Is there any record of a state utilizing Lean and Six Sigma to institute reform and improve efficiency of their healthcare system? I am reading a lot of this methodology being applied to healthcare system in hospitals or healthcare organizations. Loo

Is there any record of a state utilizing Lean and Six Sigma to institute reform and improve efficiency of their healthcare system? I am reading a lot of this methodology being applied to healthcare system in hospitals or healthcare organizations. Looking for information on it being applied to an all encompassing state healthcare delivery system.