Managing Quality Improvement in Healthcare
Healthcare providers strive to improve service quality by implementing various quality management programs. Customers tend to seek for higher quality of care when choosing treatments, providers, and health plans. For healthcare organizations that desire to provide high quality care and compete in the global market, choosing a quality management program to implement is critical for performance and efficiency. Many studies have been conducted to analyze the effectiveness of such programs. Lean, Six Sigma and Total Quality Management (TQM) are three programs that will reviewed by three different case studies in efforts to understand them and to compare and contrast their capabilities.
In a qualitative study, Sobek (2011) identifies and articulates the critical success factors and strongest inhibitors to the implementation and sustainability of lean quality management practices within healthcare organizations. The study methodology consisted of a thematic analysis of literature, a cross-case analysis of medical centers that have attempted lean implementation, and a Delphi study conducted by a panel of experts in lean healthcare application. The findings showed that lean has been successful in healthcare and shows much potential. The two strongest success factors were widespread involvement of all key stakeholders and strong leadership support. Emphasis was placed on communication, training, problem solving, and standardizing for increased success with lean procedures. Despite the improvements shown with lean standards in the manufacturing industry, lean healthcare still faces many barriers.
Many healthcare facilities struggle with lean implementation and sustainability because of performance regression, difficulty in process, unrealistic expectations, culture change, time, and funding. The Delphi panel stressed the importance of regular performance measuring to ensure improvements are sustained. When staff understood the reasons behind the changes and how they improved the productivity and quality of care for patients, they were more likely to sustain the implementations. Developing a culture with the appropriate elements to support continuous improvement was seen as vital to see success with the lean methodologies.
A quantitative study conducted by Lifvergren, Gremyr, Hellstrom, Chakhunashvili, and Bergman (2010) analyzed the experiences and from a hospital group during a three-year period after the introduction of Six Sigma. It reports on 22 large Six Sigma improvement projects, their results and influence on other improvement activities. The study shows that 75% of the completed projects reached their goals within 18 months. The average net cost savings per completed project/year was $55,300. Overall, the results showed that Six Sigma is a useful concept when trying to improve healthcare processes. They recommend that Six Sigma should be an addition to the...