THE USE AND IMPACT OF SIX SIGMA IN

HEALTHCARE

COMPLETED BY

GROUP D (NOS. 13 – 16)

AZEEZ ABIODUN S.

GODWIN ONAH

VALENTINE O. SULE

ABDULKAREEM OWOLABI

CONTENTS

1
ABSTRACT

SECTION 1 BACKGROUND OF SIX SIGMA IN HEALTHCARE

SECTION 2 BACKGROUND OF SIX SIGMA IN HEALTHCARE

SECTION 3 THEORETICAL BACKGROUND OF SIX SIGMA

SECTION 4 SIX SIGMA METHODOLOGY IN HEALTHCARE

SECTION 5 BENEFITS OF SIX SIGMA PRINCIPLES IN HEALTHCARE

SECTION 6 IMPACT OF SIX SIGMA IN HEALTHCARE

SECTION 7 SIX SIGMA STRATEGIES TO IMPROVE QUALITY HEALTHCARE

SECTION 8 CONCLUSION

ABSTRACT

2
SECTION ONE

3
 BACKGROUND OF SIX SIGMA IN HEALTHCARE

1.0 INTRODUCTION

The aim of every business is to for continuous improvement in effectiveness and

efficiency for the ultimate purpose in achieving the sole missions and goals of the

business in style. The healthcare business is not left out as the healthcare delivery to the

patient(s) is of utmost importance and cannot be relegated to the background.

According to a study by healthcare organization Johns Hopkins Medicine, 10% of all US

deaths are caused by medical error. This connotes a total of 250,000 deaths every year at

a cost of between $187.5 billion and $250 billion to the healthcare industry. (Daniel, M.,

2016).

Consequently, Healthcare organizations are currently facing pressures to improve on the

efficiency of care delivery and quality initiatives. To this end, the application of Total

Quality Management (TQM), Continuous Quality Improvement (CQI), Business

Processes Review (BPR) and Benchmarking have evolved over time with only a few

managing to deliver sustained value improvement to the patient.

The application of Six Sigma to Health has become handy to offer a new lease of life to

patients and workers in Healthcare delivery.

SECTION TWO

THEORETICAL BACKGROUND OF SIX SIGMA

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2.1 INTRODUCTION

Sigma is a Greek letter of the alphabet used to describe variability, or in mathematical

terms, standard deviation. Six sigma offers a way of measuring the performance

capability of existing systems or processes. It is a statistical unit of measure that reflects

the likelihood that an error will occur (Taner M. T. and Gebze B. S., 2007).

Six-sigma relies on rigorous statistical methods, and implements control mechanisms, in

order to tie together quality, cost, process, people, and accountability. It begins with an

understanding of customer requirements, and values (Riebling, 2005). The six-sigma

goal is to reduce both variance and control processes in order to assure compliance with

the critical specifications.

The higher the sigma level, the higher the performance of the healthcare system. For

example, a three-sigma process has a defect rate of 6.7 percent whereas a six-sigma

process has 3.4 defects per million opportunities. An Institute of Medicine (IOM) report

states that deaths attributable to anesthesia have fallen to 5.4 per million, which

approaches five-sigma and added that medical errors are responsible for the deaths of

44,000 to 98,000 hospital patients every year (Bion and Heffner, 2004).

In addition, reducing medical errors can also result in significant financial savings,

reporting that total national costs of preventable medical errors resulting in injury account

for between $17 billion and $29 billion per year. The study noted that preventable

5
 adverse drug reactions can increase average hospitalization costs by $4,700 per admission

(Bion and Heffner, 2004). Also, the average of doctor prescription writing has been

found to be between three and four-sigma (Rudisill and Druley, 2004). These examples

can be improved by means of applying the six-sigma philosophy.

Six Sigma principles have their roots in manufacturing. Lean production was originally

used by the Japanese car manufacturing company Toyota. Since then, these principles

have been adopted and developed by organizations from all industries, including

healthcare, to streamline processes and reduce waste.

