Quality Improvement Programs

A number of quality improvement (QI) programs exist in addition to the Model for
Improvement that is highlighted here. We use the Model for Improvement because we
believe it teaches foundational concepts and skills that are applicable to a wide variety of
settings. It is basic and easy to understand for health care professions students and others.
Organizations often choose one QI program so that there is consistency for faculty, staff, and
learners in the organization. However, you may encounter—or may want to apply—one or
more improvement programs in your health care organization. Each program described
below can be considered the “next generation” of performance improvement, has strengths,
and often has specific terminology.
Six Sigma
• Developed by Motorola and popularized by General Electric
• Goal is to achieve defect-free performance at the level of three or fewer defects per million
(that is, six sigma)
• Five-step problem-solving approach (DMAIC—Define, Measure, Analyze, Improve, Control)
• Certification to designate expertise (Yellow, Green, and Black Belts)
Lean
• Developed by Toyota and known as the Toyota Production System
• Key theory is to reduce waste and increase speed
• Emphasis on work flow and customer orientation
Robust Process Improvement (RPI)
• Developed by The Joint Commission to improve system processes and clinical outcomes
• Blends Lean, Six Sigma, and change management methodologies
• Focuses on building expertise of staff and leadership, embedding tools and methods into
everyday work
• Is key toward moving health care organizations to high reliability