Quality and Six Sigma are often considered as links in a chain. For example, when quality is poor, many times the immediate response is, “Let’s improve it using Six Sigma.” But does Six Sigma, or any other program for that matter, really improve quality? Or, are they simply mirrors to let us know where we are, what we’re doing, and where we’re heading?

If these programs are simply mirrors, then how do we address the issue of doing the work that actually improves quality? Do we use a top-down approach, such as Six Sigma, TQM, TPM, or some other high-tech, jargon-rich program? Or do we use a bottom-up approach like quality circles, motivating the workers, and so forth, at the grass-roots level?

To begin to answer these question, let’s look at two scenarios.

Large corporate hospital

First, consider a quiet, popular, and posh hospital with all the modern amenities, such as a large lounge with a help desk; all the proper credentials, accreditations, and positive customer feedback; and the impressive growth figures that go with it. All of this, of course, is prominently displayed for customers and employees to see.

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