Tackling all areas at once could make the initiative seem overwhelming and the obstacles to change insurmountable.
During initial phases, a key step involves scoping a project into manageable and measurable segments.
For instance, a large-scale effort to improve the emergency department may break down into several smaller projects targeting specific areas such as admissions, charting, equipment availability and patients leaving without being seen (LWBS).
Such shortcomings must be addressed to achieve system-wide clinical quality improvement.
Medical error reporting: Given a litigious and punitive climate, providers are understandably hesitant to report medical errors.
Perhaps less obvious – and until recently less documented – is the impact it can make in clinical areas such as infection control and medication delivery.
Clinicians are often receptive to Six Sigma given its familiar scientific and evidence-based foundation – adherents, however, must acknowledge the unique nature of patient care delivery requiring some translation of the methodology from manufacturing to medicine.Quality in healthcare has come to mean many things to many stakeholders – from satisfaction with service to the clinical outcome of the patient’s treatment.The most widely accepted definition was stated by the Institute of Medicine in the publication .The IOM defined quality of care as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” The terminology is carefully chosen to include all points along the continuum of care.The IOM also identified three basic quality-of-care issues in medicine: overuse, underuse and misuse.Rather than viewing all factors as equal, it’s important to identify and address critical to quality elements that drive the most variability or defects.In other words, although 15 potential causal factors could impact the safe, timely and appropriate delivery of medication, it may be determined that only three of those factors are responsible for 75 percent of the errors or defects.Defects in any business carry an associated expense, but medical errors also carry significant human costs.And the IOM report estimates that medical errors cost the nation approximately .6 billion each year, with roughly billion of those costs associated with preventable errors.Six Sigma is scalable to organizations of every size and demography and as the results above illustrate, it can be effectively applied to many areas and issues in healthcare, addressing clinical as well as operational challenges.Data collection: One obstacle in bringing Six Sigma to healthcare has been the ability to collect the right data, due to insufficient IT infrastructures and a shortage of resources.