Leandro,
Of course six sigma can be applied to the psychological services area. Let’s start with what your business critical to quality characteristics are. You would know them best. It could be not using restraints or reducing depressions. You then can look at the process you have in place to prevent these things from occuring — and you can standardize and improve this process based on data you collect. Does that make sense? What do you consider to be your most important business issues?
Tony

I’d start with Jack Welch and BillyBob, they seem to be in the most dire need.

Mel, I fully agree your proposed statistical analysis…but just a little remark, ANOVA exists since early 1900 and Six Sigma was coined about 80 years later. Therefore, this analysis is what a competent psychologist was expected to do since 100 years ago. Why do you need to label it as “Six Sigma”? Does it add some credibility to your conclusions? Following this approach, Intelligent Coefficient studies, which I assume are based on Gauss distribution (nearly 300 years old), would be another glory of Six Sigma.
I think Six Sigma is a wonderful innitiative which uses the best statistical methods that were developed in the past, but I believe it is frivolous to name statisticals methods introduced by great men as Gauss, Fisher, Box, etc., as “Six-Sigma statistical approaches”. Gospel, which is even older than Gauss distribution, says…”to Caesar what is Caesar´s…” In my modest opinion, the great merit of Six Sigma is not to invent the Statistical Methods, but to increase the use of them by ordinary engineers.
Regards
Arturo

Arturo,
Excellent response. Thanks.

Arturo –
Well put. Clinical physcologists and bio statisticians have been applying statistics for years.
Best wishes,Eoin

Leandro,
Interesting question. Similar to one I posted over a year ago in this discussion group. I’m a pyschologist working as quality officer for a children’s treatment center. I’ve been introducing the Six Sigma methodology to our quality program for the past year. As Arturo rightly points out, statistics are not new to psychology. Nor is the use of statistics to examine processes, which Deming and Juran advocated sixty years ago. What I find useful is Six Sigma’s project methodology, DMAIC/DMADV, which allows non-professional staff to think about what they do, whether it’s direct treatment of clients or administrative support services, from the standpoint of efficiency and/or effectiveness.
Finally, a short note. You mentioned using the WISC. I’m not sure how you could use this as an outcome measure, as intelligence is not usually amenable to change through therapy. You wouldn’t, for example, expect a client’s WISC score to improve dramatically after treatment, thereby providing you with an objective measure of treatment effectiveness. There are other measures used with kids that do measure changes in functioning, and these could be used for outcomes purposes. However, this WISC is not one of these. For more information, check out the State of California, Department of Mental Health website and look at their section on Performance and Outcome measures. There downloadable instruments, complete with training manuals. These might help you in your clinical work.
And thanks for bringing this issue up (again)!
Dave

in terms of outcomes and treatment it is important to also include in the diagnostic the thing most neglected ; the eating habits which cause the neurotransmitters to malfunction. This is the major error in contemporary mental health delivery systems. Not recognizing the primacy of this messes up the rest of the DMAIC.  And costs a lot more. State tax payers dollars at work here.

David,
Customers faced with excess insurance costs are angered by the inefficient methods of treatment which are employed by state agencies and HMO’s. Historically good nutrition has not been utilized in all age groups as can be easily seen by stats concerning fiber and fresh produce consumption by all ages.. The new work being done with pro and pre biotics(intestinal bacteria) represents the most cutting edge medical breakthroughs of the new millennium. Also the new information concerning toxic metals (like mercury and pesticides) affect many biochemical processes. The information about the effects of Aspartame  and violent behavior as well as weight gain is  of tremendous diagnostic import. Toxic bodies do not want to exercise, or do many activities which would help the life process . This IS environmental. 
 The most irrational thing to me is that the last letter of A.A.’s founder concerning depletion of Vitamin B1 and circulated by his wife after his death has not to this day been acknowledged within the paradigm of delivery services paid by taxpayers in county and state run alcohol  programs. This is an outrage when you consider outcome-based-solutions in terms of the tremendous amount of recidivism following treatment. Check out what Dr. Joan Larson is doing in her Health Recovery Center in MInneapolis if you are interested in neurotransmitters. Or the work of Dr. Jeffrey Bland in Gig Harbor Washington.To me this area is  ripe for Six Sigma  implementation in psychological services. And one which comes in hands down the least expensive.

Cesar,
Sorry for the delay in replying to your post. I’ve been away for a few days. I work at an agency in Southern California, near Los Angeles. As more behavioral health agencies are seeking accreditation, quality management is increasingly a required concern, which is how I got involved in it. I’d be happy to assist you in your efforts in Brazil. Feel free to e-mail me directly if you’d like.