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Six Sigma chapter: Bettering High quality and Efficiency in Your Nonprofit Group  copyright 2016 by Gary M. Grobman

What’s Six Sigma?

Six Sigma (a.okay.a. “6 Sigma”), a registered trademark of the Motorola Company, refers to a statistically-based approach to scale back variability in enterprise processes. Its intent is to scale back waste and rework, and streamline these enterprise processes, eliminating pointless steps which will add to defects, and enhance processes to additional the meant objective of manufacturing “just about excellent” outcomes—thus rising income and rising buyer satisfaction.

It will get its title from the Greek letter (σ) used within the statistical time period representing commonplace deviation. Its objective is to scale back the variety of occasions by which a product falls outdoors of meant acceptable limits to .0034%, equal to 6 commonplace deviations from the imply. In sensible phrases, which means the objective is to scale back defects to three.4 per million occasions.

’Six Sigma’ has come to imply various things to completely different folks as a result of the core idea has diversified to turn into a philosophy, a perception system, and a disciplined course of for fast enchancment (Lazerus & Butler, 2001).

A lot of its recognition, starting within the late Nineties, resulted from studies of spectacular outcomes, together with these of Normal Electrical’s legendary CEO, Jack Welch, an early adopter. Investments of lots of of tens of millions of {dollars} within the technique had been reported to have resulted in billions of {dollars} in financial savings (Suresh, Antony, Kumar, & Douglas, 2012).

Why it’s important—as a philosophy

Six Sigma conjures up a brand new mind-set about enterprise processes—“how one can work sensible” quite than “how one can work exhausting” (Dong-Suk, 2010).  It has a lot in frequent with the sooner variations of high quality enchancment administration methods, reminiscent of TQM and BPR. Like TQM, it includes the participation of each member of the group, and infuses staff with a spirit of enhancing the standard of the group’s services or products supply at each doable method it could. Like BPR, it’s a “high down” administration instrument (Dong-Suk, 2010), and it systematically seeks to revamp any enterprise course of that’s both pointless, or contributes to defects. And by doing so, it has the potential to advertise the elimination of jobs and elements of jobs that aren’t including to the group’s worth.

“As a result of Six Sigma is predicated on scientific rules, selections had been based mostly on info and knowledge as a substitute of emotions and instinct,” writes the authors of a case research of a program launched in a 384-bed common hospital within the Netherlands in 2003 that was credited with saving lots of of hundreds of {dollars} (van den Heuvel, Does, & Bisgaard, 2005).

As I write this in 2016, TQM and BPR as formal change administration applications have fallen out of favor. And Six Sigma, and its sister, Lean Six Sigma, are flourishing. Maybe one cause is that Six Sigma acknowledges that staff want some direct motivation to purchase into this technique, and formal Six Sigma applications sometimes present compensation to staff based mostly partly on the success of outcomes which might be facilitated by Six Sigma methods. By its reliance with statistical instruments, the advantages of Six Sigma—by way of the discount of faulty merchandise, much less waste, and fewer rework—is measurable. And there may be substantial proof that this instantly impacts the underside line of firm income, or its euphemistic equal within the nonprofit sector, “web income.”

Formal Six Sigma applications concentrate on discrete particular person tasks that concentrate on a selected enterprise course of. It’s not uncommon for a undertaking to be thought of solely when the financial savings from a profitable implementation is at the least $25,000—and thus a part of the method is quantifying the monetary advantages of implementation. When a possible undertaking fails to satisfy that threshold, it’s merely not accredited.

Why Six Sigma is of curiosity to the nonprofit sector

All nonprofits, as enterprise organizations, have some work processes in frequent which might be targets which might be ripe for Six Sigma interventions. Invoicing, accounts payable and receivable, personnel recruitment, and buyer scheduling are examples. Eliminating waste from fundraising procedures and volunteer administration are some which might be distinctive to the sector.

