With the arrival of the Accountable Care Organization and the Patient-Centered Medical Home, physicians face a new challenge. They must assess how they provide healthcare in such a way that they become more valuable to patients, efficient in their clinical practices, and effective to their bottom line.

Enter Lean Six Sigma, which has gotten some notice in the medical field recently.

ACO and PC Medical Home

An Accountable Care Organization, according to this article from Kaiser Health News, is a local healthcare organization and a related group of providers (such as primary care physicians, specialists, and hospitals) that are held accountable for the cost and quality of care delivered to a specific patient population.

According to the U.S. Department of Health and Human Services, a Patient-Centered Medical Home provides relationship-based healthcare focused on providing care to the whole person by connecting with “patients and their families to understand and respect each patient’s unique needs, culture, values, and preferences.”

Both ideas revolve around the concepts of improving outcomes and quality while lowering costs – “producing results not volume.”


According to the October 2012 American Hospital Association Trendwatch report, regardless of whether you use Lean, Six Sigma or another model, there are important steps to improve quality:

  • Identify target areas for quality improvement efforts. To ensure a higher likelihood of success, first determine where you will get the most for your efforts. For example, the Joint Commission developed protocols to prevent wrong-site surgery. “In 2011, organizations following the protocol reported reductions in the proportion of surgical cases in which there was a process-related defect that could result in a wrong procedure.”
  • Determine what processes to adjust to improve outcomes. According to the report, despite safety protocols, there is room for improvement. Point in fact, hand hygiene compliance, thought to be at 70% or higher, was actually less than 50%.
  • Develop and implement effective improvement strategies. Quality gains and cost savings come from well-designed, well-executed strategies.
  • Track and share results. To further quality improvements, track and disseminate successful quality strategies to maximize future success throughout the organization.

Ultimately, healthcare must be about improving and maintaining the health of patients as well as controlling costs through proactive and preventative care, not reactive care.

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