Keywords

evidence-based management, health care, Lean, quality, Six Sigma

 

Authors

  1. DelliFraine, Jami L. PhD
  2. Langabeer, James R. II PhD
  3. Nembhard, Ingrid M. PhD

Abstract

Background: Popular quality improvement tools such as Six Sigma and Lean Systems (SS/L) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether these 2 quality improvement tools actually improve health care quality.

 

Methods: The authors conducted a comprehensive literature review to assess the empirical evidence relating SS/L to improved clinical outcomes, processes of care, and financial performance of health care organizations.

 

Results: The authors identified 177 articles on SS/L published in the last 10 years. However, only 34 of them reported any outcomes of the SS/L projects studied, and less than one-third of these articles included statistical analyses to test for significant changes in outcomes.

 

Conclusions: This review demonstrates that there are significant gaps in the SS/L health care quality improvement literature and very weak evidence that SS/L improve health care quality.