As a proper change administration technique, Six Sigma might not be enticing to the small soup kitchen, day care middle, or symphony orchestra, partly as a result of the price of implementing it – for consultants, specialised pc software program, compensation packages, and coaching—would possibly properly exceed your entire finances of the that small nonprofit. Regardless of that limitation, it may be constructive to study Six Sigma ideas, if solely to consider what imperfections exist in the best way work processes are being accomplished that contribute to errors being made.

Nonprofits have restricted sources, and wasteful spending usually implies that worthy purchasers can’t be served. Employees sources, virtually all the time restricted, could be higher dedicated to increasing companies quite than coping with the results of defects within the provision of companies. It’s usually way more environment friendly and less expensive to altering a system that creates defects than correcting these errors after they happen.

In bigger nonprofits, notably within the healthcare and better training sectors, Six Sigma applications are probably cost-effective, and in some circumstances, in a transformational method. And one further benefit is that many of those organizations have already got TQM applications in place, decreasing any disruption on account of piggybacking Sigma Six efforts and making present TQM outcomes extra profitable (Revere, 2003). Integrating Six Sigma to a present TQM program “can be utilized to enhance, embellish, and strengthen such applications” (Revere, 2003, p. 382).

Interviewed in a web-based trade publication, the director of Six Sigma for Sharp HealthCare, Patricia Atkins, R.N., commented that, “Too usually in well being care, we accept 90% once we ought to be aiming for 100%. My ardour about Six Sigma is that we will use it to save lots of lives. It’s the toughest factor I’ve ever accomplished, and it’s value it” (Borgert, N., 2006).

One could make a robust case that it’s a good end result to scale back defects in tv units to a typical of three.4 per million occasions (99.9997%) from three commonplace deviations, 66,800 per a million occasions (93.3%). It’s irritating to a buyer and expensive to a producer to reply to buyer complaints a couple of faulty newly-purchased tv. Now, examine that to the worth to society taking into account the results of a surgical staff taking out the unsuitable kidney or a toddler protecting companies employee putting a weak baby with abusive foster care mother and father.

Errors are going to be made by employees, no matter circumstances. That’s one facet of the human situation. But each group, in attaining some mission or program objective, has procedures that contribute, by means of their design, to rising or reducing the likelihood {that a} mistake shall be made. The philosophy of Six Sigma is that utilizing statistical methods and gathering adequate knowledge, it’s doable to see the place present procedures regarding work processes are contributing to errors, after which analyzing what steps could be carried out to revamp these processes to scale back the likelihood that the errors will reoccur.  

A 2008 research commissioned by the Society of Actuaries calculated that the price of medical errors in the USA was $19.5 billion, inflicting 2,500 deaths and 10 million misplaced work days yearly on account of 1.5 million errors (Hobson, 2010). A subsequent research that factored in further financial components, reminiscent of the prices of misplaced workdays and the worth of the lives that had been reduce brief, estimated that the associated fee approached $1 trillion (Andel, Davidow, Hollander, & Moreno, 2012). Even when Six Sigma may cut back this pointless price by just one%, that’s actually substantial, even placing apart the immeasurable price to society of unnecessary struggling.

 On account of the rising diffusion of Six Sigma methods into the nonprofit sector, and success tales reminiscent of these beneath, Six Sigma is “gaining floor” within the sector (Zell, 2014). And academic settings, notably increased training, are fertile areas for Sigma Six program adoptions. A web page on the College of Alabama web site titled Increased Training and Six Sigma: a Good Match, makes the case why this high quality enchancment technique is so invaluable. 

In the present day’s administration crucial focuses extra on the underside line and on enhancing your aggressive place. That is completed by assembly the wants of all of your prospects, together with college students, mother and father, college, workers, donors, higher than anybody else. The enterprise of training additionally has better accountability than it has prior to now. Because of this implementing high quality enhancements throughout the board is extra necessary at present than ever earlier than. It will be significant for each enterprise and educational objectives. A high quality enchancment program can enhance all areas of upper training. Six Sigma is a transformative method designed to sort out these challenges.  All work is course of. Managers in increased training and different transactional fields can use Six Sigma to know their work processes, and how one can enhance them. Six Sigma can be utilized in all departments and processes; admissions, registration, requisitions and buy orders, data know-how,  grants administration,  accreditation, restore and upkeep, and extra (College of Alabama, n.d.).

