Thursday, September 25, 2008
One of my former students asked me if she should discontinue her plans to seek Six Sigma training and I answered no. There's still value in understanding the concepts and theories underlying Six Sigma and in certain restricted corners of a business, Six Sigma could be the best tool for addressing process improvement. But I retain the opinion that there are few, if any, of those corners in healthcare and it is a methodology which, if broadly applied in any business, will squeeze agility and innovation to death.
Monday, September 22, 2008
Six Sigma is appropriate if your organization:
- Is in a low volatility industry. Stated otherwise, the business state of the market is relatively stable; innovation is less important than consistent delivery on the status quo; competition is minimal; and consumer demand for better products and/or lower prices is low.
- Can focus on quality at the expense of schedule and production volumes, in the delivery of its products and services.
- Produces products and services in an environment which is readily measurable, i.e., the variables in the equation of “Quality” for those products and services can be quantified with reasonable accuracy and consistency
Healthcare, I would argue, is not an industry which fits any of these criteria. Nay, few if any industries or markets fit these criteria today.
There are many reasons for Motorola’s fall from grace, but it is more than simple coincidence that Six Sigma was once its crown jewel. I had the great opportunity to work with Motorola as a customer of their products while I was in the Air Force in the 1980s. During that period, innovation and agility were less important across all industries than they are today. At that time, TQM, CQI, and ISO were focusing on quality, repeatability, and execution. Motorola was relatively innovative, but they were better known for highly reliable, cost effective products, and their execution on commitments. At about this same time frame, Motorola started to embrace the notion of Six Sigma for eliminating virtually all defects in their products. As an Air Force information systems officer, reliability of my equipment was paramount, so I was clearly impressed by and supportive of Motorola’s intentions.
Fast forward to the mid-1990’s when I was a small-time consultant to Motorola on their Iridium project. Ignoring the flaws in Iridium’s business model, such as the failure to account for the loss of telecommunications tax revenue in countries which benefited from land-line communications and eventually cell phone towers, the Iridium project gave me a thin-slice insight into a larger problem at Motorola—the Six Sigma process was squeezing agility, and subsequently innovation, to death. Fast forward once again to today and we see a Motorola that has, in fact, been squeezed to death. The agility and innovation of their competitors are like pythons, slowly crushing the culture of this once great company, and has Motorola crying for a buy-out. Other early champions and adopters of Six Sigma are showing the same fate—Allied Signal, Honeywell, Jaguar, Sun Microsystems, et al. I would argue that GE, Motorola’s Six Sigma protégé, is floating the same river.
I recently visited the “official” Six Sigma web site and found it proudly proclaiming “1,176 slides” available for DMAIC training for only $99. I didn’t know if I should laugh or shake my head in sad appall. Any process improvement methodology which allows for that degree of largesse, needs to recursively turn its own processes back on itself. In stark contrast, I’ve seen the tenets of the Toyota Production System and Lean process improvement taught to a group of nurses with no manufacturing background in as few as 20 slides in the morning, and those same nurses applying Lean to their own departments later in the afternoon.
Don’t make healthcare worse by rushing to the popular cliff of Six Sigma…. Unless, of course, you’ve equated it to Lean and then I would encourage you to normalize your vocabulary to standards. :-)
This article in the Washington Post describes the increased presence of Russian nuclear-armed submarines off the coast of the US, reflectin...
The following comment was posted on the Mr HISTalk web site, in response to my earlier blog about interoperability: "Dale, why hasn’...
I was searching through some files today, looking for something else, when I came upon this. It's my "CIO Watch List" from Nov...
Population health isn’t as complex or novel an idea as some people make it out to be. We're wringing our hands and making it more comp...