The system has six themes:
● Customer (patient) focus ● Data driven ● Process emphasis ● Proactive management ● Boundaryless collaboration ● Aim for perfection; tolerate failure.
The first three themes are similar to other quality management programs. The focus is on the object of the service; in nursing’s case, this is the patient. Data provide the evidence of results, and the emphasis is on the processes used in the system.
The latter three themes, however, differ from other programs. Management is actively involved and boundaries are breached (e.g., the disconnect between departments). More radically, Six Sigma tolerates failure (a necessary condition for creativity) while striving for perfection.
Lean Six Sigma Lean Six Sigma focuses on improving process flow and eliminating waste. Waste occurs when the organization provides more resources than are required. Data driven, Lean Six Sigma focuses on identifying steps that have little or no value to the care and cause unnecessary delays. Further- more, the method strives to eliminate variations in care and improve efficiencies and effective- ness. Because the goal of Lean Six Sigma is to identify and reduce waste, it provides tools that can be used with a Six Sigma management system.
Studies have shown Lean Six Sigma to be effective in reducing inappropriate hospital stays, improving the quality of care and reducing costs at the same time (Yamamoto et al., 2010).
74 PART 1 • UNDERSTANDING NURSING MANAGEMENT AND ORGANIZATIONS
In addition, when the method was used in one hospital, researchers found that a collaborative effort improved the care of inpatient diabetic patients (Niemeijer et al., 2010).
DMAIC Method DMAIC is a Six-Sigma process improvement method (as shown in Figure 6-2). Steps in the method are:
● Define what measures will indicate success ● Measure baseline performance ● Analyze results ● Improve performance ● Control and sustain performance (DMAIC Tools: Six Sigma Training Tools, 2011)
TQM, CQI, Six Sigma, Lean Six Sigma, and DMAIC are quantifiable systems that measure performance against set standards. The goal is to improve the quality of health care. In addition, other efforts to improve the quality of care are ongoing.