The Increased Studying Fee, the accreditation physique for establishments of upper studying within the north-central area of the USA, requires its member establishments to reveal a dedication to high quality enchancment.  A method for them to do that is to take part within the Fee’s Educational High quality Enchancment Program (AQIP), considered one of three choices for satisfying this formal dedication (Holmes, Jenicke, & Hempel, 2015).

Amongst these faculties taking part is Illinois Central Faculty (ICC) in East Peoria, Illinois, which adopted Six Sigma in 2004. A report of how the establishment has integrated Six Sigma into its operations to reinforce productiveness and high quality is included in a 2010 report out there on the faculty’s web site.

Using Six Sigma has fostered a sharper concentrate on the usage of knowledge, data, and efficiency ends in decision-making at ICC. Previous to chartering a staff to check an issue, baseline knowledge is gathered to find out how essential processes are functioning. These knowledge assist to find out if a staff is critical and to slender their project to a manageable undertaking. The primary section within the staff’s work is to outline the issue by gathering voice-of-the-customer data from the stakeholders within the course of and to map the method. Baseline knowledge

are used to know the general “well being” of the method in quantitative phrases. Information are used all through the DMAIC course of to scale back variability and enhance course of outcomes. Every course of should be designed to satisfy the wants of the folks being served. By way of the

use of the DMAIC course of, an expectation is being established that knowledge are important to sound decision-making (Illinois Central Faculty, n.d.).  

Success tales

You’ll find many different success tales on-line about how nonprofit organizations have used Six Sigma. Amongst examples are—

1. The YMCA’s nationwide useful resource workplace in Chicago, Illinois, started implementing a Six Sigma program in 2014 to improve its youth improvement applications, spearheaded by a newly transplanted workers member who had Six Sigma coaching as a local people YMCA CEO in Dallas, Texas. Management recognized an issue with YMCA day camp applications—they had been changing into “stale.” Concepts had been thought of that would come with ensuring each camper discovered one thing new every day, made a pal at camp, and have become extra bonded to the group. The change administration technique is credited with at the least 40% of YMCA day camps across the nation adopting the upgraded camp program, with a 2017 objective of 75% adoption thought of to be inside attain (Jacobsen, 2016).
2. Youngsters & Adolescent Remedy Companies (CATS) in Buffalo, NY, used Six Sigma to scale back ready occasions for youngsters to see a psychological well being skilled, not solely decreasing its ready record, however decreasing from 65 days to 25 the time it took from the primary name the group acquired to scheduling a remedy session. The Buffalo-Erie United Method has been a pioneer in spreading the usefulness of Six Sigma by means of its partnership with 60 affiliated nonprofits, spearheaded by a retired Six-Sigma director who was with Honeywell earlier than he retired. In response to a neighborhood enterprise publication lauding the hassle, CATS noticed a $200,000 improve in web income attributed to the initiative (Zell, 2014).
3. Thibodaux Regional Medical Heart, in Thibodaux, Louisiana, claims to have “elevated the hospital’s working margin to 12% and created a money reserve of $24 million in simply two years on account of its Six Sigma tasks. Treatment errors had been lowered 42% and the ability saved $2 million (Minitab, Inc., 2008).   
4. Pink Cross Hospital in Beverwijk, the Netherlands. This common hospital with an annual finances of $70 million, reported lots of of hundreds of {dollars} in financial savings from Six Sigma initiatives. They ranged from shortening the size of keep for sufferers with persistent obstructive pulmonary illness (COPD); decreasing errors made on invoices; standardizing its accounts payable insurance policies, and acquiring reimbursements for allowing mother and father to remain in a single day with their hospitalized kids by convincing insurers that doing so would lower the typical size of keep, thus considerably decreasing prices (van den Heuvel, Does, & Bisgaard, 2005).
5. Mount Carmel Well being in Columbus, OH, an early adopter of Six Sigma within the healthcare sector, reported an $857,000 improve in web revenue from 52 Six Sigma tasks by the tip of 2001 (Revere, 2003).

