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Six Sigma: Opportunities for Ergonomics & MSD Prevention

Six Sigma is a data driven, statistics based, industrial engineering approach to improving performance. Six Sigma tools can help in identifying issues affecting work quality, creating solutions to control process variability, and creating feedback to ensure quality is maintained, organizational output is improved, and customer expectations are met. It applies a philosophy from Total Quality Management and has been closely connected with Lean because of similarities and complementary concepts1.

The Six Sigma concept began at Motorola in the mid-1980s and has evolved and spread from manufacturing to other sectors, such as healthcare2. Six Sigma draws on a large set of different tools and methods, while using a systematic approach to manage projects aiming to eliminate quality deficits. These tools could also be applied to reduce Musculoskeletal Disorders (MSD) risk and improve the quality of working environments.

A few of the Six Sigma tools and approaches discussed in this position paper include:

DMAIC - Define, Measure, Analyze, Improve/Implement, Check, is a standard overarching improvement process associated with Six Sigma. Each step has a prescribed function in the task of establishing process control. The MSD Prevention Guidelines use a similar investigation process flow, and practitioners likely use a similar mental model in their ergonomic assessments. DMAIC provides a formal, structured approach to the improvement process, which could be more familiar with other organization members.

Process Mapping - Process mapping provides a graphical diagram of the work flow for a process or product, demonstrating the direction of workflow, decisions, inputs, and outputs. It can be applied to the study of current and future states and could be used to identify critical ergonomic concerns in the process. An extension of process mapping is value stream mapping where value adding steps in the process or product are noted via symbols to better understand the flow of information and material. A similar approach could be used from an ergonomic perspective to identify where risk factors are elevated and increase the chance of injury or points where a review for ergonomics should be completed3.

Data Collection Sheet - Also referred to as Check Sheets, Data Collection Sheets are structured sheets set up to collect and organize useful data for analysis. This style of checklist is a familiar concept for ergonomists using, for example, discomfort forms or pain surveys in current MSD prevention.

Failure Modes and Effects Analysis (FMEA) - The FMEA is used to quantify the level of risk associated with the possible failure of a part or process. It combines information on the chance of failure, the severity of failure consequences, and the current controls in place to create a combined score that assists with prioritizing actions to manage the issue. Researchers have demonstrated the integration of ergonomics into FMEAs for design stage risk management4.

Key messages:

  • Elements for MSD prevention can be integrated into Six Sigma managed improvement projects and associated assessments.
  • The adaptable framework and some existing tools can serve as a standalone process to investigate MSD risk using existing risk assessment approaches.
  • Using approaches that are familiar to managers and engineers can help gain their support.

To read the full position visit CREMSD.


  1. Wedgewood, I. (2016). Lean Sigma - A Practitioner's Guide (2nd Edition): Prentice Hall.
  2. Evans, J.F., and Lindsay, W.M. (2005). An Introduction to Six Sigma & Process Improvement, Thomson/South-Western.
  3. Lim, A. J., Village, J., Salustri, F. A., & Neumann, W. P. (2014). Process mapping as a tool for participative integration of human factors into work system design. European Journal of Industrial Engineering, 8(2), 273-290.
  4. Village, J., Annett, T., Lin, E., Greig, M., and Neumann, W.P. (2011). Adapting the failure mode effect analysis (FMEA) for detection of human factors concerns. Proceedings of the 42nd Annual Conference of the Association of Canadian Ergonomists, London, Ontario (October 17-20).