Building a Six Sigma model for the Italian public healthcare sector using grounded theory

The purpose of the research presented in this paper is to propose a Six Sigma model for the Italian public healthcare sector and to compare it with the manufacturing model. The healthcare model is based on ten theoretical principles/categories linked together using the 'story line' of grounded theory. Two interviews, a focus group and two observations have been carried out within two Italian public hospitals. The results of this qualitative inquiry have been analysed by means of grounded theory. Results show the following differences between Italian public healthcare and the manufacturing sector: a strong emphasis on patient satisfaction, improvements sometimes conducted without adding profit, organisational climate, the mandatory use of risk management tools, doctors and nurses' attitudes towards statistical tools and difficulties in implementing Six Sigma as a whole. Managerial implications, recommendations and scope for future study are presented.