Sigma Six methodology

For making any specific manufacturing course of efficient, Six Sigma makes use of the DMAIC technique:

• Outline
• Measure
• Analyze
• Enhance
• Management

“Outline” includes figuring out the method that’s to be focused for enchancment.

“Measure” pertains to assessing which elements of a selected enterprise course of that impacts buyer satisfaction and which could be improved in a method that reduces defects.

“Analyze” pertains to the section the place the enterprise course of is studied to find out the all potential sources that lead to variability, and thus contribute to a defect.

“Enhance” is the section by which the method is redesigned and carried out, and a cost-benefit evaluation is carried out.

“Management” is the ultimate section by which what has been achieved is documented and monitored, and outcomes are verified utilizing statistical management processes (Classes from Sweden’s first large-scale implementation of Six Sigma in healthcare (Lifvergren, S., Gremyr, I., Hellstrom, A., Chakhunashvili, A., & Bergman, B., 2010).

There are some variations of this framework. For instance, for creating new merchandise or course of designs, the strategy of alternative is DMADV:

• Outline
• Measure
• Analyze
• Design
• Confirm

The Six Sigma tradition

The builders of Six Sigma had been lovers of the martial arts, and adopted titles of a hierarchy for practitioners that correspond to Six Sigma certification ranges of coaching, data, expertise.

Black Belt: These are people who’re licensed to guide Six Sigma groups in organizations, and who can act as coaches and mentors to those that are licensed at decrease ranges. This certification sometimes requires at the least 140 hours of black belt coaching. They sometimes dedicate all of their skilled duties to Six Sigma actions.

Inexperienced Belt: These are employees who’ve Six Sigma coaching, however who incorporate the methods of Six Sigma into their main duties with the group, which may be engaged on a selected manufacturing course of. Six Sigma coaching is usually below 100 hours, largely in statistical methods and staff problem-solving.

Yellow Belt: These with this certification have acquired coaching in primary Sigma Six ideas and language, maybe 15-25 hours of coaching, and sometimes are concerned in knowledge assortment.

Champion: This designation is for top rating group managers who’re tasked with greasing the wheels to guarantee that Six Sigma tasks are profitable with assist from the group, and dealing to take away limitations to success.

White Belt: These are novices inside the group who’ve acquired maybe a couple of hours of Six Sigma coaching, usually as a method to create an organizational tradition amongst employees who could also be affected by adjustments in designs and processes, however who won’t essentially be utilizing any Six Sigma instruments and strategies instantly (ASQ, n.d.).

Historical past of Sigma Six

Walter Shewhart (1891-1967) was a College of California-Berkeley skilled physicist who was one of many pioneers of high quality management. Initially incomes his residing as an instructional, he grew to become an inspector for the Western Electrical Co. in Hawthorne, Illinois, in 1918. His supervisor there was George D. Edwards, who later grew to become the primary president of the American Society for High quality Management (renamed American Society for High quality in 1997) (Smith, 2009). This plant, which manufactured tools for Bell Phone, had many staff who had been pioneers within the high quality motion. Amongst them had been Edward Deming, who was an intern at this plant, and who was impressed by Shewhart’s actions, in addition to Joseph M. Juran, whom was mentored by Shewhart. (see web page insert). A brief memo from Shewhart to Edwards in Might 1924 proposed a revolutionary method of decreasing pricey manufacturing errors, and served because the blueprint for what is understood at present as course of high quality management. His 1931 ebook, Financial Management of High quality of Manufactured Product, served to diffuse statistical management far past Western Electrical and had substantial affect on manufacturing processes throughout World Struggle II.