The method used to apply Six Sigma principles in an organization is the same as the

method used to diagnose and treat medical conditions. It is built on the idea that

organizational issues should not be dealt with from the boardroom, but instead by

frontline workers who are usually closer to and understand the problems.

In healthcare, rather than senior management making decisions, it is the nurses, doctors

and technicians who are tasked with solving key issues.

2.2 THE NEED FOR SIX SIGMA – INEFFICIENCIES ASSOCIATED WITH

HEALTHCARE

Health care today is a vast web of complexity and contradiction. It offers astounding

advances in technology and treatment, but is often overburdened by inefficiencies, errors,

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resource constraints and other issues that threaten the accessibility and safety of patient

care.

In 1998, the Institute of Medicine released an assessment stating that 98,000 people die

each year as a result of medical errors, highlighting the necessity for quality

improvements (Lazarus and Neely, 2003).

An estimated £400 million is being paid in clinical negligence claims and adverse

incidents resulting in approximately £2 billion per annum (Department of Health, 2001;

Milligan and Robinson, 2003).

Over the past decade, the need and desire for healthcare institutions to operate more

efficiently has been driven largely by financial concerns. With decreasing

reimbursements and the rising cost of labour and supplies, healthcare organizations have

been driven to look inwards to generate savings.

Generally, there are two primary areas to find savings – either through reductions in

labour costs or by reducing the high cost of supplies. With the continuing shortage of

qualified healthcare professionals, registered nurses, registered radiologic technologists

etc., the opportunities to reduce expenses solely by reducing labour costs can play an

important role in causing bottlenecks in healthcare services.

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Today’s health care organizations are complex dynamic systems focusing to improve

quality of care that meets stringent guidelines. Re–examining the method of evaluating

the service performance has become necessary. This would give room to focusing

activities on quality improvements in clinical outcomes, satisfaction and efficiency

(Taner M. T. and Gebze B. S.).

SECTION THREE

SIX SIGMA METHODOLOGY IN HEALTHCARE

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3.1 INTRODUCTION

3.1.1 DMAIC IN SIX SIGMA HEALTHCARE MANAGEMENT

Employing Six Sigma tools in healthcare does not only help to improve quality but helps

to solve healthcare problems. The DMAIC is a five-step improvement cycle with the aim

to continuously reduce errors The DMAIC approach – define, measure, analyse, improve

and control – is a structured problem-solving technique widely popular in business.

DEFINE

First of all, the identity of patients, as well as their needs and wants, will be clearly

defined. In the same vein, the objectives of the process and its capabilities also require

accurate definition.

MEASURE

Moreover, the performance of healthcare, based on the improvements, need to be

measured. Changes or improvements can be measured by the level of patient satisfaction,

service cost, the rate of clinical excellence and so on.

However, data and information collected for measurement should be clear and concise.

ANALYSE

Furthermore, Six Sigma tools should be used to analyse data collected for measurement

to ensure efficiency. The analysis stage may involve complex statistical techniques to

zero in on the actual cause of a quality issue.

IMPROVE

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 During the Improve stage, the entire approach to patient care may need to undergo

several changes and modifications. To track progress, effective monitoring of the

performance of these improvements is an essential component of this stage.

CONTROL

This stage consolidates the gains from previous stages. It may involve the introduction of

new policies, protocols, etc, to ensure that care is provided at the high that has been

achieved throughout the DMAIC processes.

Healthcare providers face a lot of challenges in a bid to deliver outstanding patient care.

Some of these include stiff competition, rising health care costs, lack of access to

information, high patient expectations and advancement in technology among many

others. However, healthcare management can leverage on Six Sigma tools like, FMEA,

DFSS, CAP and others to help them overcome these problems.

