A note on unwanted variation in healthcare

AbstractPurposeInitiatives in the Quality Management area, such as Six Sigma, originating in an industrial context have been applied in a healthcare context. A focus of these initiatives has been on decreasing variation in performance caused by uncontrollable so-called noise factors. To create a product that is insensitive to these factors is the goal of Robust Design Methodology (RDM). The purpose of this paper is to illustrate the applicability of RDM in healthcare, by exploring possible contributions of a RDM practice to increase patient safety.MethodologyThe case study, used as inspiration in this paper, was carried out at a Swedish hospital as a part of an action research project. Data was collected through participation in project meetings/work and by interviews.FindingsVariation is discussed and problematized in a healthcare setting as well as in industry. These discussions target various form such as variation in the care provided based on your place of residence, your gender, or your ethnical background. Variation can also be interpreted as unwanted variations in care depending on varying levels of compliance. This paper shows that RDM can be useful in designing processes in which un-controllable sources of variations do not lead to patient risks.OriginalityThis paper contributes to research on RDM by showing an application in a new context, and to healthcare providers by adapting a practice from RDM to support design of robust and safe healthcare processes.Key words: Robust design methodology, healthcare, Six Sigma, Design for Six Sigm