NUR 630 Week 4: CLC-Quality Models

NUR 630 Week 4: CLC-Quality Models

Assessment Description

The purpose of this assignment is to examine quality models used in health care.

Create a 1000 to 1200 word essay on Lean, Six Sigma, and 5S quality models. Include the following in your paper:

  1. A description of each quality model.
  2. A brief history of each quality model.
  3. A description and examples of how each quality model can be applied to the health care setting.

Use a minimum of four peer-reviewed, scholarly references as evidence.



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Sample Research Paper : CLC Quality Models

In a well-functioning practice, health care organizations should be continually involved in care quality improvement. They should regularly analyze their performance and improve where necessary by integrating the essential change. For better outcomes and to make informed decisions, health care organizations should apply quality improvement (QI) models to enhance performance. QI models help providers collect and analyze data as the basis for testing change (American Academy of Family Physicians (AAFP), 2022). They guide the improvement process by providing a systematic, formal approach to achieving better results. The purpose of this paper is to describe the quality models, a brief history of each model, and their application in health care settings.

NUR 630 Week 4: CLC-Quality Models
NUR 630 Week 4 CLC-Quality Models


Lean, Six Sigma, and 5S Quality Models

The lean quality model is among the dominant quality improvement models. It applies lean ideas in health care facilities through an ongoing system of improvement whose primary objective is to eliminate waste in health care processes, procedures, and tasks (AAFP, 2022; Ramori et al., 2021). Implementing the lean quality model requires health care professionals to incessantly identify waste areas and ensure that everything reducing patient value is eliminated. Mechanisms to reduce waste include minimizing overproduction, decreasing patient movement, and reducing waiting time. Efficiency should dominate all processes.

The Six Sigma model shares some features with the lean model, but their general approach to quality improvement differs profoundly. Unlike the lean model, which focuses on eliminating waste, the Six Sigma model is metrics-driven, primarily focusing on reducing medical errors and removing defects that hamper care quality (Pyzdek, 2021). Its central tenet is that care quality varies inversely with the number of defects. As a result, removing such defects to a significant statistical measure is critical to improving performance proportionately. Other objectives include optimizing operations and increasing patient value like the lean model. From a health dimension, defects represent activities or processes associated with poor quality of care.

Besides health care processes, the health of the nursing staff and the condition of the work environment affect care quality. Shahali et al. (2019) described the 5S quality model as a structured approach for improving a health care facility’s work environment. To improve the work environment, health care providers utilize the 5S defining elements, including sorting, implying removing unnecessary materials in the care environment, and setting in order, which is the orderly arrangement of materials in the work environment. Other concepts include shine (maintaining cleanliness), standardizing processes, and sustaining the sorted workplace to maintain a quality culture. Implementing the effective and simple model transforms the work environment from a physical to a functional space.

A Brief History of Each Model

The lean model is more than half a century old. The model originated in the automotive industry in the mid-1950s, where motor companies such as Toyota applied it to make the manufacturing process more efficient (Ramori et al., 2021). Efficiency was achieved by reducing waste in the manufacturing process as much as possible. Over time, the model was adopted in management and health care sectors to standardize processes and improve efficiency. Health care providers apply the model to enhance care quality by striving to achieve maximum output using the least resources possible.

The Six Sigma model also started in the manufacturing sector before adoption in other industries. Its primary objective was to address process defects to optimize productivity in companies like Generic Electric (Agency for Healthcare Research and Quality (AHRQ), 2020). Due to its effectiveness in reducing defects, the health care industry adopted the model to guide defects-free processes. The health care industry achieves the outcomes of Six Sigma by applying detection methods and analytical tools to identify process variations and address the identified defects appropriately.

Like the lean approach and the Six Sigma quality models, the genesis of the 5S quality model can be traced to the manufacturing industry. According to Shahali et al. (2019), the 5S quality model started in the manufacturing sector in Japan before its adoption in the western world. Its success in the manufacturing sector fuelled its adoption in the health care industry to help health care professionals to organize and standardize the work environment. Through the 5S model, the workplace is kept neat and unnecessary stuff removed. Order is also maintained, optimizing safety, a critical component of quality health care.

Application to the Health Care Setting

Health care organizations apply the lean model guided by the principle that minimizing waste is the foundation of efficient, satisfactory, and quality care. Health care processes aiming to reduce waiting time apply the lean model’s principles. A fitting example of the lean model’s application in health care delivery is using alert systems to quickly respond to patients in distress. Bach et al. (2018) found alert systems such as alarms highly effective in quickening response time hence reducing complications, injuries, and deaths. The lean model can also be used to redesign patient rooms where all devices, supplies, and medications that patients require are kept close to the patient. Such an arrangement reduces response time like safety alerts.

The Six Sigma model can be applied in health care facilities seeking to reduce variations in processes and outcomes. An effective way of applying this model is utilizing error detection systems to reduce errors in treatment processes as much as possible. Minimizing medication errors through a proactive response leads to a proportional reduction in hospital stays and complication rates (Slight et al., 2019). As a result, the gap between the current and desired output is reduced by reducing possible defects (poor quality triggers) in health care procedures.

The 5S quality model can be applied in health care settings to create a safe workplace. The most effective way of applying the model is utilizing its five components to make the work environment orderly and free from debris. A suitable example of its application in a health care facility is first sorting the workplace by identifying materials that are not used regularly. To keep it orderly, such materials are kept in the store or a safe cabinet to be retrieved only when needed. Storing such materials also enables health care facilities to apply the shine component (cleanliness). The process can then be standardized and sustained by developing policies or training programs to ensure that nurses understand the workplace norms regarding the order, sorting of materials, and cleanliness and apply them effectively.


Health care organizations should be committed to improving patient care outcomes as health conditions, trends, and situations prompt. Improving care quality implies a commitment to improving efficiency, safety, and other critical outcomes. As discussed in this paper, quality improvement models provide a systematic framework for establishing and implementing quality improvement interventions in health care settings. They focus on different elements affecting care quality, including defects, process variations, and waste. Most models were first used in the manufacturing industry before their relevance grew in health practice.



AAFP. (2020). Basis of quality improvement.

AHRQ. (2020). Section 4: Ways To Approach the Quality Improvement Process (Page 2 of 2).

Bach, T. A., Berglund, L. M., & Turk, E. (2018). Managing alarm systems for quality and safety in the hospital setting. BMJ Open Quality7(3), e000202.

Pyzdek, T. (2021). The lean healthcare handbook: A complete guide to creating healthcare workplaces that maximize flow and minimize waste. Springer.

Ramori, K. A., Cudney, E. A., Elrod, C. C., & Antony, J. (2021). Lean business models in healthcare: a systematic review. Total Quality Management & Business Excellence, 32(5-6), 558-573.

Shahali, S., Khajehasani, M., Torabipoor, A., & AhmadiAngali, K. (2019). The impact of applying 5S management method on patient satisfaction in healthcare centers’ services. Research Square.

Slight, S. P., Tolley, C. L., Bates, D. W., Fraser, R., Bigirumurame, T., Kasim, A., … & Watson, N. W. (2019). Medication errors and adverse drug events in a UK hospital during the optimisation of electronic prescriptions: A prospective observational study. The Lancet Digital Health1(8), e403-e412.

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