3.1.2 FMEA IN SIX SIGMA HEALTHCARE MANAGEMENT

FMEA (failure mode and effects analysis) is a proactive tool embedded within the Six

Sigma method of quality improvement. It enables errors to be detected and prevented

before they occur. Moreover, the primary goal of Six Sigma in healthcare management is

to prevent defects that could be injurious to patients, their families as well as employees.

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 In addition, FMEA can help to identify and eliminate concerns in the early stage of

process development or new service delivery. FMEA is a systematic approach to Six

Sigma in healthcare management. It can be used to continuously check and detect likely

errors in a process. By so doing, management can redesign the process into a new model

that is free from errors. When FMEA is properly executed in the health care system,

patient safety and satisfaction increase.

3.1.3 DFSS IN SIX SIGMA HEALTHCARE MANAGEMENT

Design for Six Sigma (DFSS) is a Six Sigma tool used to design a product or service

from scratch. The most popular design for this method is DMADV (Define, Measure,

Analyze, Design, and Verify).

Like all Six Sigma projects, this approach also requires that the customer requirements

are well defined. The needs of the customers and the competitors should be measured and

determined. The process options should be analyzed and designed in detail to meet the

customer’s needs. Finally, the performance of the design and its ability to meet the needs

of customers must be verified.

3.2 KEY CONCEPTS OF SIX SIGMA IN HEALTHCARE

At its core, six-sigma revolves around the following key concepts:

3.2.1 CRITICAL TO QUALITY

Attributes most important to the patient.

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3.2.2 DEFECT

Failing to deliver what the patient wants. In terms of impact to the patient, a defect in the

delivery of healthcare can range from relatively minor to significant. In a worst-case

scenario, the defect can be fatal, as when a medication error results in the patient’s death.

3.2.3 PROCESS CAPABILITY

What the healthcare process can deliver.

3.2.4 VARIATION

What the patient sees and feels.

3.2.5 STABLE OPERATIONS

Ensuring consistent, predictable processes to improve what the patient sees and feels.

3.2.6 DESIGN FOR SIX SIGMA

Designing to meet patient’s needs and process capability.

SECTION FOUR

BENEFITS OF SIX SIGMA PRINCIPLES IN HEALTHCARE

4.1 INTRODUCTION

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(Chakraborty, S.), advocated that depending on which sector of the world of business

one looks at, other programs in the form of Six Sigma have been implemented (though

have different names) such as TQM (Total Quality Management), Six Sigma,

Breakthrough Management, Lean Transformation, Re – engineering, Operational

Excellence, etc. The heart of these programs have always been targeted at changing the

way business is executed.

In many cases, the benefits, in terms of employee morale and culture, customer

satisfaction and the bottom line have turned elusive. The question is – why is there this

variation in levels of success among adopters of these programs?

The answer lies in the fact that most methodologies offer steps that are necessary to

achieve success; they are neither sufficient nor exhaustive.

(Graves A., 2014), opined that as more and more healthcare practitioners become

increasingly aware of issues around quality of care, Six Sigma in healthcare is becoming

an increasingly popular concept.

Although Six Sigma is a very difficult strategy to master and execute, especially in

healthcare, its pros far outweigh its cons.

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 The benefits that could be adduced in the adoption of a Six Sigma program in Healthcare

– helping to prevent medical errors, reducing mortality rates, decreasing time spent in

hospital, improving patient care and to boosting quality – can also make the difference

between a successful and a failed deployment. The benefits are analyzed as follows:

4.1.1 REDUCTION IN ADMINISTRATIVE COSTS

These principles are also used to help reduce departmental siloes, deliver better safety,

and streamline practices. Not only do these methodologies help reduce healthcare costs

by billions of dollars each year, but they can also be the difference between life and

death.

4.1.2 IMPROVEMENT OF HEALTHCARE PROCESSES

Every business seeks to improve its processes in order to meet and exceed customer

satisfaction. Likewise, in healthcare, the primary focus is on improving patient safety and

satisfaction. The conventional belief that patients will continue to use the same health

care services irrespective of their processes is fast changing.

