Six Sigma in European public health care : A proposed comparable model.

Six Sigma is commonly applied and well established in the manufacturing sector, especially in the USA. Since the beginning of the 1990s several public administrations, particularly in the field of health care, have also been implementing Six Sigma. In Europe, public health care is very different from US health care in terms of organisation and its relationship with stakeholders. A specific Six Sigma model for European public health care is missing from the literature. In order to gain real advantages for such a health care system it is worth analysing, discussing and designing a possible dedicated model and comparing it with the manufacturing one.The idea of such a comparison has originated from the Italian public health care system. In fact the Italian health care sector has a mission and values, a culture, an organisation, strategies and processes that are often very different from the production sector. However, many of these differences can also be found in European public health care. As described in the first chapter, among the European systems there are fundamental common features that can justify a dedicated research. In order to achieve the aim, the thesis has been conducted in two stages. Although the thesis is primarily deductive, the first stage is typically inductive and the second one is deductive. A third minor stage based on qualitative-inductive methods helps to put the finishing touches to the proposed model by showing the differences from the manufacturing model and the features of the European system. The final model attempts to make new contributions to the literature by primarily bringing knowledge to the stakeholders in the academic field and secondarily to the practitioners. The main contribution is surely a roadmap for shaping a missing Six Sigma model for European public health care.