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01-10-2016 | Systems-Level Quality Improvement

Use of Six Sigma Methodology to Reduce Appointment Lead-Time in Obstetrics Outpatient Department

Authors: Miguel A. Ortiz Barrios, Heriberto Felizzola Jiménez

Published in: Journal of Medical Systems | Issue 10/2016

Abstract

This paper focuses on the issue of longer appointment lead-time in the obstetrics outpatient department of a maternal-child hospital in Colombia. Because of extended appointment lead-time, women with high-risk pregnancy could develop severe complications in their health status and put their babies at risk. This problem was detected through a project selection process explained in this article and to solve it, Six Sigma methodology has been used. First, the process was defined through a SIPOC diagram to identify its input and output variables. Second, six sigma performance indicators were calculated to establish the process baseline. Then, a fishbone diagram was used to determine the possible causes of the problem. These causes were validated with the aid of correlation analysis and other statistical tools. Later, improvement strategies were designed to reduce appointment lead-time in this department. Project results evidenced that average appointment lead-time reduced from 6,89 days to 4,08 days and the deviation standard dropped from 1,57 days to 1,24 days. In this way, the hospital will serve pregnant women faster, which represents a risk reduction of perinatal and maternal mortality.

Dellifraine, J. L., Langabeer, J. R., and Nembhard, I. M., Assessing the Evidence of Six Sigma and Lean in the Health Care Industry. Qual. Manag. Health Care 19:211–225, 2010. doi:10.1097/qmh.0b013e3181eb140e.CrossRefPubMed

Cabello, J. J., Garcia, D., Sagastume, A., Priego, R., Hens, L., and Vandecasteele, C., An approach to sustainable development: the case of Cuba. Environ. Develop. Sustain. 14(4):573–591, 2012.CrossRef

Taner, M. T., Sezen, B., and Antony, J., An overview of six sigma applications in healthcare industry. Int. J. Health Care Qual. Assur. Int. J Health Care QA 20:329–340, 2007. doi:10.1108/09526860710754398.CrossRef

Antony, J., Antony, F. J., Kumar, M., and Cho, B. R., Six sigma in service organisations. Int J Qual & Reliability Mgmt International Journal of Quality &amp. Reliab. Manag. 24:294–311, 2007. doi:10.1108/02656710710730889.

Sehwail, L., and Deyong, C., Six Sigma in health care. Leadersh. Health Serv. 16:1–5, 2003. doi:10.1108/13660750310500030.CrossRef

Lopez, L., Six Sigma in healthcare: a case study with Commonwealth Health Corporation. Real World Examples of Success, World Class Applications of Six Sigma, 1997. doi:10.1016/B978-0-7506-6459-2.50011-1.

Taner, M. T., Sezen, B., & Antony, J. An overview of six sigma applications in healthcare industry. 2013. doi: 10.1108/09526860710754398.

S. Bhat and N. A. Jnanesh. Application of Lean Six Sigma methodology to reduce the cycle time of out-patient department service in a rural hospital. 14(3); 222–237, 2014. doi:10.1504/IJHTM.2014.064257.

Gijo, E. V., and Antony, J., Reducing Patient Waiting Time in Outpatient Department Using Lean Six Sigma Methodology. Qual. Reliab. Eng. Int. 30(8):1481–1491, 2014. doi:10.1002/qre.1552.CrossRef

10.

W. D. Lin, X. Jin, and S. Y. Chia, “Simulation based lean six sigma approach to reduce patients waiting time in an outpatient eye clinic,” in 2014 I.E. International Conference on Industrial Engineering and Engineering Management. 394–398, 2014. 10.1109/IEEM.2014.7058667.

11.

S. Y. Lin, D. Gavney, S. L. Ishman, and J. Cady-Reh. Use of lean sigma principles in a tertiary care otolaryngology clinic to improve efficiency. 123(11); 2643–2648, 2013. doi:10.1002/lary.24110.

12.

Mandahawi, N., Al-Araidah, O., Boran, A., and Khasawneh, M., Application of Lean Six Sigma tools to minimise length of stay for ophthalmology day case surgery. Int. J. Six Sigma Compet. Advant. 2011. doi:10.1504/IJSSCA.2011.039716.

13.

Fischman, D., Applying lean six sigma methodologies to improve efficiency, timeliness of care, and quality of care in an internal medicine residency clinic. Qual. Manag. Healthcare 19(3):201–210, 2010. doi:10.1097/QMH.0b013e3181eece6e.CrossRef

14.

M. G. Huddle, A. Tirabassi, L. Turner, E. Lee, K. Ries, and S. Y. Lin. Application of Lean Sigma to the Audiology Clinic at a Large Academic Center. 154(4); 715–719, 2015. doi:10.1177/0194599815627774.

15.

Bhat, S., Gijo, E. V., and Jnanesh, N. A., Productivity and performance improvement in the medical records department of a hospital. Int. J. Product. Perform. Manag. 2015. doi:10.1108/IJPPM-04-2014-0063.

16.

Lamm, M. H., Eckel, S., Daniels, R., and Amerine, L. B., Using lean principles to improve outpatient adult infusion clinic chemotherapy preparation turnaround times. Am J Heal. Pharm. 72(13):1138–1146, 2015. doi:10.2146/ajhp140453.CrossRef

17.