4.1.3 SETTING QUALITY STANDARDS

Nowadays, patients look out for quality as a requirement choosing a healthcare service.

In addition, patients can make more informed decisions about their treatments based on

their experiences and level of satisfaction. This is where Six Sigma in healthcare plays a

vital role.

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4.1.4 REDUCTION IN THE ERRORS

Six Sigma is a management tool used in organizations to improve business processes by

reducing the likelihood of errors occurring. Six Sigma helps to improve quality of

products and services, customer satisfaction as well as profitability.

4.1.5 IMPROVEMENT IN PATIENT CARE

In healthcare, poor quality (referred to as “defects” in Six Sigma) of care can be a

determining factor between life and death. Defects may range from long waiting time to

wrong diagnosis, prescriptions and treatments. Thus, employing Six Sigma in healthcare

will help improve quality patient care, reduce waste and eliminate these defects.

4.1.6 ENHANCEMENT IN THE MANAGING OF HEALTHCARE PROCEDURES

Besides reducing cost and increasing efficiency, Six Sigma gives healthcare management

an idea on how to manage procedures. These include registering patients, filing claims,

surgeries and transplants that require different processes.

4.1.7 REDUCTION IN VARIATION OF HEALTHCARE PROCESSES

Variation is the enemy of quality. This method of quality improvement helps to reduce

variations in healthcare processes and identify best practices. Also, Six Sigma in

healthcare helps to manage change and achieve substantial improvements to healthcare

processes.

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4.1.8 REDUCTION IN MEDICAL ERRORS AND DEFECTS

Efficiency and safety in healthcare are often crippled by medical errors and defects in

care. However, implementing Six Sigma in health care will help reduce all of these to the

barest minimum. Six Sigma helps hospitals to deliver health care services effectively and

efficiently. This quality improvement methodology leads to less morbidity and mortality.

It also ensures safer patient care, quick service delivery and more coordinated care.

4.1.9 IMPROVEMENT OF PATIENT’S SATISFACTION

In general, Six Sigma improves the levels of patient’s satisfaction. It helps to reduce

patients waiting time, thereby promoting quick service delivery. Besides, Six Sigma helps

to improve patient care by reducing errors caused by clinicians and other staff.

4.1.10 IMPROVEMENT IN TURNAROUND TIME

In addition, the Six Sigma method improves turnaround time of diagnostic laboratories

and other related departments. Similarly, it speeds up the process of insurance claim

reimbursements.

4.1.11 IMPROVED COMMUNICATION AT ALL LEVELS

Six Sigma in healthcare plays an important role in making information easily accessible

to patients. It also ensures that the voice of the patient is central to considerations in

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healthcare services. Ignoring this important voice could lead to lower demand for care.

This may, in turn, lead to huge financial losses.

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 SECTION FIVE

IMPACT OF SIX SIGMA IN HEALTHCARE

5.1 INTRODUCTION

Six Sigma has been used to address many of the most common challenges facing

healthcare, including patient safety, technology optimization, market growth, resource

utilization, length of stay and throughput. In some cases, it has been used to focus on a

specific department or process, and in other cases it has been implemented on an

enterprise-wide basis to achieve a cultural transformation.

The figures in the table below illustrate several healthcare processes by sigma level. They

also illustrate that sometimes being 99 percent effective is just not good enough in

healthcare delivery. And the figures show the value in striving for a Six Sigma level of

excellence, (Pexton, C.).

