Chassin M R
Department of Health Policy, Mount Sinai Medical Center, New York, NY 10029, USA.
Milbank Q. 1998;76(4):565-91, 510. doi: 10.1111/1468-0009.00106.
Serious, widespread problems exist in the quality of U.S. health care: too many patients are exposed to the risks of unnecessary services; opportunities to use effective care are missed; and preventable errors lead to injuries. Advanced practitioners of industrial quality management, like Motorola and General Electric, have committed themselves to reducing the frequency of defects in their business processes to fewer than 3.4 per million, a strategy known as Six Sigma Quality. In health care, quality problems frequently occur at rates of 20 to 50 percent, or 200,000 to 500,000 per million. In order to approach Six Sigma levels of quality, the health care sector must address the underlying causes of error and make important changes: adopting new educational models; devising strategies to increase consumer awareness; and encouraging public and private investment in quality improvement.
太多患者面临不必要服务的风险；错过使用有效护理的机会；可预防的错误导致伤害。像摩托罗拉和通用电气这样的先进工业质量管理从业者致力于将其业务流程中的缺陷频率降低至每百万少于3.4个，这一策略被称为六西格玛质量。在医疗保健领域，质量问题经常以20%至50%的比率出现，即每百万中有20万至50万例。为了达到六西格玛质量水平，医疗保健部门必须解决错误的根本原因并做出重大改变：采用新的教育模式；制定提高消费者意识的策略；鼓励公共和私人对质量改进进行投资。
