Fast Tracking Improvements Through Six Sigma

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Standardization and Quality

How many times have we flown in an airplane knowing who the pilot and co-pilot are? Even without knowing, we are fairly confident that the crew are well trained and will get us to our destination. The reason for our well-placed trust is that all pilots are well trained and can be interchangeable without having any impact on the outcome. Could we say the same about surgeons? It is very likely that we would check the reputation of the surgeon/hospital before undergoing surgery. This is, in essence, one of the key issues facing healthcare today. How can we standardize the process and provide seamless service so that every patient gets the right treatment the first time, every time?

Quality and Healthcare: Are They a Good Fit?

In an effort to fast track improvements in healthcare, the industry is looking for answers in areas such as aviation and nuclear energy, among other highly-reliable industries. There is a lot that can be learned from these industries to mitigate risks in healthcare through the use of Six Sigma and Lean to achieve quality control and quality improvement, as well as process management and process improvement.

For example, in the 1950s aviation was not as safe as it is today. In the last 50 years, commercial aviation-related fatalities have reduced over 80 percent, even while the passenger volumes have increased substantially. The key success factors for aviation include relentless pursuit of safety, building countermeasures to error that could result in unintended consequences (Helmrich coined the phrase "Error Troika" for the countermeasures, namely error avoidance, error trapping and error mitigation), collecting and analyzing data from accidents or near-misses and looking at problem as a system issue rather than a people issue.

Quality and Healthcare: Successes and Challenges Explored

The healthcare industry has been successful in delivering consistent high-quality care in some areas. For example, anesthesiology in elective surgeries and radiology has been successful in delivering consistent reliable care. However, it has been difficult to spread this process excellence and continuous improvement to other areas such as trauma surgeries.

There are several factors that make the spread of standardized care in healthcare difficult, if not impossible. For example, the variability in patient condition/disease; variability in treatment options; and stress placed on the health care provider such as staff shortage, fatigue, operating in a culture of blame and fear of mal-practice suits all slow down the pace of change. These issues make quality management and quality control difficult.

The Six Sigma Factor

How can Six Sigma help healthcare become another high-reliability organization like aviation and civilian nuclear industry? In the simplest terms, Six Sigma’s goal is the reduction of variance. One way to reduce variance is to standardize care. How can we ensure that every health care provider delivers quality care, where the patient is no longer worried about who the provider is, just like the passenger in the plane who is not worried about who the pilot is? We will explore this in detail in forthcoming articles.