Sigm Patients with Coding Phone Calls Defects Per Percent

a Misplaced Errors Exceeding Million Yield

Level Personal Requiring the Two Opportunities

Items Corrections Minute on

Hold Limit

3 3,660 770 per day 257 each 66,800 93.32000

everyday day

4 340 everyday 72 per day 24 each day 6,210 99.34900

5 12 everyday 13 per week 5 each week 230 99.97700

6 6 every month 10 per year 3 each year 3.4 99.99966

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5.2 SOME IMPACTS OF SIX SIGMA IN HEALTHCARE

According to (Taner M. T. and Gebze B. S., 2007), some of the impacts of Six Sigma

methodology in healthcare industry are analyzed as follows:

1. Decreasing unnecessary laboratory tests

2. Improving Magnetic Resonance (MR) image quality

3. Decreasing waiting times before surgery

4. Reducing catheter infections

5. Decreasing excess length of stay in hospitals

6. Improved Logistics in Medical Treatment

7. Waste Reduction from Medical Errors

5.2.1 DECREASING UNNECESSARY LABORATORY TESTS

Many blood tests and urinalyses requested in the pediatric and obstetrics-gynecology

wards must be repeated due to procedural errors. The result is delay in getting final

results to the physician and unnecessary costs due to rework. While human error is an

important cause in the majority of cases, important background factors may exist which

need to be understood. These include complexity, exhaustion, distraction, and inadequate

supervision by senior staff.

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5.2.2 IMPROVING MRI IMAGE QUALITY

Many imaging technologies are introduced to the healthcare market each year. These

modalities deliver increased image quality and provide diagnostic confidence to

physicians to more accurately treat patients. However, this is generally achieved only at

considerable additional expense. Redesign for cost and medical management have

become necessary (Taner and Antony, 2000). Six sigma tools can be used in optimizing

design protocols in radiology. In diagnostic imaging, there is always the risk of variation

since the reading may change from observer to observer. By superior imaging techniques,

this problem can be overcome.

5.2.3 DECREASING WAITING TIME BEFORE SURGERY

Patients often register their dissatisfaction while they wait for surgery. From hospital’s

viewpoint, this resulted in wasted resources, increased costs, and additional risk to the

patient. As for the patients, they complain that their time has been wasted, and added that

there has been great inconvenience to the family. Moreover, the protracted anticipation of

surgery has been distressing.

Substantial delay has been found to be due to the laboratory tests to be reported and for

the ECG (Electrocardiogram) unit to become available.

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5.2.4 REDUCING CATHETER INFECTION

Catheter infection has been established to be one of the serious problems that patients

face after surgery. The need to reduce the occurrence of catheter infection has become a

major issue in both the quality improvement and patient safety arenas during the catheter

insertion and maintenance procedures.

This process is also beneficial in identifying various needs: the need for staff to

understand the nature and severity of the problem; a uniform education program for

nurses and physicians; selection of insertion site to reduce infection risk; standards for

aseptic practice during catheter insertion and replacement; standardization of skin-

antisepsis; standardization of sterile attire and compliance with its use.

5.2.5 DECREASING EXCESS LENGTH OF STAY IN HOSPITAL

Medical errors and adverse events in healthcare organizations are mostly common and

many of them are potentially avoidable. In addition to their capacity to harm patients,

these potentially avoidable outcomes can increase the length of stay adding considerably

to economic difficulties of healthcare organizations.

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 It is important that an effective discharge planning be put in place in order to ensure a

smooth transition from hospital to home thereby producing better outcomes for the

patient, and reducing the likelihood of readmission to hospital.

5.2.6 IMPROVED LOGISTICS IN MEDICAL TREATMENT

Hospitals generally think of their offerings as services rather than products. The core

service is patient care. However, the provision of medical treatment and patient care

creates demand for tangible medical and nonmedical products. Although personnel,

nursing, and physician pay accounts for a large portion of a hospital’s operating budget,

yet costs related to inventory, logistics, and administration processes are nevertheless

significant.

(Scheyer, W. L., 1995), (Poulin, E., 2003) and (Jarrett, P. G., 2006) have shown that

30% to 40% of hospital spending is invested in various logistical activities, such that

approximately half of this amount derives from the direct cost of acquiring materials and

services and the other half from the cost of managing them after acquisition. Nowadays,

healthcare providers are seeking to improve their logistics and supply chain management

in order to reduce the current high healthcare cost.

