Implementing Six Sigma in The Netherlands

Background: Six Sigma, a process-focused strategy and methodology for business improvement, can be used to improve care processes, eliminate waste, reduce costs, and enhance patient satisfaction. Experience with Six Sigma in The Netherlands: Six Sigma was introduced in 2001 at the 384-bed Red Cross Hospital (Beverwijk). During the Green Belt training, every participant was required to participate in at least one Six Sigma project. The hospital's total savings in 2004 amounted to $1.4 million, for an average savings of $67,000 for each of the completed 21 projects. Three Examples of Successful Projects: In one project, the team designed a new admission process for the operating rooms, resulting in an average starting time nine minutes earlier. This relatively minor improvement made it possible to operate on an additional 400 patients a year and to achieve a net savings of > $273,000. A second project reduced the number of patients receiving intravenous (IV) antibiotics by switching to oral administration, yielding an annual savings, based on medication costs alone, of > $75,000. A third project reduced the length of stay in the delivery room from 11.9 to 3.4 hours, yielding an annual savings of $68,000. The "Ultimate Cure?": Six Sigma, which entails involvement of health care workers; use of improvement tools (from industry); creation of trained project teams to tackle complex, often crossdepartmental processes; data analyses; and investment in quality improvement may prove the "ultimate cure" to the current cost, quality, and safety issues that challenge health care.