Lean’s strength lies in its set of standard solutions to common problems and its focus on the customer. Lean seeks to prevent suboptimization by its focus on the entire value chain. However, Lean is weak on organizational infrastructure, details, deployment plans, analytical tools, quality improvement, and control.

Six Sigma is deployed by carrying out improvement projects. Project selection is usually based on a translation of the company strategy into operational goals. Six Sigma provides an organizational structure of project leaders and project owners. There are fewer standard solutions but a general analytic framework for problem solving, and an organizational infrastructure is provided.

The ideal solution is to combine the two approaches.

The combination results in something similar to that of good medical practice i.e., relevant information is assembled followed by careful diagnosis. After a thorough diagnosis is completed, a treatment is proposed and implemented. Finally, checks are applied to see if the treatment was effective.

How does this apply to healthcare design? By incorporating an organizational framework and programs for project management, coordination, tracking, and support, the following resource-draining problems can be identified:

• Projects that are not necessarily of strategic relevance;

• Projects that do not always have a significant business case;

• No systematic project-tracking system;

• No uniform methods for project management and control; and

• Too many uncompleted projects.

Lean/ Six Sigma projects in healthcare typically include both medical and administrative problems. Some think healthcare quality improvement methods should address only clinical defects, such as medication errors. Experience is finding that significant gains can be made in patient outcomes by widening the field of applications to all processes and to all operational inefficiency and waste.

This is reason enough to consider applying these principles to healthcare design.