Also, (Jørgensen et al., 2013), (Ferretti et al., 2014) and (Volland et al., 2017) revealed

several focus areas in the healthcare logistics’ studies including logistics activities

22
 (supply and procurement, inventory management, transportation, and distribution and

scheduling), holistic supply chain management, lean logistics, patients’ logistics, and

logistics technology. In the search for ways to improve healthcare logistics, academics

and practitioners have looked into methodologies that have been applied successfully in

other sectors, especially the manufacturing sector in order to replicate same in the

Healthcare sector.

5.2.7 WASTE REDUCTION BY MEDICAL ERRORS IN HEALTHCARE

According to (Graves A., 2014), Six Sigma has a successful history of helping corporate

environments reduce waste, and now these positive impacts have made their way into the

health care industry.

Six Sigma has long been used in a corporate or business environment to streamline

processes and reduce wasteful spending.

Implementing Six Sigma in healthcare facilities can help reduce healthcare costs by

billions of dollars each year. These costs can be decreased significantly by cutting the red

tape, preventing medical mistakes, providing improved patient care and initiating cost-

saving efficiencies.

5.2 COMMON FACTORS IN SIX SIGMA HEALTHCARE SUCCESS AND

FAILURE

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According to (Pexton, C.), the following are some of the common Six Sigma success

factors shared by healthcare organizations:

1. Providing strong leadership involvement and support.

2. Using techniques to promote culture change and break down silos.

3. Selecting the ‘best and brightest’ for Six Sigma leadership.

4. Delivery of project-based training and mentoring for an adequate number of

Green Belts, Black Belts and Master Black Belts.

5. Selecting and scoping projects to achieve financial and quality results.

6. Setting measurable objectives aligned with organizational goals.

7. Establishing clear roles and responsibilities.

8. Over-communicating by a factor of 1,000.

9. Paying attention to the Control phase to maintain results.

10. Including project tracking and reporting capabilities.

11. Stressing accountability and recognizing achievements.

Conversely, some of the factors that have characterized less-successful Six Sigma

deployments are as follows:

1. Lack of leadership support

2. Poor communication

3. Inadequate training and mentoring

4. Projects that have not been clearly defined, and

5. Neglect of the cultural or human side of change

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It is important for any healthcare organization considering or deploying Six Sigma to

recognize that it will not transform the Healthcare System overnight. It requires strategic

vision, diligence, patience and hard work.

First and foremost, the organization must make a clear and unequivocal commitment to

leading the six sigma initiative by providing adequate time, resources and communicating

results. Otherwise, the chances for long-term success will be diminished.

Driving significant, sustainable results in healthcare is not about training, and it is not

even just about the tools. It is about changing the culture and developing enough

experience to know which tool to apply to each issue. Some problems may need the rigor

of Six Sigma, while others may simply be a matter of making a decision – with many

variations in between.

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 SECTION SIX

SIX SIGMA STRATEGIES TO IMPROVE QUALITY HEALTHCARE

6.1 INTRODUCTION

These are determined by system characteristics. Improving levels of patient satisfaction is

very critical to a healthcare organization’s long-term success. To improve patient

satisfaction, healthcare providers must focus on quality improvement strategies. That is,

healthcare professionals must demonstrate attributes consistent with organizational

culture. Six attributes for a quality healthcare system are identified as follows:

1. Safe.

2. Effective.

3. Patient – centred.

4. Timely.

5. Efficient.

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6. Equitable.

Monitoring these attributes is a crucial element of organization’s philosophy and should

be part of the quality improvement initiative. Much effort has in the past and in some

places still is directed at imposing quality rather than concentrating on optimizing the

healthcare system.

Sigma methodology is an optimization tool that focuses on developing and delivering

near-perfect services. It is one of the most powerful performance improvement

methodologies that are changing the face of modern healthcare delivery.

