Research Paper on Maximizing Efficiency Through Lean & Six Sigma Business Strategies

Introduction

A variety of business management strategies for improving the performance of organizations have been developed by improving the procedures in which they undergo their work. Lean and Six Sigma are among the strategies which aim at implementing improvement processes through coordinating a set of principles and practices of promoting greater efficiency and effectiveness with fewer errors (Schweikhart, & Dembe, 2009). These improvement strategies evolved from their original application in manufacturing firms and extended to other firms such as software development, health care delivery, and construction and laboratory sciences. This research aims at discussing in detail improving patient outcomes through the use of Lean and Six Sigma philosophies.

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The Lean Approach

Lean is also called Lean enterprise, Lean production, and Lean thinking, which involves a set of principles, methods, and practices for designing, improving, and managing processes (Tagge et at., 2017). The development of Lean was facilitated by Taiichi Ohno's articulation of the Toyota production system. Ohno's aim was to improve efficiency by eliminating some wastes which absorb time and resources but do not add value. The kind of wastes include mistakes that need ratification, movement of people or material without a purpose, unneeded process steps, and creation of services that are not required by end consumers.

The Six Sigma Approach

Six Sigma resembles Lean, and it's a business management strategy aimed at improving the quality and efficiency of operational processes (Zhu et al., 2018). As Lean focuses on identifying ways to improve processes and reduce waste, Six Sigma, on the other hand, aims at making the processes more uniform and precise by applying statistical methods. Bill Smith of Motorola was the original developer of Six Sigma in 1986 as a way of eliminating defects in manufacturing, where a defect was viewed as a process or product that fails to meet consumers' requirements and expectations. The Six Sigma is further defined as the quality level to the near-perfect defect rate of 3.4 defects in every million opportunities.

Improving Patient Outcomes by Use of Lean/Six Sigma

Lean approaches have facilitated workflow processes as healthcare organizations have empowered front line workers to improve quality and efficiency (Tagge et at., 2017). The results of Lean and Six Sigma approaches have significantly helped in reducing monitoring time for patients and medication delivery. Healthcare organizations have sought to target idle inventories, time, confusion, and processing by these approaches. Lean approaches have aimed at removing the seven non-valued added activities, which are; wasted inventory, wasted motion, rework, and waste from processing, waste from transport, and overproduction and underproduction. In improving patient outcomes, three factors to put into consideration by the Healthcare organizations were raised by Lean, and Six Sigma approaches. First, the healthcare organizations to identify the waste in their daily activities and assess the significance of the waste on the bottom line. Second, healthcare organizations to be willing to change and adopt the quality improvement process. Lastly, the third factor is healthcare organizations to clearly identify the problem in their operations and communicate those problems in order to make change happen.

In the late 1980s, health care organizations, especially large scale health firms, began to adopt and study industrial quality management methods, including Total Quality Management (TQM) and Continuous Quality Improvement (CQI) approaches (Schweikhart, & Dembe, 2009). The early applications primarily focused on establishing programs and infrastructures to be used in measuring quality and enhancement of organizational culture, which surrounds quality issues. Some hospitals adopted TQM methods to implement the improvement process and redesigning, both clinical and non-clinical workflows. An example of TQM interventions includes the formation of cross-disciplinary committees to improve and examine work processes, training of employees as a way of identifying quality improvement opportunities, and the use of statistical application methods for process improvement.

Under the banner of CQI and TQM, health care organizations started to evaluate and implement changes to a variety of care practices. For example, the health organizations selected basic laboratory, medical records, admitting and discharge, pharmacy, material report service, and housekeeping were relocated to patient care areas as a way of improving organizational efficiency. Applying TQM principles, health organizations restructured their processes in order to make sure that the care of patients is focused. One of the TQM application, the turnaround reports of radiology was improved through revising workflow to future electronic signature, which was achieved by elimination of a trainee signature, radiologists, structured reports, accelerated transcription, faster film delivery to reading desk, and training on the importance of radiology reports for clinical decision making. Many health organizations were inspired by TQM and established a broad and more focus on patient quality measurement systems, which included patient questionnaire, appraisal performance, infection rate surveillance, patient monitoring reports, and quality and appropriateness reviews.

Although TQM approaches become wide common on health care organizations during the 1990s, many authorities expressed reservations and skepticism about their effectiveness and the ultimate effect on improving patient outcomes and health care delivery (Zhu et al., 2018). Several critics characterized TQM as an indistinct fad and vague, with little tangible content. Other studies claimed that whether or not health care organizations adopted TQM had little effect on various outcomes of care for patients receiving coronary artery bypass graft surgery. Lean and Six Sigma emerged from a fertile environment that was created by TQM. The recent application of Lean and Sigma in health care organizations attempt to improve on previous experiences with TQM through making delivery of projects more discrete and measurable, retain a strong patient focus, quantify results, and attempt to deliver quality improvements within a designated time frame.

Since 2000, there have been a number of projects applying Lean and Six Sigma strategies to health care organizations for quality improvement (Lee et al., 2018). For example, pilot programs utilized the Lean approach at Intermountain Healthcare, which resulted in a substantial reduction in turnaround time for pathologist reports from an anatomical pathology lab. Other Lean facilitations at Intermountain Healthcare included reducing the time needed to perform glucose and checks on patients, reducing IV in pharmacy, and streamlining electronic payment for large vendor accounts. Several Lean applications were also instituted at a Dutch hospital, which resulted in the reduction of complexity of hiring part-time clinical staff, optimizing operation rooms which were scheduled by designing new pre-surgical admission process for patients and developing a new work plan system for completion of equipment maintenance requests. The U.K.'s National Health System also adopted most of the Lean strategies, which included; redesigning the number of steps inpatient care and hence time efficiency.

Conclusion

Lean and Six Sigma processes improvement approaches are well suited in helping healthcare organizations to achieve their goals of patient improvements in clinical and non-clinical practices. Through these approaches, many healthcare organization has been able to identify wastes in their processes for quality improvements. Although the Lean and Six Sigma approaches were initially been adopted in the manufacturing industries, healthcare organizations have majorly adopted them with a view of achieving their organizational goals of patient satisfaction.

References

Lee, J. Y., McFadden, K. L., & Gowen III, C. R. (2018). Exploratory analysis for Lean and Six Sigma implementation in hospitals: Together is better?. Health care management review, 43(3), 182-192.

Schweikhart, S. A., & Dembe, A. E. (2009, October). The applicability of Lean and Six Sigma techniques to clinical and translational research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835466/

Tagge, E. P., Thirumoorthi, A. S., Lenart, J., Garberoglio, C., & Mitchell, K. W. (2017). Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology. Journal of pediatric surgery, 52(6), 1040-1044.

Zhu, Q., Johnson, S., & Sarkis, J. (2018, January). Lean six sigma and environmental sustainability: a hospital perspective. In Supply Chain Forum: An International Journal (Vol. 19, No. 1, pp. 25-41). Taylor & Francis.