Operation Improvement is the historic approach that's been successful in the engineering industry over several decades. The health care industry have recently adopted this by using the Six Sigma and Lean concepts which are inherent to both operational as well as clinical improvements.

For health care the old stragegy of quality assurance was our attempt at improvement. Now with more scientific, evidence-based methodologies, we have seen major successes in the health care arena.

My recommendation is that they should be integrated and not seperate. Integration eliminates the waste (lean) in the processes and is best practice for resource management. Integration also allows for transparency and sharing of data/information which is key for any improvement or action plan - you're only as good as your data.

Integration also reduces opportunity for silos which is a hindrance to improvement operationally or clinically.

I almost always see six sigma and lean used in the same sentence. But how many hospitals really use the lean process.

Our OE Department is comprised of Six Sigma Master Black belts and Black belts. We also have Green Belts deployed throughout the org assigned to their regular duties. All managers are expected to complete Yellow Belt raining at the minimum to be well versed in Lean and Six Sigma terms, methods, ect. Our Management Engineers are in a separate department but frequently work side by side with OE on clinical projects. They are also an integral member at our weekly briefings for Finance and Quality. They typically work in tandem and report out at a monthly Six Sigma meeting to Seniour Management.

Two years ago we hired industrial engineers into our Quality department; consolidate training around Six Sigma & lean principals and imbedded project management services inside of the Quality division. It was been a great success, the clinical team has more support and we are achieveing our targets.

Our Quality and Performace improvement dept is integrated and report to the CMO.Not sure i see it being effective any other way. Where it ulimately report may be up for debate but not integration.

We are integrating our PI specialists into our clinical services and performance improvement projects. I think it helps provide structure and time frames. They can also serve as links between clinical teams/projects since they are involved.