The DNA of the six sigma methodology can be felt while reducing variation that leads to

safer, quicker and more coordinated care, less mortality and morbidity, better response to

needs and better value from resources. Up-to-date, six sigma projects in healthcare

industry have focused on direct care delivery, administrative support and financial

administration (Antony et al., 2006).

(Taner M. T. and Gebze B. S., 2007), asserted that Six sigma projects can be executed

(but not limited to) in the following healthcare processes:

1. Increasing capacity in X-ray rooms;

2. Reducing avoidable emergency admissions;

3. Improving day case performance;

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 4. Improving accuracy of clinical coding;

5. Improving patient satisfaction at Emergency Room (ER);

6. Reducing turnaround time in preparing medical reports;

7. Reducing bottle necks in emergency departments;

8. Reducing cycle time in various inpatient and outpatient diagnostic areas;

9. Reducing number of medical errors and hence enhancing patient safety;

10. Reducing patient falls; reducing errors from high-risk medication;

11. Reducing medication ordering and administration errors;

12. Improving active management of personnel costs;

13. Increasing productivity of healthcare personnel;

14. Increasing accuracy of laboratory results;

15. Increasing accuracy of billing processes and thereby reducing the number of

billing errors;

16. Improving bed availability across various departments in hospitals;

17. Reducing number of post-operative wound infections and related wound

problems;

18. Improving MRI exam scheduling; reducing lost MRI films;

19. Improving turn-around time for pharmacy orders;

20. Improving nurse or pharmacy technician recruitment;

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 21. Improving operation room throughput;

22. Increasing surgical capacity; reducing length of stay in ER; reducing ER

diversions;

23. Improving revenue cycle; reducing inventory levels;

24. Improving patient registration accuracy;

25. Improving employee retention.

Organizations need to improve what they are currently doing as well as changing

operations to what they should be doing, and after measuring the outcomes they should

search for improvements on other new activities. Every improvement requires a change,

either in small scale or in large scale, and every change requires an act of creation

(Sommers, 1998). Patient satisfaction, physician satisfaction, reduced overtime, reduced

patient wait times, increased revenues and an enhanced quality of life for healthcare

personnel are some of the outcomes of moving to the higher sigma level. The goal is to

move from the current state to a future, more productive state.

By means of adopting six-sigma philosophy, the healthcare organization can achieve a

cultural change. This will result to the realization of sustainable bottom – line results in

hospitals. From emergency room to boardroom, six-sigma can reduce variability and

waste by translating to fewer errors, better processes, improved patient care, greater

patient satisfaction rates, and happier, more productive employees.

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 SECTION SEVEN

CONCLUSION

7.1 INTRODUCTION

Application of Six Sigma has increased in healthcare settings over the past 10 years.

However, they still remain largely under-utilized across the industry, particularly in areas

such as triage and post-surgery (Graves A., 2014).

Healthcare industry is still in the early stages of evolution with regard to six-sigma.

Therefore, healthcare personnel should seek guidance for training and implementation by

the support of the top management. Successful execution of simple projects in hospitals

can enable practitioners to tackle tougher initiatives in the future and create clinical

change on a broad scale.

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 Appropriately implemented, Six Sigma clearly produces benefits in terms of better

operational efficiency, cost-effectiveness and higher process quality. In addition, it also

has an impact in clinical areas such as infection control and medication delivery.

The application of six sigma in health care industry will continue to grow as time

progresses.

7.2 RECOMMENDATION

High level of internal communication is also necessary to facilitate the implementation of

Six Sigma.

For Six Sigma to be successful in health care, the following should be put in place:

1. Improved financial resources;

2. Improved human resources;

3. Improved time;

4. Improved leadership skills;

5. Proper training;

6. Proper selection;

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 7. and Reduced Internal resistance.

Six Sigma as an effectiveness and efficiency strategy in the healthcare sector would

enable the delivery of a truly high – class service to patients which would definitely

improve the quality of lives of patients.

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