Though Shewhart felt that manufacturing processes wanted to be modified every time variation exceeded a three-Sigma commonplace (by which the expectation is that not more than 93.32% of output just isn’t faulty), adherents of Six Sigma rediscovering his writings and adopted Shewart’s strategies with the upper commonplace.

Edward Deming, usually thought of to be the daddy of high quality management (see web page insert) collaborated with Shewhart for a few years and was influenced by Shewhart’s method (Smith, 2009).   

A lot of the work of Shewhart languished in relative obscurity till it was rediscovered on account of intense competitors between U.S. and Japanese manufacturing industries. Japanese trade targeted on enhancing the standard of their merchandise and decreasing prices, and the outcome was a quantum improve of their market share, virtually all of it on the expense of American merchandise. The response from the opposite aspect of the Pacific at first was met with smug complacency, adopted by panic on the hemorrhaging of income and market share.

Among the many responses to the problem from Japan’s high quality revolution in manufacturing was the “Zero Defects” Motion, which had its genesis within the Sixties within the aerospace and auto industries. Amongst its proponents was Phil Crosby, the writer of the Foreword to this ebook who, together with Edward Deming and Joseph Juran, was one of many three gurus of the 20^th century high quality motion, and the writer of High quality is Free. Crosby grew to become the Johnny Appleseed of the Zero Defects motion, making a robust case that it was less expensive to stop defects in services in comparison with fixing them and implementing inspection applications. Accepting that there’ll all the time be some degree of defects really encourages them to be made, he asserted, and administration ought to by no means settle for this and do no matter it could to eradicate each doable defect of their enterprise processes. Crosby believed that there’s not solely a direct price to a defect of a services or products, however a hidden price, as properly, in inspection time, wasted materials, wasted labor, and buyer dissatisfaction. The rules he espoused have discovered their voice in Sigma Six (Crosby, 1979).

Motorola was one of many first American corporations to attempt to “beat (the Japanese) at their very own recreation.” The corporate directed its engineers to mixture the best-known high quality practices they may discover, and the outcome was the primary Six Sigma program, with the preliminary objective of enhancing high quality by 10 to 1 inside 5 years. By the point the standard enchancment program had been accomplished in 1991, Motorola had achieved a company-wide enchancment of 800 to 1, surpassing the Japanese high quality methods (MSG Displays, n.d.).  

Six Sigma’s Relationship to Lean

Lean is a associated administration approach that focuses main on taking a look at enterprise processes within the context of what’s actually of worth to the tip buyer. Thus, if any specific enterprise course of or a part of one doesn’t actually add something that’s of worth to the shopper, measured as one thing that the shopper can be prepared to pay extra for, then it’s eradicated—until, after all, it’s required by legislation or regulation or would in any other case present some aggressive benefit (Sherman, 2014). So, Lean analyzes enterprise processes to eradicate waste and cut back the time it takes to finish every enterprise course of.

Lean Six Sigma combines these appropriate two change administration methods into one.

Among the many classes of waste within the context of Lean Six Sigma are:

1. Defects—This includes selections amongst scrapping, remodeling, returns from the shopper, and all different issues emanating from the manufacturing of a product/service that doesn’t meet buyer specs.
2. Overproduction—Creating extra capability of the services or products than the market is prepared to purchase means no income is ever generated from the work that went into creating that services or products.
3. Ready—This encompasses not solely ready for uncooked supplies and partially accomplished completed merchandise to be acquired by the following enterprise course of, but additionally acquiring approvals and high quality checks earlier than the following course of could be carried out. For instance, a whole staff of execs could also be saved ready due to a delay within the consumption strategy of one other staff.
4. Personnel inefficiencies—Pointless conferences, convention calls are among the many examples of how the time of enormous numbers of individuals could be “wasted.”
5. Transportation—This includes the prices and time delays of transferring supplies round throughout the course of.
6. Stock—There are penalties of getting an excessive amount of or too little stock. An excessive amount of ties up capital and limits space for storing, and requires extra administration to maintain monitor of it. Too little implies that necessary elements won’t be out there when they’re wanted, including to attend time.
7. Movement—This refers to holding sources (together with folks, however together with instruments, supplies) farther away the much less necessary they’re, and arranging personnel and supplies effectively to scale back the time it takes to coordinate all enterprise processes.
8. Further Processing—This refers to eliminating processes that price cash however don’t add to the worth of the completed product, reminiscent of overheating or air-con, or utilizing machines to ship elements when easy gravity may change them (Goleansixsigma.com, n.d.).