Kim, Y. K., Song, K. E., Lee, W.-K., Harry, M., Schroeder, R., Westgard, J., Klee, G., Burtis, C., Ashwood, E., Gras, J., Philippe, M., Riebling, N., Tria, L., Nevalainen, D., Berte, L., Kraft, C., Leigh, E., Picaso, L., Morgan, T., Westgard, J., Westgard, S., Simmons, J., Riebling, N., Tria, L., Jackson, J., and Woeste, L., Reducing Patient Waiting Time for the Outpatient Phlebotomy Service Using Six Sigma. Korean J. Lab. Med. 29(2):171, 2009. doi:10.3343/kjlm.2009.29.2.171.CrossRefPubMed

18.

Gijo, E. V., Jiju, A., Jose, H., and Johny, S., Reducing patient waiting time in a pathology department using the Six Sigma methodology. Leadersh. Heal. Serv. 26(4):253–267, 2014. doi:10.1108/LHS-02-2012-0004.CrossRef

19.

J. S. Bender, T. O. Nicolescu, S. B. Hollingsworth, K. Murer, K. R. Wallace, and W. J. Ertl. Improving operating room efficiency via an interprofessional approach. 209(3); 447–450, 2015. doi: 10.1016/j.amjsurg.2014.12.007.

20.

Sedlack, J. D., The Utilization of Six Sigma and Statistical Process Control Techniques in Surgical Quality Improvement. J. Healthc. Qual. 32(6):18–26, 2010. doi:10.1111/j.1945-1474.2010.00102.x.CrossRefPubMed

21.

Cima, R. R., Brown, M. J., Hebl, J. R., Moore, R., Rogers, J. C., Kollengode, A., Amstutz, G. J., Weisbrod, C. A., Narr, B. J., and Deschamps, C., Use of Lean and Six Sigma Methodology to Improve Operating Room Efficiency in a High-Volume Tertiary-Care Academic Medical Center. J. Am. Coll. Surg. 213(1):83–92, 2011. doi:10.1016/j.jamcollsurg.2011.02.009.CrossRefPubMed

22.

Coronado, R. B., and Antony, J., Critical success factors for the successful implementation of six sigma projects in organisations. TQM Mag. 14:92–99, 2002. doi:10.1108/09544780210416702.CrossRef

23.

Jiménez, H. F., and Amaya, C. L., Lean Six Sigma en pequeñas y medianas empresas: un enfoque metodológico. Ing. Rev. Chil. Ing. Ing. Rev. Chil. Ing. 22:263–277, 2014. doi:10.4067/s0718-33052014000200012.CrossRef

24.

Sharma, S., and Chetiya, A. R., An analysis of critical success factors for Six Sigma implementation. Asian J. Qual. 13:294–308, 2012. doi:10.1108/15982681211287810.CrossRef

25.

Su, C. T., and Chou, C. J., A systematic methodology for the creation of Six Sigma projects: A case study of semiconductor foundry. Expert. Syst. Appl. 34(4):2693–2703, 2008. doi:10.1016/j.eswa.2007.05.014.CrossRef

26.

Ortíz, M. A., Felizzola, H. A., and Isaza, S., A contrast between DEMATEL-ANP and ANP methods for six sigma project selection: a case study in healthcare industry. BMC Med Inform Decis Mak BMC Med. Info. Dec. Making, 2015. doi:10.1186/1472-6947-15-s3-s3.

27.

Su, C., and Chou, C., A systematic methodology for the creation of Six Sigma projects: A case study of semiconductor foundry. Exp. Syst. Appl. 34(4):2693–2703, 2008. doi:10.1016/j.eswa.2007.05.014.CrossRef

28.

Kwak, Y. H., and Anbari, F. T., Benefits, obstacles, and future of six sigma approach. Technovation 26(5):708–715, 2006. doi:10.1016/j.technovation.2004.10.003.CrossRef

29.

Snee, R. D., and Rodebaugh, W. F., Frontiers of Quality: The project selection process. Qual. Prog. 35(9):78–80, 2002.

30.

Gijo, E. V., and Rao, T. S., Six Sigma implementation – Hurdles and more hurdles. Tot. Qual. Manag. Bus. Excel. 2005. doi:10.1080/14783360500077542.

31.

Büyüközkan, G., and Öztürkcan, D., An integrated analytic approach for Six Sigma project selection. Exp. Syst. Appl. 37(8):5835–5847, 2010. doi:10.1016/j.eswa.2010.02.022.CrossRef

32.

Ortíz, M. A., Cómbita, J. P., De la Hoz, A., Felice, F. D., and Petrillo, A., An integrated approach of AHP-DEMATEL methods applied for the selection of allied hospitals in outpatient service. Int. J. Med. Eng. Info. 8(2):87–107, 2016. doi:10.1504/IJMEI.2016.075760.CrossRef

Title: Use of Six Sigma Methodology to Reduce Appointment Lead-Time in Obstetrics Outpatient Department
Authors: Miguel A. Ortiz Barrios
Heriberto Felizzola Jiménez
Publication date: 01-10-2016
Publisher: Springer US
Published in: Journal of Medical Systems / Issue 10/2016
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI: https://doi.org/10.1007/s10916-016-0577-3

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Use of Six Sigma Methodology to Reduce Appointment Lead-Time in Obstetrics Outpatient Department

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