Authors: Bahadir Inozu, Dan Chauncey, Vicki Kamataris and Charles Mount

Publisher: McGraw-Hill – 319 pages

Book Review by:  Nano Khilnani

This is an excellent, one-of-a-kind book. It is the only book I know of on business that introduces the use of three outstanding management strategies – Lean, Six Sigma and Constraints Management – to maximize customer (and patient or client) satisfaction, minimize cost, and boost employee morale.

Applied to healthcare, this integrated approach having the three components named above, and already being used in U.S. hospitals, helps managers identify the top problems in a given organization, analyze them, and provide effective solutions that have been proven to be successful elsewhere.

As some of you may know, the Six Sigma system originated in the 1970s. It applied to manufacturing and business processes. Its goal was to minimize defects in products as well as to apply high standards in other business operations so that a company would have higher revenues and lower costs, without sacrificing certain requirements.

In manufacturing the Six Sigma ideal is to have almost zero defects in products (99.99966% of defect-free products) that a company makes, or just 3.4 defects per million products. It utilizes the DMAIC process to maximize product quality and improve company performance.

According to Wikipedia, the DMAIC project methodology has five phases:

  • Define the problem, the voice of the customer, and the project goals, specifically.
  • Measure key aspects of the current process and collect relevant data.
  • Analyze the data to investigate and verify cause-and-effect relationships. Determine what the relationships are, and attempt to ensure that all factors have been considered. Seek out root cause of the defect under investigation.
  • Improve or optimize the current process based upon data analysis using techniques such as design of experiments, poka yoke or mistake proofing, and standard work to create a new, future state process. Set up pilot runs to establish process capability.
  • Control the future state process to ensure that any deviations from target are corrected before they result in defects. Implement control systems such as statistical process control, production boards, visual workplaces, and continuously monitor the process.

The second management strategy – Lean – was probably (I am not sure, I admit) first developed in 2002 by Michael George with the release of his book entitled “Lean Six Sigma: Combining Six Sigma with Lean Speed.”

The Lean system espouses the elimination of the seven kinds of wastes: defects, over-production, transportation, waiting, inventory, motion and over-processing

Michael George was probably also the one who integrated the Lean and the Six Sigma strategies and developed the Lean Six Sigma system. The training for Lean Six Sigma is provided through the belt-based training system similar to that of Six Sigma. The belt recipients are designated as White Belts, Yellow Belts, Green Belts, Black Belts and Master Black Belts.

One of the chief values of any book is the work background and education of the author or authors. Book reviewers look for the experience and achievement levels of the writers to answer the question: what makes these people qualified to write about this field?

In that respect all four authors of this book – Bahadir Inozu, Dan Chauncey, Vicki Kamataris and Charles Mount are qualified to write about how to improve performance in business in general and healthcare in particular. All have at least earned a Black Belt. In addition, some have achieved higher distinctions, as noted below.

Bahadir Inozu, Ph.D., is a Lean Six Sigma Master Belt and Theory of Constraints Jonah. He has over 20 years of experience in performance improvement in government, healthcare, and the maritime fields, as well as in the MRO (maintenance, repair and overhaul) industry. He has led more than 20 major applied research projects and written more than 70 articles and conference papers while he was a professor at the University of New Orleans

Dan Chauncey, MBA, leads a team of five Master Black Belts in mid-level commands across the U.S. Navy. Dan has been directly involved in the development and application of process improvement methodologies for more than twenty years. He has served in the military and has worked at Humana Inc. where he led a structured approach to process improvement in the customer service center.

Vicki Kamataris, RN, is a Lean Six Sigma Master Black Belt and a registered nurse with several certifications, including CPHQ (certified professional in healthcare quality). She has been a Quality Leader for the Corporate Healthcare and Medical Program at General Electric. She has extensive experience in leading interdisciplinary, global teams to achieve extraordinary improvements in a broad range of clinical and business processes.

Capt. Charles Mount has a Lean Six Sigma Black Belt. He has spent 38 years in the U.S. Navy where he helped advance the cause of improving patient care, safety and satisfaction at U.S. military hospitals worldwide, including coordinating the implementation of the Total Quality Management (TQM) program  for 5,000 employees at the U.S. Navy’s largest medical center, in San Diego.

This book discusses how to enhance the patients’ experience and reach their expected outcome, bring down the rising cost of healthcare services, and improve employee performance and Esprit de corps.

The book’s content in over 300 pages is organized in seven chapters. Each chapter’s main focus is outlined in its title, the topics and subtopics are laid out, and discussion on them ensues. A conclusion for the chapter is then presented. This simple chapter organization format makes absorption of the material easier.

The seven chapters deal respectively with: how to improve performance in healthcare; what is the Constraints Management system, what are its applications, and how best to use them; what exactly is the integrated approach (the three-part system introduced at the beginning of this book review), who leads it and how is it deployed, in detail; how to assess the results of that integrated approach; how to plan for deploying the healthcare performance improvement program; how to apply the right tool to the tight problem; and lastly, how sustain the program with oversight, succession planning, mentoring and training.

This book presents a fresh new approach – for the first time using three powerful and proven management strategies – which managers can use to achieve superior performance in their companies, keep a lid on costs, and deliver better service.