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Lean Six Sigma and QAPI: Complementary Initiatives to Improve Quality

Lean six sigma is a perfect methodology to comply with the upcoming CMS mandate for QAPI (Quality Assurance and Process Improvement). By combining a rigorous, resident-centered, project-based process improvement philosophy with existing quality assurance program data, providers can not only meet CMS regulations, but also put in place a program that will generate true value for residents by focusing on improving quality and reducing waste in the pursuit of excellence.

Lean Six Sigma and The Five Elements of QAPI

Element 1: Design and Scope

Lean six sigma programs, by design, encompass an entire organization. Indeed, to be successful, lean philosophy must become ingrained in the organization’s core leadership and mission. Providers must commit to relentlessly eliminating waste by practicing continuous, systematic improvement. By promoting a culture of improvement and developing people to understand and create more value in their work, lean six sigma programs also help ensure “everyone is on board.”

Element 2: Governance and Leadership

QAPI requires that the governing body and administration commit both in writing and in practice to a culture of quality improvement and excellence. A lean six sigma program starts with acceptance and promotion by the governance structure and is most successful with active administrative support. Lean six sigma takes leadership a step further and commits to a method of problem solving that respects people and creates lasting value in pursuit of the organization’s mission.

Element 3: Feedback, Data System, and Monitoring

Built on the principle of continuous improvement, lean six sigma programs provide a rich framework to monitor quality, measure improvements, and maintain gains. By focusing on data, lean six sigma is primed for compliance with QAPI. Further, by creating systems of quality and cultures of active participation and respect, lean six sigma can help organizations move quickly beyond traditional nursing metrics and look at value creation opportunities in dining, marketing, and ancillary services.

Element 4: Performance Improvement Projects

By integrating Six Sigma project discipline, improvement activities will already by organized into measured, documented projects in compliance with CMS standards. While lean six sigma promotes continuous improvement, most focused activities are completed in projects, either through a DMAIC process or with A3 thinking, meaning organizations will be well prepared to demonstrate effective improvement project outcomes.

Element 5: Systemic Analysis and Systemic Action

Lean six sigma culture, through documented quality improvement, ensures an organization strives forward. As hospitals and health systems look more and more to partner with organizations that can prove their value, a lean six sigma base provides hard data on organizational excellence. Further, the program allows organizations to quickly attack any problem area with a focused, universal improvement discipline, increasing teamwork across functional silos and generating a stronger sense of togetherness across the organization.

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