We’ve all heard of Six Sigma. It’s familiar terminology to any healthcare leader focused on quality improvement. Surely, however, there are some of you out there who know only that it is a methodological tool used to recognize variability, prevent error and manage change. How, exactly, does it work? Will understanding it better help you to do a better job? No doubt.
Six Sigma is essential knowledge for any healthcare leader seeking to guide his or her organization toward error-free operation for zero patient harm. This methodological approach to recognizing and reducing error is viewed by some as a framework supporting the high-reliability organization. When Chassin and Loeb first recommended in 2013 that healthcare strive for high reliability, Six Sigma was one of the three process-improvement tools they recommended—along with Lean and Change Management.
Fortunately, ACHE members and nonmembers alike can learn more about Six Sigma in the second edition of High-Reliability Healthcare: Improving Patient Safety and Outcomes with Six Sigma by Robert Barry, PhD; Amy C. Smith, DNP, RN, FACHE; and Clifford E. Brubaker, PhD. As the authors point out in a chapter entitled “Why Six Sigma?”, some healthcare executives don’t need to review this volume. If you lead an organization that “provides error-free care to your patients, your patients are discharged on schedule every time, every patient leaves with a correct financial statement and the proper instructions for at-home care…. Your facility has happy and loyal clientele, your staff has professional satisfaction, and your managers and resources are applied to positive purposes,” then you, most certainly, do not need this book.
If that description doesn’t quite fit you yet, you may want to pick up this reader-friendly text written with the practical needs of the healthcare executive in mind. The book explores and explains how the Six Sigma approach can improve an organization’s output by reducing variability and error, solving problems, managing change and monitoring progress quantitatively. Six Sigma can be put to work to improve your patient outcomes and deliverables, reduce waste, augment profits and boost employee morale.
One of the keys of Six Sigma is poka-yoke (pronounced po’ kah yo’ kay), which translates from Japanese to “prevention of error by inadvertent action.” The three rules of poka-yoke are:
- Make it easier for the person to do the right thing than the wrong thing.
- Make mistakes obvious to the person immediately.
- Allow the person to take corrective action on the spot.
Six Sigma applies poka-yoke guidelines to task design, provides systematic problem-detection and solving methodologies, and offers a quantitative way to manage change—making it especially applicable to healthcare and the goal to eliminate preventable harm. Six Sigma derives its name from the goal of achieving no more than 3.4 errors per million opportunities. In an industry in which errors can easily mean significant patient or employee injury or worse, Six Sigma is an essential instrument for the healthcare leader’s toolkit.