Sunday, 18 April 2010

Lean and Six Sigma in Healthcare?

I was asked the other day about the differences between lean and six sigma. Whilst attempting to explain, it dawned on me that we unconsciously morph the two. To us they are just both names, labels.

When for example we’re problem solving using the A3 approach we often, without thinking about it, employ so called six sigma approaches. DMAIC and A3 are one and the same to us really.

We were once invited to conduct a review of a Trust’s lean implementation as they felt that they were not gaining enough traction across their organisation.

On this occasion, because it was appropriate, we actually employed the Six Sigma approach to conduct a review on lean implementation!!!!

Incidentally, the review revealed that this Trust were very early adopters of lean thinking in healthcare, and were employing the rapid improvement event (RIE) approach. In fact it transpired that over a period of three years they had conducted 86 RIEs although they didn’t actually know that they had done so many.

Upon further investigation it turned out that these 86 RIEs had consumed £1.9 million in people hours and yet had only achieved 10% of the planned deliverables.

A lesson learnt about the RIE approach there.

The interesting thing that has become apparent to us, is that whilst A3 thinking is currently very much in vogue, most of the ‘lean experts’ now adopting it have not been trained in the basic problem solving quality tools to really get to the deep causes of the problems that they are trying to solve.

So having stopped in my tracks whilst attempting to answer this question the other day, all I could really say is that lean and six sigma complement each other perfectly, and not to get hung up on the labels.


  1. Hi - great to see you gents blogging and posting videos!

    I think it's not always true that Lean and Six Sigma blend perfectly. It depends on the method behind the label. If "Six Sigma" for a hospital means that experts dive in and fix everything, that staff members aren't engaged in improvement... and and you try to use real Lean (engaging staff in daily kaizen) then those methods might really conflict.

    Again, glad to see you blogging!

  2. Hey Mark

    Great to hear from you - it’s been a while.

    Absolutely agree that if the six sigma approach, for a given hospital or organisation, involved so called experts diving in and attempting to fix everything without staff engagement that would be at odds with ‘true’ lean.

    However if this were to happen, as you know, that would not be ‘true’ six sigma. This would also apply if the reverse were to happen.

    I guess the point here is that if both (or either) approaches are indeed ‘true’ ie really solving problems in the appropriate time frame, we should not get hung up on the label as long as it works for the organisation, hospital, staff and most importantly the patient.