Overview

In recent years, Six Sigma has moved beyond its manufacturing roots and caught the attention of corporate leaders in other sectors, including healthcare. It is not hard to see why. Six Sigma is fundamentally a set of tools to address problems of process quality and consistency. In the hospital environment, process consistency is critical to the quality of care delivered, and in the new era of public disclosure, documented quality of care is critical to a hospital's reputation.

The core of Six Sigma is the Define, Measure, Analyze, Improve, Control methodology (DMAIC) and its associated toolkit. DMAIC offers a structured approach to identify and resolve problems as well as prevent their recurrence. The tools include both qualitative and quantitative techniques to identify, measure, and control. Through DMAIC and the tool set, Six Sigma enables its practitioners to attack specific problems of process consistency and process control.

The effective deployment of Six Sigma tools, however, is not easy. There are difficult challenges, often overlooked, that have much more to do with the complexities of advanced management process than with the technical application of the tools. Six Sigma is one of many tools that Thomas Group applies within its Process Value Management methodology and like any successful initiative the selection of the right tool is imperative for maximum results.

Core questions to address when applying Six Sigma include:

• How to select and rank the problems to be worked on in terms of their broader impact on the hospital enterprise?
• How is it possible to ensure that these limited, specialized resources are applied to achieve the greatest benefit for the total organization?
• Since the highest leverage opportunities cut across department and other boundaries, how can we align the priorities and resources of different groups to tackle these problems, particularly when many of these groups have a poor history of collaboration?

Six Sigma provides a strong technical toolkit for problem analysis, but does not provide any hints on the best ways to change the way people think and behave. An implicit assumption is that, once a problem has been analyzed and understood, the solution will be obvious to everyone. Unfortunately, solutions to the highest leverage problems usually require significant changes in behavior and even in the way people think about their jobs. Six Sigma provides no tools for this purpose.

Six Sigma books and courses tend to focus on tools and methods for implementers, not for senior managers or executives. Yet senior management involvement is critical to maximizing the benefits from Six Sigma. What is the right role for senior managers?

Organizations that achieve less than outstanding results from their Six Sigma initiatives have usually failed to deal with some or all of these challenges. Those that succeed do so because they have put in place an effective Change Management Framework that goes beyond the nuts and bolts tools of Six Sigma in addressing these issues.