A Hospital Wide Quality Improvement Program inspired by industrial experiences

Worldwide, healthcare faces tremendous challenges with respect to safety, accessibility and medical quality. Due to more costly treatments and an aging population cost is increasing. Also, customer expectations are rising. New ideas on organising healthcare are needed. Are xperiences from the quality movement in manufacturing and service industries possible to translate to the healthcare context? Will they solve the problem? Even if it is too early to give a definite answer to questions like these we will illustrate efforts in this direction based on an improvement programme at the Skaraborg Hospital Group. The Skaraborg Hospital Group (SkaS) is located in the Western Region of Sweden and serves a population of 260 000. The group consists of four hospitals – the hospitals of Lidköping, Skövde, Mariestad and Falköping. The services offered by SkaS include acute and planned care in a large number of specialities. The strategy of SkaS is to excel at quality development by constantly orientating towards and taking actions to fulfil the needs and expectations of its patients. This strategy requires a mature quality system that combines both incremental and breakthrough improvement initiatives. In 2005 SkaS initiated a Six Sigma initiative in order to reach breakthrough improvement. The aim of the Six Sigma program is to improve outcomes of critical healthcare processes as well as to increase patient safety by systematically looking for and reducing unwanted variation. A lot of projects have been completed with successful results, including for example a warfarin project, reducing haemolysis in blood tests at the emergency ward, lowering the rate of Caesarean sections and lowering HbA1C in patients with diabetes. The systematic problem solving approach DMAIC has been used. In addition to mproving outcomes of the critical healthcare processes, a unique learning process has evolved throughout the organization. It has become evident that in order to be able to improve critical healthcare processes we must understand and control their variation. Findings in this paper are restricted to SkaS. However, it indicates a promising road towards better healthcare utilising concepts and ideas evolved within the quality movement in industry.

کلیدواژه ها:

Healthcare ، variation ، Six Sigma ، change ، learning ، breakthrough improvement