ORIGINAL RESEARCH article
Front. Health Serv.
Sec. Patient Centered Health Systems
Volume 5 - 2025 | doi: 10.3389/frhs.2025.1621233
This article is part of the Research TopicThe State of the Art of Person-Centered Healthcare: Global PerspectivesView all 11 articles
The Contribution of a Person-centred Model of Lean Six Sigma to the Development of a Healthful Culture of Health Systems Improvement
Provisionally accepted
Sean Paul Teeling1,2*
Deborah Baldie2,3Ailish Daly4Anne Marie Keown1,5Ciara Dowling6Aileen Igoe5Martin McNamara1- 1UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
- 2Centre for Person-Centred Practice Research Division of Nursing, School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
- 3Research and Practice Development, NHS Grampian, Edinburgh, United Kingdom
- 4Beacon Hospital, Dublin, Ireland
- 5Mater Hospital, Dublin, Ireland
- 6Incorporated Orthopaedic Hospital of Ireland, Dublin, Ireland
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: A failure to distinguish between person-centredness, person-centred care, and person-centred cultures can result in improvement initiatives focusing solely on improvement initiative metrics and outcomes, excluding the authentic experiences of patients and staff. Building on the foundational work of Dewing and McCormack, we have designed, piloted, and implemented the Person-centred Lean Six Sigma (PCLSS) model in public and private acute and community healthcare settings across Ireland. This model uses Lean Six Sigma, a widely adopted improvement methodology, through a person-centred lens with which improvement practitioners and healthcare staff can inspect their Lean Six Sigma practice and critically evaluate whether, to what extent, and how it is synergistic with person-centred approaches.Aim: This paper explores the deployment of the PCLSS model across four clinical study sites and examines its alignment with McCance and McCormack's conceptual work on healthful cultures, evaluating its contribution to creating cultures that support sustainable improvement, compassion, and respect.The PCLSS model was embedded within a university-accredited education programme for healthcare staff. The model was applied across four distinct healthcare settings in Ireland: a public acute teaching hospital, a private full-service acute hospital, an integrated ophthalmology service bridging hospital and community care, and a public rehabilitation hospital. A case study methodology was used to examine implementation and impact.Results: Across all four sites, the PCLSS model facilitated improvements in operational efficiency, staff and patient engagement, interprofessional collaboration, and reflective practice. The model supported leadership at all levels, fostered sustainable change, and successfully mapped onto key domains associated with healthful cultures, as articulated in the work of McCance and McCormack.The PCLSS model represents a sustainable, values-based approach to improvement that aligns operational excellence with person-centred principles. Its application contributes meaningfully to the development of healthful cultures in healthcare organisations.
Keywords: Lean Six Sigma, person-centred care, healthful cultures, Healthcare improvement, systems thinking, reflective practice, Staff empowerment, sustainable change 1. Introduction
Received: 30 Apr 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Teeling, Baldie, Daly, Keown, Dowling, Igoe and McNamara. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sean Paul Teeling, UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.