Factors critical to the success of a Six-Sigma quality program in an Australian hospital

Abstract

While there is substantial evidence from manufacturing industries, there is limited empirical evidence demonstrating the relationship between factors associated with a Six-Sigma quality program and the performance of organisations in the health sector. In this paper we examine this relationship, drawing on data obtained from the Royal Victorian Eye & Ear Hospital. The hospital is an acute tertiary teaching hospital based in East Melbourne, Victoria, Australia. While the hospital's quality improvement approach was not founded on Six Sigma, the improvement method adopted has many common elements of the Six-Sigma Methodology DMAIC – Define, Measure, Analyse, Improve and Control. Data were collected using questionnaires to examine the relationship between the factors of the hospital's quality program and performance. For the purposes of the study, the performance of the hospital is defined as equitable and timely access into the clinical services of emergency, outpatients and surgery and the appropriate safe and timely discharge back to the community. The questionnaires were able to provide responses showing the relationship between structures, behaviours and outcomes. There are gaps between what the respondents expect as being a necessary part of a quality program and the actual results in the hospital. A number of factors that comprise the quality program are significantly associated with the hospital's performance. The CEO and executive of the hospital have determined that the questionnaires will be adopted and administered regularly. The executive noted that a number of factors showed the actual performance was close to the performance expected by the managers. This was in agreement with the prevailing view and supported by data from the performance measures. On the basis of the results an extension of the hospital's regular training course has been agreed on and will be conducted throughout all levels of the hospital. This is aimed at closing the gaps indicated in the results. The hospital will use the questionnaires in benchmarking with other like hospitals, in particular partners in its international benchmarking project.