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Quality Management in Healthcare

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This paper is a description of the Six Sigma strategy of quality management and its levels. The paper also discusses the impact Six Sigma can have on TQM/CQI in US healthcare if it is adopted as a quality management tool.

Quality management ensures that firms are able to meet their obligations to the customers, even as they seek to realize their business goals in an environment that is considered competitive. One of the widely applied management strategies in the contemporary businesses world is the Six Sigma model. It aims at improving the quality of process outputs through elimination of defects and processes which are defective. The strategy involves the identification and removal or minimization of the causes of errors or defects and variability in the manufacturing and business processes. Six Sigma model has gained wide prominence in the management of the various business because of its characteristic of using statistical methods. Its prominence is also partly because of its use of special infrastructure in which people are divided into groups within an organization. Such groups are assigned particular processes. That assumes, the special infrastructure elements divide employees in Black Belts and Green Belts. This paper describes the Six Sigma strategy of management, its levels, and how it can impact the Total Quality Management/Continuous Improvement processes on the USs healthcare if it were adopted.

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The Concept of Six Sigma and its Levels

Six Sigma strategy of management is a methodological approach that encompasses a process of continuous improvement through systematic, factual, and scientific based approach to issues of manufacturing and service provision. The purpose of the strategy is to eliminate unproductive steps by focusing on new measurements and application of technology to aid in the improvement. The first methodology is the DMAIC, which includes the definition, measurement, analysis, improvement, and control of processes. Second methodology is the DMADV, which includes the definition, measurement, analysis, designing, and verification of processes in order to improve the system that is used to develop new products or processes at different levels. Each of these methodologies has six quality levels that must be achieved in order to attain the anticipated improvement. The levels are executed by Six Sigma Black Belts and Green Belts and are overseen by the Six Sigma Black Belts (Fallon, Begun, & Riley, 2013).

One of the levels of Six Sigma strategy is the control chart level. It helps to monitor variance of processes in a given time and enables the firm to be aware of any unexpected variation in performance which is likely to cause defects. For instance, in a healthcare, dispensation of medicines by pharmacists can be done through the use of control chart level. It can help physicians to follow the process through which they dispense the prescribed medicines and ensure that patients are getting the exact medicines prescribed to them. The next level is defect measurement. It helps to account for the frequency of defects that cause lapses in service quality. An example is the evaluation of drug manufacturers in the health industry to ensure that medicines that are manufactured have the exact composition as is required. The frequency of defects as captured in defect measurement will assist health care providers to determine where the problem might be emanating from in case their patients are not healed after they finish their doses (Fallon, Begun, & Riley, 2013).

On the other hand, the Pareto diagram level focuses on problems or efforts which can yield the greatest potential improvement by revealing the relative frequency in a downward graph. At this level, the implementation of Six Sigma is based on the Pareto principle that 20 percent of the defects can cause up to 80 percent of the problems. For example, a failure in one of the departments in the healthcare service provider, e.g., in the procurement department, could cause a failure of the service delivery in an entire institution.

The process mapping level describes how things are done. It enables the participants to visualize the whole process. This assists in the identification of strong, as well as weak areas for personalized improvements. The importance of this level is that it reduces the cycle time of improvement implementation and defect while, at the same time, supporting the value of individual contributions of the affected area (Rocha-Lona, Garza-Reyes, & Kumar, 2013).

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The next step is the root cause analysis which seeks to establish the original reason for non-conformance with a definite process. The supposition is that the removal or correction of the root cause will result into the elimination of non-conformance in a process. The last process in Six Sigma strategy involves the statistical process control. It entails the application of statistics in analyzing the data, monitoring, and studying the process capability with a view of recommending improved ways. For instance, in a health institution, statistical process control could be applied by looking at the number of return patients who are suffering from malaria and establish why they do not get treated in their first visits. This may include looking at all sides, including the medical aspect, as well as administration of drugs for treating malaria. Statistical process control will reveal the level of success that malaria patients achieve when they are treated and, therefore, inform the process of improvement on the quality of service (Cross, 2012).

Impact on TQM/CQI Process on the U.S. Healthcare System if Adopted

TQM, as a management concept, has the main principle of improving the quality of services through conformance to internal requirements. It can be achieved through the reduction of errors in the service delivery, increase customer satisfaction, and streamlining supply chain management. This is mostly done through the improvement of tools of work and ensuring that workers have relevant skills to do their work. If Six Sigma strategies are adopted in the healthcare sector in the US, it will require the processes of TQM to be aligned with the steps of TQM in ensuring that services in healthcare improve. For example, during the root cause analysis, healthcare providers will be required to identify the cause of stalled services in the supply chain. It may be those services that increase the number of days required before certain drugs are delivered to their users. In this case, the root cause analysis will ensure that the streamlining of supply chain management in healthcare institutions is based on evidence provided through analysis and not just on abstract measures. Six Sigma strategies will require the supply chain managers in healthcare institutions to find the cause for inefficient supply chain before recommending actions for improvement of services in their departments (Ross, 2013).

Though the CQI, which is based on the concept of traditional quality methods of assurance, will be implemented, it will not be based on the traditional methods. Rather, it will be based on the defect measurement approach that is useful in getting the frequency at which defects occur in the process. For instance, in healthcare, it is common to change head of department whenever there is a problem in the system. However, the cause of the problem might not even be the personnel working in a certain department, but rather, a defective step in the system. This means that there will be the need for the step to be rectified in order to achieve an improved service delivery in healthcare institutions. Thus, through defect measurement at each step, the Six Sigma will change the traditional quality assurance indicators that are applied in many healthcare institutions with the aim of improving the services in healthcare. Similarly, each level in Six Sigma will require a change in the way healthcare practitioners deliver their services. They will seek to employ a scientific and factual-based approach to problems in the systems rather than the traditional quality assurance approaches that are common in TQM/CQI models of quality management (Mosser & Begun, 2013).


Six Sigma approach is now widely accepted in many industries although it was initially limited to the manufacturing industries where its application started. Service sectors like healthcare can also find a lot of applications in using Six Sigma in improving their services. The Six Sigma application can help eliminating defects in the service based sector like in healthcare. In this case, there is a need to adopt scientific approaches like defect measurement, root cause analysis, statistical process control among others. This will see an improvement of the quality of services being offered by healthcare providers.

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