At the last Institute for Healthcare Improvement conference, Don Berwick asked attendees to recommit to measurement, statistics and evidence. But from looking at the hundreds of poster presentations, I can tell you that most teams are still using line, bar and pie charts with an occasional trendline to tell their improvement story.

As the author of Lean Six Sigma for Hospitals and the QI Macros, I can tell you it's not that hard to draw a control chart, histogram or Pareto chart and start to understand the clinical and operational processes in a hospital. And it doesn't take weeks or months to do the analysis; you can do it in an hour or two.

As we all know, Six Sigma is easy; people are hard, but ZERO HARM is the new target for healthcare. To get there will take a willingness to embrace the few key tools required to improve healthcare.

Eston, what nice work with the write up. You've nicely captured some of the challenges we face in healthcare.

To our colleague above, well said on many points. The zero harm target makes for a great talking point that we all strive for. I would respectfully disagree with the ease you seem to feel the defect reduction associated with Six Sigma occurs. Charts of all sorts are easy to make and yet that is not the heart of the process.

Glad to hear about the challenge and setting this goal that is easy to endorse, would respectfully add that following our progress toward it, knowing whether we are sustaining our efforts, and knowing when (and whether) to intervene requires a rigorous understanding of how our process performs rather than just how we feel about it. I would add that a great system is built on the fire to achieve zero harm and the rigorous data collection and evaluation that lets us know when we've gotten there and / or that we need to do more.

I also agree: zero harm is the goal and would add we are making progress in healthcare in that we can see the goal. That's a start. The next layer, I think, is to continue to embrace data driven framing of our goal and this is not often done yet in our field to the level seen in other realms. Last, Lean and Six Sigma are, unfortunately, not easily deployed or executed well in healthcare that I've ever seen...but are very worthwhile when they are as they can unlock incredible improvements.

Curious: given your obvious expertise with Lean and Six Sigma tools, how do you feel about the rise of Big Data in Healthcare and where have you seen it used for quality? Do you see it as more valuable to discover counter intuitive solutions than our typical Six Sigma tools?