Quality and Safety in Health Care, Part XCV: Sensemaking.

Many times in high reliability organizations, there is uncertainty about the meaning of various happenings or circumstances. Unfortunately, in an emergency, there is often no time to fully investigate events or what is going on in the environment before action must be taken to avoid unfortunate results or disaster. In groups, sensemaking refers to the process of interrelating with others so that a shared understanding may be reached, taking advantage of the differing observations, expertise, and opinions of the people involved, and then taking appropriate action.

Quality and Safety in Healthcare, Part XCIV: Six Sigma and Lean Six Sigma in Health Care.

For existing goods or services, Six Sigma uses the steps of DMAIC and the statistical analysis of data to decrease variation and errors, improve the value of an organization's outputs to the customers, and increase the profitability of the organization. In health care, in view of the training required and other issues, Six Sigma is best used for large complex problems, although it has also been applied successfully to smaller issues. Many examples of the use of Six Sigma and Lean Six Sigma in health care are reviewed.

Quality and Safety in Healthcare, Part XCIII: Design for Six Sigma and Lean Six Sigma.

Design for Six Sigma (DFSS) is used to design new outputs such as manufactured products or to design new processes. The steps in DFSS are define, measure, analyze, design, and verify. Many sophisticated statistical tools are often used.

Quality and Safety in Healthcare, Part XCII: Introduction to Six Sigma.

Six Sigma is a methodology to diminish variation and errors and improve efficiency, quality, value, and profit, using certain defined steps and statistical analysis. For existing products and services, the DMAIC (Define, Measure, Analyze, Improve, and Control) acronym is used to stand for its steps. For new products and services, the Design for Six Sigma methodology is used.

Quality and Safety in Healthcare, Part XCI: Lean Thinking in Healthcare.

Lean thinking refers to the thought processes utilizing the main characteristics of Lean to improve processes, reduce waste, and increase value to the customer. Lean thinking can be used to improve health care organizations using such tools as the A3 form, root-cause analysis, value stream maps, Gemba walks, kaizen events, and defining standard work. Examples are given about how Lean thinking improved scheduling and productivity, as well as better compliance regarding core measures and adherence to best practices.