Week 4

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▶ Lean and Six Sigma Management Defined

Six Sigma, as its name implies (sigma being the Greek symbol used in statistics to measure variation), utilizes statistical methods to identify and reduce variation in processes (Duffy, Farmer, & Moran, 2009). (See Chapter 4 for a detailed description of types and causes of variability.)

In 1986, when Motorola originated and launched the continuous improvement and innovation effort they called Six Sigma, it was an evolution of quality methods that originated in in the United States and Japan that then further developed at Motorola. The U.S. and Japanese quality leaders, followed by other companies, learned from each other as they further evolved systems of quality management. Ford Motor Company developed mass production systems that Toyota developed further into the Toyota Production System (TPS) through their emphasis on elimination of waste, which they termed muda, muri, and mura (Muda, muri, mura—Toyota production system guide, 2013).

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Muda: Wasting Resources Muda is the waste due to nonvalue-added activities, which was translated back by companies in the United States as elimination of waste in the use of seven resources: transportation, inventory, motion during production, waiting time spent during production, over- processing (by doing more than necessary), over- production (by producing more products or items than needed), and defects, such as producing faulty parts or making mistakes in the process. Often, the focus of the Lean Management System (LMS) in health care is reducing muda, especially with respect to waiting time experienced by patients, mistakes or “near misses” in patient care, transitions in pati