The Science of Quality Improvement.

The manufacturing industry has supplied many quality-improvement methodologies that have been successfully utilized in health-care delivery, such as Plan-Do-Study-Act (PDSA) cycles, Total Quality Management, Six Sigma, and Lean. Many tools of quality improvement, such as PDSA cycles and DMAIC (Design-Measure-Analyze-Improve-Control) of the Six Sigma method, are similar to the scientific method that is familiar to clinicians. Correct identification of the sources and types of process variation within a system is paramount for process improvement. Reduction in process variation via standardization and reinforcement of process protocols leads to improved process outcomes. Quality-improvement projects should define a clear governance structure to maintain project timeliness and completion.