Efficient, advanced, and accessible healthcare is one of the essential pillars of any modern society. All the more important is the fact that according to Kumar et al., in all developed nations medical expenditures grow at a rate exceeding GDP growth (z Gowen et al., 2012, p. 134). As a result of this trend, the issue of the effectiveness of healthcare systems has been gaining relevance for years. One of the significant factors associated with higher medical costs is medical errors of various sorts. Process Improvement (PI) initiatives are used to address the issues of medical errors and subsequently optimize medical costs. These initiatives include Continuous Quality Improvement (CQI), Six Sigma Initiatives (SSI), and Lean Management Initiatives (LMI). Each of these approaches has its own set of advantages and disadvantages and can be applied in different scenarios. Specific areas of interest where these initiatives can be employed are patient safety, organizational effectiveness, and competitiveness.
The difference between approaches can be quite considerable. Sollecito and Johnson state that “CQI is an incremental approach toward process improvement and takes an organization-wide systems perspective” (as cited in Gowen et al., 2012, p. 135). CQI implies using the plan, do, check/study, and act (PDCA/PDSA) method, patient satisfaction rates, rewards and recognition system for staff, promotion opportunity, and competitive benchmarking. The employees utilize PDCA/PDSA methods; rewards, recognition, and promotion are deployed to improve performance, while patient satisfaction measures are used for evaluation; finally, competitive benchmarking implies an assessment of processes against other hospitals.
Six Sigma approach is very different, as it focuses on outputs that are critically important for customers and clear financial returns (Evans & Lindsay, 2015). To achieve that, Six Sigma implies constant search and elimination of causes of errors and aberrations in the organization’s processes. Six Sigma approach utilizes such instruments as “define, measure, analyze, improve, and control (DMAIC) process, green belt and/or black belt employee training, statistical process/quality control, project review and closure” (Gowen et al., 2012, p. 135). Regarding the metrics used in SSI, those are quality, productivity, cost, and profitability (Evans & Lindsay, 2015). Green/black belt employee training within SSI revolves around leadership, team building, and statistical techniques as statistical process control is widely applied to assess process variation. Project closure and review are necessary to determine the success of projects and share some of the practices across the company.
Finally, regarding LMI, those include tools such as “process mapping, value stream mapping, Kaizen improvement events, just-in-time (JIT) process management, and “5S” principles” (Gowen et al., 2012, p. 135). The “5S” principles describe five following steps: sorting for necessity, simplifying the workplace, shining for cleanliness, standardizing processes, and sustaining standard processes. Process mapping is used to optimize operations through redesign, if necessary, while value stream mapping helps to visualize the process flow and evaluate its effectiveness. “A Kaizen improvement event consists of defining the problem, analyzing workflows, cycle times, value stream maps, testing improvement alternatives, deploying the selected solution, and reporting out to top management” (Gowen et al., 2012, p. 136). JIT process management optimizes transportation, time, employee actions, and inventories, thus getting rid of the identified waste completely. Overall, it is crucial to understand that as each of the methods uses different tools and has different philosophies, their respective utilities may vary significantly based on the particular area of interest.
References
Evans, J.R., & Lindsay, W.M. (2015). An introduction to Six Sigma & process improvement (2nd ed.). Cengage Learning.
Gowen, C.R., McFadden, K.L., & Settaluri, S. (2012). Contrasting continuous quality improvement, Six Sigma, and lean management for enhanced outcomes in US hospitals. American Journal of Business, 27(2), 133-153. Web.