September 30, 2018

six sigma in healthcare

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. six sigma in healthcare

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.

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.

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.

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.

Thus, this article will help readers to:

  • Understand the concept and benefits of Six Sigma in healthcare.
  • Discuss the role of Six Sigma in healthcare management.
  • Draw lessons from contextual Six Sigma healthcare examples.
  • Evaluate the use of Six Sigma in healthcare.

Six Sigma in Healthcare – Benefits and Advantages

Although Six Sigma is a very difficult strategy to master and execute, especially in healthcare, its pros far outweigh its cons. 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.

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.

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.

More benefits of Six Sigma in healthcare…

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.

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.

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 healthcare services. Ignoring this important voice could lead to lower demand for care. This may, in turn, lead to huge financial losses.

Six Sigma methodology – DMAIC

Employing Six Sigma tools in healthcare does not only help to improve quality but helps to solve healthcare problems. The DMAIC approach – define, measure, analyse, improve and control – is a structured problem-solving technique widely popular in business.


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.


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.


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.


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.


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.

Six Sigma in Healthcare Management

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

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.

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.

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, Analyse, Design, 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 analysed 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.

Six Sigma Healthcare Examples

Although Six Sigma is quite new to the healthcare sector, it can be used in a number of medical fields to achieve optimal results. For example, Six Sigma can be used to optimize resources used to operate machines, like MRI, and the scheduling of time for testing equipment. Likewise, Six Sigma can be used to discharge patients faster and to plan a higher priority service for patients.

Six Sigma in healthcare can be used to improve nursing, treatments, hospital support, laboratory, technical and managerial services. A number of Six Sigma healthcare examples exist to buttress this point.

Example 1: $15 million in savings (Stanford Hospital and Clinics)

The Stanford Hospital and Clinics applied Six Sigma to its coronary artery bypass graft operations process and was able to achieve a savings of $15 million every year. In addition, costs were brought down by 40% and mortality rates declined from 7.1% to 3.7% (George and Rago, 2005).

The average incubation time was reduced drastically from 12-16 hours to 4-6 hours while the average time spent in intensive care decreased by 8 hours.

Besides, Stanford Hospital and Clinics deployed more Six Sigma projects, as well as other process improvements, to regulate its purchasing process. They were able to save $25 million annually.

Example 2: Increased capacity (Private hospital in Turkey)

In the historic city of Izmir, located along Turkey’s Aegean coast, a private hospital with advanced technological infrastructure had a high demand for their services. The problem was that they had the capacity to treat 32 patients per day only. They executed a Six Sigma project and the daily patient treatments increased to 64 (Cimen & Deniz, 2016). That was double their capacity without hiring a single additional staff.

Moreover, they reported a decrease in patient waiting time from 2.5 hours to 20 minutes. Treatment start time also decreased from 3-4 months to less than a month. Consequently, by doubling their number of patients, they also increased their profits by 100%.

Example 3: Faster life-saving procedure (non-profit hospital)

Another Six Sigma healthcare example is a large non-profit hospital. The hospital staff struggled to meet the Centre for Medical Services’ (CMS) new standard of 90 minutes from door-to-balloon time in the treatment of ST-segment elevation myocardial infarction.

When the new standards were set in 2006, they were only able to achieve a door-to-balloon time of within 90 minutes by 47% in the third and fourth quarters of that year. They used the Six Sigma DMAIC method and FMEA along with other methods to identify the problem. By so doing, the hospital was able to remove the waste identified and implement necessary measures. Consequently, they achieved a door-to-balloon time within 90 minutes in 73% of their patients.

Example 4: Reduced obstetric waiting time (private hospital in Kuwait)

In a Kuwaiti private hospital, Six Sigma was used in its obstetrics and gynaecology clinic to reduce patient waiting time.

For patients with appointments, waiting time was reduced by 63% on weekdays and 67% on Saturdays. For walk-in patients, the waiting time was reduced by 46% on weekdays and 55% on Saturdays (Alfandi et al, 2019).

The hospital improved patient satisfaction and profitability by improving their process.

Example 5: Saving and making millions of dollars in profits

The Charleston Area Medical Centre applied Six Sigma (Branco, 2012) to its surgical supply chain management and was able to save $1 million. Similarly, Scottsdale Healthcare organization improved its emergency room process with Six Sigma. By so doing, it was able to reduce the time needed to transfer a patient to an inpatient hospital bed and increase profits annually by $1.6 million.

In a Master’s dissertation, Ioannis (2017) reported how Mount Carmel Health System employed Six Sigma project to correct operational defects and business management. By so doing, the health system saved $3.1 million, improved physician and employee satisfaction and increased profits.

More Examples of Six Sigma in Healthcare

One other Six Sigma healthcare example is Rapides Regional Medical Centre. This hospital used Six Sigma methodology to reduce defects in its emergency care unit. As a result, patient waiting time reduced and more patients were attended to. More so, the hospital achieved a yearly savings of $950,000.

Similarly, by employing Six Sigma approach, Valley Baptist Health System was able to reduce surgery cycle time. They also increased their potential annual income by $1.3 million. Also, the hospital expanded its capacity to accommodate 1,100 extra cases of surgery annually.

In addition, The Women and Infants Hospital of Rhode Island also used Six Sigma methods to regulate its techniques for embryo transfer. Their implementation rates increased by 35%.

Furthermore, a not-for-profit healthcare system discovered that it constantly went below national standards in adhering to instructions concerning clinical quality for inpatient heart failure. They employed Six Sigma methods to identify the problem and implement solutions. The observed rate of compliance increased from 45.3% to a minimum of 90%.


In a bid to satisfy patients, healthcare organizations are faced with a lot of issues. For example, the needs and expectations of patients, employee motivation and satisfaction, technological changes, stiff competition and increased healthcare costs. As a result, healthcare organizations are forced to look for effective means that will be beneficial to the organization, staff and patients. This is where Six Sigma comes into play.

Although Six Sigma is a very tedious strategy to implement in healthcare, the benefits far outweigh the risks.

Six Sigma is an effective tool that can help healthcare organizations rely on valid data that may help prevent managers from using personal judgement to make decisions. Thus, Six Sigma in healthcare management will reduce incorrect solutions. It reduces the cost incurred based on false guidance while ensuring accurate decision-making.

Also, Six Sigma encourages teamwork in an organization. Hence, it gives employees a sense of belonging. It makes them active rather than passive and motivates them to help the organization achieve its goals.

Furthermore, Six Sigma in healthcare helps organizations to understand the salient characteristics of patient services that have a high impact on patient satisfaction and loyalty. By so doing, patient’s satisfaction will increase and so will referrals, recommendations and profits.

Moreover, a number successful implementation of Six Sigma in healthcare examples exist to confirm the effectiveness of Six Sigma in health. By embracing Six Sigma methods, many hospitals have saved or made millions of dollars in profits.

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