Lean-Six Sigma for Healthcare: A Senior Leader Guide to Improving Cost and Throughput, by Chip Caldwell, Jim Brexler, and Tom Gillem, Milwaukee, Wis: ASQ Quality Press, 2005. 195 pages (a floppy disk), hardcover, $50.00
The 3 authors of this book make some good points early in the work. First, this volume is directed at the organization's senior leadership, those executives who have decision-making authority covering not just a division or department but the entire organization. As the authors argue, "the elements of lean thinking and Six Sigma can be driven only by the senior leaders of the organization."1(pxx) Second, they point out the futility in commonly observed attempts to use the Lean-Six Sigma approach in a tactical manner, rather than strategically. They emphasize that their purpose in the present endeavor is strategic. They immediately got this reviewer's attention with this approach.
The work has a lot to recommend it. It is relatively short, with 9 chapters. No space is wasted-each chapter is packed with substantive instructions and directions. Each chapter has an array of support materials, including electronically available checklists and tools, recommended learning sessions, references, and recommended additional readings. A Web site is identified in connection with the list of accessible checklists and tools.
As if that were not enough, the volume includes a CD. The contents of the CD are organized with reference to (1) the roles taken by senior leaders and their consulting Black Belts, quality professionals, and educators; (2) the focus of or question confronting these participants; and (3) book chapters.
Despite their strategic orientation, the writers have provided some tactical help to the reader in the form of little icons. A light bulb icon signals the reader to slow down and digest the highlighted concept. A little hammer tells the reader that there is a relevant reader-accessible tool that can be found in the appendices, the CD, or online.
Chapters 2, 3, 7, and 8 address, respectively, cost and waste; the application of such quality management methods as the define-measure-analyze-improve-control (DMAIC) method, the plan-do-check-act (PDCA) method, and the 100 Day Workout; engaging the medical staff in the program; and an illustrative case study of a real-world major institution-the Morton Plant Hospital. Chapter 2 contains an extremely helpful model or script of a learning session for a 1-hour meeting of directors and managers. The 4 appendices would be extremely helpful to a senior management team. They contain sample documents and worksheets drawn from Lean-Six Sigma, DMAIC, and PDCA sources.
Chip Caldwell, president of Chip Caldwell {&} Associates and former president of HCA Atlanta Health Systems, specializes in the strategic deployment of quality improvement initiatives in health care organizations. Jim Brexler's background includes several senior executive posts in large health care systems. He is now the chief executive officer of Erlanger Health System of Chattanooga, Tenn. Tom Gillem brings to the work a background in journalism, media, and public relations, editing, and developing quality and process-improvement methodologies.
In fact, this book is a marvel of organization. While the authors hold that it is not intended as a "how-to" book, even senior leaders focusing on strategic issues and organization-wide change sometimes could use some practical help. They can get it here. This work can be recommended to anyone who is involved in the development and long-range implementation of a quality management system in a health care setting.
Jean Gayton Carroll, PhD, Editor
Quality Management in Health Care, Chicago, Ill
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