J Clin Outcomes Manage
2009 Sep ;16(9):411-414
Optimizing patient care processes in a children's hospital using six sigma
Abstract Objective: To describe a children’s hospital experience with applying Six Sigma methodology to improve clinical processes. Methods: Three projects are described. The first project sought to reduce the time from order to insertion of peripherally inserted central catheters (PICCs), the second sought to reduce the length of stay of patients requiring tracheostomy and gastrostomy tube placements prior to transfer to rehabilitation facilities, and the third sought to reduce medication order defects. Results: Implemented process changes resulted in a significant and progressive improvement in the mean time to PICC placement, which was reduced from 3.7 ± 2.7 days to 2.42 ± 1.6 days after 1 month and to 1.7 ± 1.2 days at 1 year. While we created a more efficient process that led to a shorter pediatric intensive care stay, we did not see a reduced time to transfer to rehabilitation facilities. At baseline, the mean number of defects per medication order was 2.1; this was improved to 1.4 at 1 month and 0.3 at 1 year. Conclusion: Clinical process analysis using Six Sigma methodology can significantly reduce defects as well as address quality aims established by the Institute of Medicine.
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