The delivery of healthcare needs to change significantly. I have briefly outlined some of the changes required to build a culture of continuous improvement. As the Secretary of the VA made clear to the department in July, the VA needs a different strategy to better meet customer needs.
It's the responsibility of both the designer and the engineer to work together to find the smartest way to deliver the desired result. Of course, that's the crux of it--figuring out how to get them working together first.
Six Sigma, Kaizen, Lean, and other variations on continuous improvement can be hazardous to your organization's health. While it may be heresy to say this, recent evidence suggests that it's time to question these methods.