The Nature of Waste

Peter Sherman, in a July 7, 2014 challenge of High quality Journal (10 causes Organizations Do Not Use Lean Six Sigma) makes a compelling argument in favor of Lean Six Sigma, and refutes most of the knocks towards it.

An instance of the place to search for to seek out wasteful enterprise processes is offered by Phil Emard, a Six Sigma marketing consultant. He notes that there could also be an inclination to automate processes that might be eradicated completely, notably people who relate to transportation of supplies, sorting, and storage (Bogert, M., 2006).   

Criticisms of Six Sigma

As with all different change administration methods on this ebook, Six Sigma has its detractors. Among the many criticisms usually lodged towards it are—

1. It’s prone to improve employee workload in nonprofit organizations the place it isn’t uncommon to have understaffing (Dong-Suk, 2010).
2. The tradition of extremely paid consultants could also be extra considering consumer billing than the spirit of high quality enchancment that was ingrained within the unique leaders of the standard revolution (Dalgleish, 2003).
3. Six Sigma is solely one other high quality fad of repackaged concepts that can come and go, and is usually an costly distraction that may have the group focus as a lot or extra on the colour of their belts and certifications than “the duties that result in a more healthy enterprise” (Dalgleigh, 2003).
4. Six Sigma requires passionate and dedicated management to achieve success. Initiatives are doomed to fail with out leaders that, amongst different qualities, think about info, pursue a transparent and compelling imaginative and prescient, work successfully with colleagues, and commit totally to this system (Suresh, Antony, Kumar, & Douglas, 2012).
5. It’s tough, if not not possible to vary a corporation’s tradition to assist Six Sigma, so as soon as the consultants go away, the group “reverts again to its unique habits” (Travispower, 2009).

As you would possibly count on, there are a lot of different causes to withstand Sigma Six. However there are actually cheap justifications for looking at this high quality administration technique the place it may be a very good match for the group. Matthew Barsalou, in a 2015 article in High quality Digest, takes a have a look at among the main criticisms of Six Sigma, and refutes them (Barsalou, 2015).

Conclusion

Six Sigma builds on the progress made with high quality administration methods reminiscent of TQM and BPR, and takes a scientific method to eliminating waste and decreasing errors which might be attributable extra to flawed enterprise processes than by employee carelessness. It seems to have an exemplary report of enhancing high quality, notably in giant organizations reminiscent of hospitals and universities. And even for these with out the sources to make a significant funding in coaching, which incorporates most nonprofit organizations, Six Sigma embraces a philosophy that makes a invaluable contribution to these with a dedication to high quality enchancment.

Andel C, Davidow SL, Hollander M., Moreno DA. (2012). The economics of well being care high quality and medical errors. Journal of Well being Care Finance, Fall 2012, 39(1) pp. 39-50. Retrieved on-line from http://www.ncbi.nlm.nih.gov/pubmed/23155743

Barsalou, M. 2015). Lean Six Sigma: 10 objections and solutions: Can we cease calling it a fad now? Retrieved on-line at: http://www.qualitydigest.com/inside/six-sigma-column/101315-lean-six-sigma-10-objections-and-answers.html

Borgert, N. (2006). Adapting LEAN administration and Six Sigma methods within the scientific lab. Scientific Lab Merchandise (On-line). February 4, 2006. Los Angeles, CA: Anthem Media Group. Retrieved on-line 4/26/2016 (Proquest).

