Introduction
Pioneers in healthcare improvement in the United States have significantly impacted the structure and policies of healthcare systems worldwide. A common philosophy among them was the belief that workplace safety and quality improvement were managerial responsibilities. Their various contributions in the field are still in use, albeit with some improvements and adjustments to fit individual and organizational needs. There are a few notable persons whose contribution is immense and almost universally accepted.
Healthcare Quality Management
Pioneers in Quality
Dr. Walter Shewhart has been credited with developing statistical methods to optimize quality processes in the goods and services sectors. In Shewhart’s theory, there are two categories of variations: “assignable-cause” and “common-cause” variations (Harolds, 2023). His main contribution to the healthcare community was the Shewhart cycle. This cycle merges management procedures with the use of statistical analysis to organize the organization’s operations. The cycle is simplified into four steps: Plan, Do, Check, and Act (PDCA).
Bill Smith formulated the Six Sigma approach from the statistical control field to evaluate a process’s capability. It is a unique method compared to other quality improvement techniques because it focuses on achieving measurable financial returns and commits to making decisions based on data & statistics (Niñerola et al., 2020). There are two main variants of this approach, namely DMAIC and DMADV.
Influence Today
In the healthcare sector, DMAIC is used because the aim is to improve an existing process. The healthcare industry heavily relies on this approach in management operations and control. It has been used to make changes that contribute to continuous quality improvement.
The first stage (Plan) involves evaluating the present process and how it can be improved in various aspects. In this step, the requirements for the results are set in the preliminary stage; then, the result is monitored, and the predictability of the output is increased. The second stage (Do) involves implementing design changes and previous advancements. The Check stage involves measurement and analysis of the procedure or the result. The Act stage is implemented if the results do not meet the set benchmark.
The PDCA procedure is operational in quality management to date. It is used to identify problems, reduce errors, modify existing processes, safeguard cash flows, and reduce waste in the healthcare industry (Tahmer et al., 2021). The five phases of this approach include defining the process and exact requirements, measuring the aspects of the current process (data collection), analyzing the data to confirm cause and effect, improving the current procedure based on statistical data analysis, and controlling the process variables and results to maintain a steady state of improvement.
Future Impact
Shewhart’s PDCA approach can be improved by the “Six Sigma” approach, expanding its use to pharmaceutical manufacturing and reducing defects in healthcare services. The Six Sigma approach has vast applications in the healthcare industry, including reducing human error, lab and department turnaround time, waiting time, and optimizing insurance claim reimbursements (Bhat et al., 2020). A possible improvement to this approach is the 1.5 Sigma shift that accounts for processes that perform well in the short term but do not in the long term. This enables healthcare providers to generate a system review schedule to prevent reversion to a lower-performance state.
Conclusion
In conclusion, these pioneers’ contributions have had a profound positive effect on healthcare quality. The effects have improved patient satisfaction and streamlined many procedures, much to the staff and customers’ liking. Better management and control, as proposed by the two approaches, yield better returns and less wastage. Continuous improvement in these approaches will undoubtedly lead to more optimization of healthcare services in the future.
References
Bhat, S., Antony, J., Gijo, E. V., & Cudney, E. A. (2020). Lean Six Sigma for the healthcare sector: a multiple case study analysis from the Indian context. International Journal of Quality & Reliability Management, 37(1), 90-111.
Harolds, J. A. (2023). Quality and safety in healthcare, part XC: the A3 approach and lean in healthcare. Clinical Nuclear Medicine, 48(7), e358-e360.
Niñerola, A., Sánchez-Rebull, M. V., & Hernández-Lara, A. B. (2020). Quality improvement in healthcare: Six Sigma systematic review. Health Policy, 124(4), 438-445.
Tamher, S. D., Rachmawaty, R., & Erika, K. A. (2021). The effectiveness of Plan Do Check Act (PDCA) method implementation in improving nursing care quality: A systematic review. Enfermería Clínica, 31, S627-S631.