Background: This paper discusses if and how the improvement
sciences of Lean Six Sigma and person-centred approaches can be melded
or blended in the health care context. The discussion highlights the
relationship between each approach to improvement science in terms of
their respective purposes, intentions and probable outcomes; positioning
these as either synergies or divergences. Comparison of the key theoretical
and methodological principles underpinning each approach to improvement
is also considered and implications for future practice, policy and research
are drawn out. The discussion is informed by part of the findings of a realist
review of relevant literature.Conclusions: Lean Six Sigma as a process improvement methodology
appeals to a wide range of stakeholders in healthcare internationally. Four
key synergies and three key divergences between Lean Six Sigma and
person-centred approaches were found. The discussion here highlights the
need for further research into Lean Six Sigma implementation and its
possible contribution to developing person-centred cultures.Impact: Adoption of Lean Six Sigma in health care by stakeholder groups,
external to nursing, has been taking place. At the same time there has been
a loss of Lean’s original intention of respect for people in favour of a
technical efficiency focus on reducing waste and variation. Our findings of
four key synergies and three key divergences between both approaches
indicate where synergies can be maximised and divergence narrowed to
improve implementation and enhance methodological coherence.
Researchers, policy makers and practitioners should be aware that use of
Lean Six Sigma alone may have a limited impact on developing personcentred
care and culture. Use of Lean combined with person-centred
approaches may appeal to a wider range of stakeholders. Yet, their
combined use and effectiveness has not as yet been evaluated.This paper was supported by
Queen Margaret University Edinburgh and
University College Dublinhttps://doi.org/10.3844/ijrnsp.2020.10.2311pubpu