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Deploying Six Sigma in a Health Care System as a Work in Progress

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Background: An integrated health care system deployed Six Sigma in four clinical projects. The selected projects targeted Medicare profitability, emergency department cycle time reduction, clinic patient preparation, and medication safety.

Cross-Project Analysis: The six-month start-up period yielded several lessons. For example, the selection and sequence for implementing strategic performance improvement (PI) projects, and the decision to use Six Sigma methods, should be guided by an overall system of project portfolio management.

Implementing Six Sigma: Fairview Health Services (FHS) had begun with a partial deployment with the intent of using the experience to inform subsequent full deployment. Yet even before completing analyses of project outcomes, FHS decided to proceed with full deployment. Leaders developed strategic and communication plans, allocated resources, and provided for further training. In 2005, three years after the initial implementation period, Six Sigma implementation has continued. A systemwide method for setting priorities for PI projects is in place, supported by a Web-based system for managing, tracking, monitoring, and communicating results.

Final Reflections: Cultural change is a challenge in any environment where staff is rooted in a single PI methodology and is skeptical about the credibility of Six Sigma because of its tie to manufacturing. Health care organizations will need to find better ways to engage physicians, especially community physicians whose patients and clinical practices could be affected by Six Sigma projects.

Document Type: Research Article

Publication date: November 1, 2005

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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