We can distill the critical elements of Six Sigma into six Themes. These principles, supported by the many tools and methods presented in our VCI® Signature Series Monographs, will give you a preview of what can happen in your practice.

Theme One: Genuine focus on the client.

As mentioned, most organizations launching Six Sigma have often been appalled to find out how little they really understand about their clients. In Six Sigma, client focus becomes a top priority, measurements start with client satisfaction and client compliance. Improvements are defined by their impact on client satisfaction and the client's perception of value.

Theme Two: Data and fact-driven management.

Six Sigma takes the concept of management by fact to a new, more powerful level. Too many veterinary practices base their decisions on outdated assumptions and opinions. The discipline of Six Sigma measurements begin to clarify what factors are key to gauging performance, and then gathers data and analyzes the variables.

Theme Three: Processes are where the action is.

When a veterinary practice focuses on delivering services, measuring performance, improving efficiency, and running the practice like a business, new process improvement systems are required. If you do not use new metrics at the "in the trench" level, positive change will not occur. Six Sigma efforts convince leaders and managers, particularly client-centered practices, that mastering processes is a way to build "world class" competitive advantages in delivering "world class" value to the clients and patients.

Theme Four: Proactive management

While the term has been overused, "proactive" simply means acting in advance of events, rather than reacting to them. In actual practice, it means making new habits out of what are usually neglected business practices: defining ambitious goals in writing, reviewing/revising them frequently, setting clear priorities inside and outside the practice scope, focusing on problem prevention, rather than firefighting, and questioning WHY we do things, instead of blindly defending them. Far from being boring or overly analytical, being truly proactive is a starting point for creativity and effective change. Six Sigma will encompass new measurement tools, and new operational practices that replace reactive habits, with a dynamic, responsive, and caring style of management.

Theme Five: Boundary-less collaboration.

Years before launching Six Sigma, Jack Welch was working to break down barriers and to improve teamwork at GE. His mantra for Six Sigma was "boundary-less-ness". The opportunities for collaboration were huge, and he wanted no one to enter a turf-protection posture, so he had to establish a new paradigm to allow Six Sigma to be most effective. Too many dollars are lost every day because of disconnects and outright competition between informal and formal groups that should be working for a common cause: providing exceptional value to clients.

Theme Six: Drive for perfection. Tolerate failure.

When we say that Six Sigma drives to perfection, and then say failure must be tolerated, it sounds like a dysfunctional position, but they are actually complimentary. No one stumbles, unless they are moving .In healthcare, stasis means death, and in veterinary healthcare delivery, stasis means death, even if you do not realize it. New ideas and different approaches always involve some risk. If people who see alternatives are too afraid of the consequences of mistakes, they will never try. The techniques we will review for improving performance include a significant dose of risk management, so the downside of setbacks or mistakes should be limited. The bottom line is that a practice that makes Six Sigma its goal will have to keep pushing the envelope, to be more perfect, while being willing to accept, and manage, occasional failures.