Factors in the Path From Lean to Patient Safety: Six Sigma, Goal Specificity and Responsiveness Capability

Abstract

The purpose of this study is to clarify the impact of lean on patient safety outcomes in hospitals. This article develops a path model for improving patient safety that includes lean, Six Sigma, goal specificity, and responsiveness capabilities. Structural equation modeling is used to test the model, using survey data from more than 215 U.S. hospitals. Results indicate that although lean doesn't impact patient safety directly, it plays an important role in encouraging Six Sigma implementation and raising goal specificity in hospital units. Responsiveness capability is found to be the key variable in translating Six Sigma, goal specificity, and ultimately lean into improved patient safety. Positive patient safety outcomes are largely attributed to increases in patient responsiveness, while Six Sigma and goal specificity influenced by lean implementation serve as the valuable venue of responsiveness. The results provide support for the notion that the information gained from lean and Six Sigma projects must be geared toward customer requirements and used as a means of responding quickly to patient needs. The results contribute to the operations literature by clarifying the role of lean by coupling it with Six Sigma and goal specificity. The interrelationships of these initiatives have not been adequately explored, and limited research discusses their combined effectiveness in healthcare.

• goal setting
• healthcare
• lean
• patient safety
• responsiveness capability
• Six Sigma

Additional information

Notes on contributors

Kathleen L. McFadden

Kathleen L. McFadden is a professor of operations management at Northern Illinois University. Her research interests are in the area of healthcare operations, aviation safety, quality management, and process improvement. Her research has been published in leading academic journals, including the Journal of Operations Management, International Journal of Operations and Production Management, International Journal of Production Research, International Journal of Production Economics, Quality Management Journal, and Health Care Management Review. She has worked as a consultant and contract researcher for the Federal Aviation Administration, and has served as an expert witness. McFadden can be reached at [email protected].

Jung Young Lee

Jung Young Lee is an assistant professor of operations management at Northern Illinois University. Her research interests include product and process innovation, supply chain management, supplier selection, knowledge management, and quality management. Her research has been published in leading academic journals including Production and Operations Management, International Journal of Production Research, and Quality Management Journal. Young Lee can be reached at [email protected].

Charles Gowen

Charles R. Gowen III is a professor of management at Northern Illinois University. His current research interests are in quality, healthcare, and strategic management. He has published in several leading journals, such as the Journal of Operations Management, International Journal of Operations and Production Management, Quality Management Journal, International Journal of Production Research, Health Care Management Review, and Journal of High Technology Management Research. He has worked in operations management at Eastman Kodak Company, in commercial credit at Bank One (now JPMorgan Chase), and in consulting for Fortune 100 companies. Gowen can be contacted at [email protected].