Contrasting continuous quality improvement, Six Sigma, and lean management for enhanced outcomes in US hospitals
- 19 October 2012
- journal article
- research article
- Published by Emerald in American Journal of Business
- Vol. 27 (2), 133-153
- https://doi.org/10.1108/19355181211274442
Abstract
Purpose: Rapidly rising healthcare costs, partially due to preventable medical errors, have led hospitals to redouble their process improvement (PI) efforts. The purpose of this paper is to examine how PI initiatives mediate the effect of medical error sources to enhance three hospital outcomes (patient safety, operational effectiveness, and competitiveness).Design/methodology/approach: Drawing from Dynamic Capabilities Theory, the authors develop a framework to explore three PI initiatives: Continuous Quality Improvement (CQI), Six Sigma Initiatives (SSI), and Lean Management Initiatives (LMI). Hierarchical regression analysis is employed to test the proposed model, using data from a nationwide survey of 210 US hospitals.Findings: For enhancing patient safety outcomes, it was found that CQI and LMI were significant in mediating hospital error sources; however, SSI was not significant after accounting for the other two PI types. For improving organizational effectiveness, CQI and SSI were significant; whereas LMI was not significant over and above the other two PI types. Finally, only SSI was significant for superior sustainable competitive advantage.Research limitations/implications: The paper provides insight into which PI initiatives were most effective for various hospital outcomes. The findings can benefit healthcare practitioners as they select among different PI programs for enhancing healthcare results. Limitations of the study include the use of perceptual measures, relatively small sample size, and potential alternate relationships relevant to the outcome variables.Originality/value: This is the first study to explore the mediating effects of three PI programs for the impact of medical errors on each of three hospital outcomes.Keywords
This publication has 81 references indexed in Scilit:
- Untangling Dynamic and Operational Capabilities: Strategy for the (N)ever‐Changing WorldStrategic Management Journal, 2011
- Reduction of Regulated Medical Waste Using Lean Sigma Results in Financial Gains for HospitalAnesthesiology Clinics, 2011
- The Current State of Lean Implementation in Health CareQuality Management in Health Care, 2010
- Lean Six Sigma in Health Care and the Challenge of Implementation of Six Sigma Methodologies at a Veterans Affairs Medical CenterQuality Management in Health Care, 2010
- Assessing the Evidence of Six Sigma and Lean in the Health Care IndustryQuality Management in Health Care, 2010
- The patient safety chain: Transformational leadership's effect on patient safety culture, initiatives, and outcomesJournal of Operations Management, 2009
- The evolving theory of quality management: The role of Six SigmaJournal of Operations Management, 2008
- Six Sigma engages physicians in achieving strategic performance improvement at OSF Saint Francis Medical CenterGlobal Business and Organizational Excellence, 2008
- Exploring the efficacy of healthcare quality practices, employee commitment, and employee controlJournal of Operations Management, 2005
- Five Years After To Err Is HumanJama-Journal Of The American Medical Association, 2005