Crosby, P. (1980). High quality is free. New York, NY: McGraw-Hill.

Dalgleish, S. (2003). Six Sigma? No thanks. April 2003, High quality Journal. 42(4), retrieved on-line from: http://www.qualitymag.com/articles/84042-six-sigma-no-thanks

Dong-Suk, Okay. (2010). Eliciting success components of making use of Six Sigma in an instructional library. Efficiency Administration and Metrics. V11n1 pp. 25-38.

Goleansixsigma.com. (n.d.). What’s waste. Retrieved on-line from: https://goleansixsigma.com8-wastes

Hobson, Okay. (2010). Research places price of medical errors at $19.5 Billion. Wall Road Journal, August 9, 2010.  Retrieved on-line from http://blogs.wsj.com/health/2010/08/09/study-puts-cost-of-medical-errors-at-195-billion/

Holmes, M., Jenicke, L., &Hempel, J. (2015). A framework for Six Sigma undertaking choice in increased training establishments, utilizing a weighted scorecard method. High quality Assurance in Training, 23(1) pp. 30-46.

Illinois Central Faculty (n.d.). AQIP programs portfolio. Might 2010. Retrieved on-line from:  http://icc.edu/about-icc/files/2014/04/ICC-AQIP-Systems-Portfolio-May-2010.pdf

Jacobsen, J. (2016). YMCA upgrades day camps utilizing Six Sigma. Making the case for high quality. January 2016. Retrieved from: http://asq.org/2016/01/six-sigma/ymca-upgrades-day-camps-using-six-sigma.pdf

Lazarus, I. & Butler, Okay. (2001). The promise of six sigma. Managed Healthcare Govt. October 2001, 11(9) pp. 22-26.

Lifvergren, S., Gremyr, I., Hellstrom, A., Chakhunashvili, A., & Bergman, B. (2010). Classes from Sweden’s first large-scale implementation of Six Sigma in well being care.  Operations Administration Analysis, (2010) 3:117,-pp. 128.

(Minitab, Inc., 2008).  Case Research: Thibodaux Medical Heart. Retrieved on-line at: http://www2.kke.co.jp/minitab//case_studies/service/pdf/Thibodaux.pdf

MSG Displays (2016). The Motorola Six Sigma story. Retrieved on-line from:  http://managementstudyguide.com/motorola-six-sigma-story.htm

Revere, L. (2003). Integrating Six Sigma with whole high quality administration: A case instance for measuring treatment errors. Journal of Healthcare Administration. November/December 2003 48(6), pp. 377-391.

Smith, J. (2009). Remembering Walter A. Shewhart’s contribution to the standard world. High quality Journal, March 2, 2009. Retrieved on-line from: http://www.qualitymag.com/articles/85973-remembering-walter-a-shewhart-s-contribution-to-the-quality-world

Suresh, S., Antony, J., Kumar, M., and Douglas, A. (2012). Six Sigma and management: Some observations and agenda for future analysis. The TQM Journal. 24(3), pp. 231-247.

Travispower (2009). Six Sigma criticism/issues, Chasing down high quality (put up). April 21, 2009.  Retrieved on-line from: https://travispower.wordpress.com/2009/04/21/six-sigma-criticismproblems/

College of Alabama (n.d.). Increased training and Six Sigma: An ideal match. Retrieved on-line from: http://coaching.ua.edu/sixsigma/sixsigma-highered.php

van den Heuvel, J.; Does, J. M. M. & Bisgaard, S. (2005). Six Sigma Discussion board Journal, February 2005 4(2).

Zell, S. (2014). Six Sigma and nonprofits: Increasing partnerships, August 8, 2014. Six Sigma Each day. Retrieved on-line from http://www.sixsigmadaily.com/six-sigma-nonprofits-expanding-partnerships/

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