Teeling Seán Paul, Baldie Deborah, Daly Ailish, Keown Anne Marie, Igoe Aileen, Dowling Ciara, McNamara Martin
UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland.
Mater Transformation, Mater Misericordiae University Hospital, Dublin, Ireland.
Front Health Serv. 2025 Aug 18;5:1621233. doi: 10.3389/frhs.2025.1621233. eCollection 2025.
A failure to distinguish between person-centredness, person-centred care, and person-centred cultures can result in improvement initiatives focusing solely on improvement initiative metrics and outcomes, excluding the authentic experiences of patients and staff. Building on the foundational work of Dewing and McCormack, we have designed, piloted, and implemented the Person-centred Lean Six Sigma (PCLSS) model in public and private acute and community healthcare settings across Ireland. This model uses Lean Six Sigma, a widely adopted improvement methodology, through a person-centred lens with which improvement practitioners and healthcare staff can inspect their Lean Six Sigma practice and critically evaluate whether, to what extent, and how it is synergistic with person-centred approaches.
This paper explores the deployment of the PCLSS model across four clinical study sites and examines its alignment with McCance and McCormack's conceptual work on healthful cultures, evaluating its contribution to creating cultures that support sustainable improvement, compassion, and respect.
The PCLSS model was embedded within a university-accredited education programme for healthcare staff. The model was applied across four distinct healthcare settings in Ireland: a public acute teaching hospital, a private full-service acute hospital, an integrated ophthalmology service bridging hospital and community care, and a public rehabilitation hospital. A case study methodology was used to examine implementation and impact.
Across all four sites, the PCLSS model facilitated improvements in operational efficiency, staff and patient engagement, interprofessional collaboration, and reflective practice. The model supported leadership at all levels, fostered sustainable change, and successfully mapped onto key domains associated with healthful cultures, as articulated in the work of McCance and McCormack.
The PCLSS model represents a sustainable, values-based approach to improvement that aligns operational excellence with person-centred principles. Its application contributes meaningfully to the development of healthful cultures in healthcare organisations.
未能区分以患者为中心、以患者为中心的护理和以患者为中心的文化，可能导致改进举措仅关注改进举措的指标和结果，而忽略患者和工作人员的真实体验。基于杜因和麦科马克的基础工作，我们在爱尔兰的公立和私立急症及社区医疗环境中设计、试点并实施了以患者为中心的精益六西格玛（PCLSS）模型。该模型通过以患者为中心的视角运用精益六西格玛（一种广泛采用的改进方法），改进从业者和医护人员可以据此审视他们的精益六西格玛实践，并批判性地评估其与以患者为中心的方法在何种程度上协同以及如何协同。
本文探讨PCLSS模型在四个临床研究地点的应用，并考察其与麦坎斯和麦科马克关于健康文化的概念性工作的契合度，评估其对创建支持可持续改进、同情心和尊重的文化的贡献。
PCLSS模型被纳入一个经大学认证的医护人员教育项目。该模型在爱尔兰四个不同的医疗环境中应用：一家公立急症教学医院、一家私立全方位服务急症医院、一个连接医院和社区护理的综合眼科服务机构以及一家公立康复医院。采用案例研究方法来考察实施情况和影响。
在所有四个地点，PCLSS模型促进了运营效率、工作人员和患者参与度、跨专业协作以及反思性实践的提升。该模型支持各级领导，促进可持续变革，并成功映射到麦坎斯和麦科马克的工作中所阐述的与健康文化相关的关键领域。
PCLSS模型代表了一种基于价值观的可持续改进方法，将卓越运营与以患者为中心的原则相结合。其应用对医疗组织中健康文化的发展做出了有意义的贡献。
