In November 2018, Physician’s Weekly published an article about quality improvement initiatives, and addressed why they can be hard to implement in clinical settings (specifically, according to the article, it’s hard to identify process improvement opportunities when you’re too close to the process).

The author explores a few strategies for making process improvement as easy as possible – including blueprints for sketching out a detailed DMAIC plan – and focuses on quick wins and low-hanging fruit (to avoid the constraints of implementation time and associated costs).

But what if a clinic wanted to create bigger change? Significant improvement? What’s the process for that? And where should a clinic start?

It Starts with Physicians… and What They’re Taught

“… physicians need to be the voice of improvement.”

Those words belong to Idalene “Idie” Kesner, Dean of the Kelley School of Business at Indiana University and the Frank P. Popoff Chair of Strategic Management.

In 2013, the Kelley School launched the Business of Medicine Physician MBA Program, and after five years, its physician graduates are helping reduce waste and improve quality in health systems across the country.

“Kelley physician MBA graduates leave our program better doctors,” Kesner said in a press release, “because they think differently about the industry. They are visionary leaders who are optimistic about the future of health care because they have the tools to make change happen.”

The Kelley School has carefully constructed a business-focused curriculum for its physician students. Part of the curriculum includes a course in Lean Six Sigma, centered around reducing the defects and overall waste in healthcare processes, and there are many students who put those lessons to use right away.

Dr. Tom Gardner, one of the program’s graduates, used the Lean Six Sigma curriculum to reduce the time investment for one specific procedure from 100+ minutes down to 29 minutes – all without sacrificing the quality of care he provided to his patients.

“You can make unbelievable differences with fairly small changes,” he said.

Like Dr. Tom Gardner, Physicians at the University of Chicago discovered the power of Lean Six Sigma and other process improvement tools. And they’ve used those tools to dramatically improve the patient experience in their organizations.

Dr. David Dickerson, chairman of the University of Chicago Pain Stewardship Program, helped spearhead a system to combat the drug overdose epidemic in his area. He employed a Plan-Do-Study-Act model to create a new screening process for patients. The process identified patients who were at a high risk for drug overdoses and helped physicians usher those patients down a more practical care pathway.

It’s a safer system for patients, and a more efficient system for physicians.

If You’re Not a Doctor, What Are the Next Steps?

Gaining buy-in is one of the trickiest aspects of change. If you’re not a physician or a decision-maker in your clinical setting, it may be difficult to propose meaningful, sweeping changes to existing processes.

But, if you’re curious in pursuing physician-driven process improvement, there is a system you can use to gain the necessary buy-in. When you pitch your ideas to physician leaders in your organization, you should…

  • Know what they want – What they really Answer how you can connect process improvement to the strategic goals of the organization.
  • Explain the process – Reference specific Lean Six Sigma tools and demonstrate how they’d improve the organization. Use examples from other healthcare organizations who have successfully implemented Lean Six Sigma practices.
  • Know who influences them – Sometimes leadership is change-resistant. If this is the case in your organization, you can make headway by appealing to the influencers, instead of the decision-makers. If you can convince someone with persuasion power, it’s almost as good as persuading the leadership yourself.

Without the support of leadership, even the most passionate and educated employees cannot implement sustainable change.