The buzz around Lean Six Sigma at hospitals

You may have heard that Lean Six Sigma is catching on with hospitals and other healthcare providers. This business management strategy specificially addresses process flow and waste issues while focusing on variation and design to promote business and operational excellence. Essentially, Lean Six Sigma helps eliminate defects throughout an organization, which in healthcare can mean preventing medical errors, decreasing mortality rates, reducing lengths of stay, improving patient care, and improving quality.

"Using Six Sigma decreases variation; process outcomes become more predictable and effective. Lean targets the efficiency of processes, decreasing waste and increasing profitability," Marti Beltz, Six Sigma instructor for American Society for Quality and healthcare quality consultant, told FierceHealthcare. "Used together, they produce a synergistic effect not only economically, but also in terms of patient and workforce satisfaction."

Perhaps more importantly, Lean Six Sigma allows hospitals to achieve balance between the seemingly mutually exclusive goals of providing cost-effective, high-quality care. "Other industries struggled with [similar dilemmas] for many years but ultimately discovered that you can indeed have both with the right management and improvement system in place," Charles Hagood, president and founder of Healthcare Performance Partners, told FierceHealthcare.

How does it work in practice? Sometimes, this strategy demonstrates successes in simple ways. "Moving a dressing room out of the imaging room to increase process flow resulted in three times the capacity for mammograms and three times the profits," Beltz said.

And for hospitals interested in concrete return on investment, organizations that have incorporated Lean Six Sigma principles are seeing strong results, Hagood said. For example, a new facility reduced the required square footage by 15 percent while increasing volumes, thereby improving deposit turnaround to 90 percent of all remittances within six hours and increasing the amount of CT scans per day by 22 percent without adding equipment or staff. Plus, some mid-sized hospitals have saved $10 million within two years by using the business management strategy, he added.

So how can other hospitals achieve similar results within their organization? Described as a "full contact sport that you can only learn by getting your hands dirty and 'doing it'," Hagood advised hospital leadership to examine daily management systems and constantly look for waste and variation to eliminate. "Ultimately, the best way to prepare management for executive positions using Lean Six Sigma principles is to create a learn-by-doing environment and to model the approach as the existing leadership leave."

The key to success, according to Beltz, is ensuring that senior management has a solid understanding of Lean Six Sigma's basic concepts, process, and requirements. Only then can the rest of a hospital's workforce deploy these methodologies. "The most successful organizations use a combination of a small group of internal consultative experts and very basic quality training for everyone," she said.

Like any other silver bullet promising a quick and easy fix to a complicated problem, Lean Six Sigma has its own obstacles--namely, physician resistance. "Physicians can be reticent to implement Six Sigma because the methodology has been incorrectly associated with huge resource output, their time specifically," Beltz said.

That's why Hagood warns hospitals about using Lean Six Sigma as a cram down. "If Lean Six Sigma is deployed correctly, [physicians] will see the value and will want to become a part of the equation," he explained. "If the value is seen and the hospital's commitment is evident, in most cases, the physicians will not be resistant over the long term."

Beltz added that hospitals should work to understand the sources of physician resistance, such as valuing intuition over disciplined problem solving to help overcome them. "The most compelling argument to get physicians to try Lean Six Sigma is to help them understand that when stripped down to its roots, Lean Six Sigma is based directly upon the scientific method--a concept well-studied and advocated in medical school," she said.

Although it might not be a cure-all for the industry's woes, hospitals could benefit from such a quality improvement initiative and its effects throughout provider organizations. --Dina

Dina Overland is the editor of FierceHealthPayer, a sister publication of FierceHealthcare.