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Quality Management in Health Care:
doi: 10.1097/QMH.0b013e3181eb140e

Assessing the Evidence of Six Sigma and Lean in the Health Care Industry

DelliFraine, Jami L. PhD; Langabeer, James R. II PhD; Nembhard, Ingrid M. PhD

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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.

©2010Lippincott Williams & Wilkins, Inc.


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