Healthcare ’ s Horizon FROM INCREMENTAL IMPROVEMENT

lizing Six Sigma and related best practices for healthcare quality and process improvement. Providers, however, continue to face a daunting and escalating array of challenges. Regulatory pressures, increased competition, cost management issues, workforce shortages and rising consumerism all vie for attention and remediation. Occupying an increasingly prominent place on the healthcare executive’s radar screen are issues involving clinical quality and patient safety. Instances of overuse, underuse and misuse of healthcare services have been costly to patients, providers and payers. Prompted by illuminating reports from the Institute of Medicine 2 and scrutiny from groups such as Leapfrog, providers are seeking effective methods for both optimizing the care they deliver and documenting the improvements. It is a pivotal moment in the history of medicine—one offering great promise through rapidly advancing technology and tremendous pressure to deliver better care to more people for less cost. At this juncture, then, it seems an appropriate time for reflection—both on the progress made through Six Sigma applications and the realm of opportunities for the future. Drawing from research and organizational experience, we can evaluate achievements and explore the next phase in reshaping the industry.