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    Using Six Sigma in Laboratory: February 2014

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    Using Six Sigma in Laboratory: February 2014

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    Usingsixsigmainclinicallaboratory

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    Using Six Sigma in Laboratory: February 2014

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    Using Six Sigma in Laboratory

    Conference Paper · February 2014


    DOI: 10.13140/2.1.1635.6484

    CITATIONS READS

    0 4,698

    1 author:

    Hager A. Saleh
    Umm Al-Qura University
    11 PUBLICATIONS   8 CITATIONS   

    SEE PROFILE

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    Using Six Sigma in Laboratory
    By

    1 Hager A. Saleh, Pharm., MS, CPHQ


    Lecturer of Health Management
    Umm Al – Qura University
    2 Outlines

    Introduction.
    What is Six Sigma?
     Sigma Metrics.
    Measure the lab. Quality on the Sigma Scale.
    Case studies.
    3 Introduction

    Among healthcare services, clinical laboratories are particularly


    important because physicians make their decisions mostly in
    accordance with laboratory results (Forsman, 1996).
     In this context, accurate test results are crucial for physicians and
    their patients. First, the laboratory must be able to produce an
    accurate test result before any other dimension of quality becomes
    important. From this point of view, the evaluation of laboratory
    performance is critical to maintaining accurate laboratory results
    (Coskun, 2007).
    4 Introduction

    Mistakes are unfortunately a part of human nature; but


    fortunately, the ability to create solutions and find better
    alternatives is also a part of human nature. We can shift the
    balance toward solutions and better alternatives using modern
    quality-management tools such as Six Sigma.
    5 Introduction

    Six Sigma methodology represents an evolution in quality


    assessment and management that has been implemented
    widely in business and industry since the mid-1980s
    (Westgard, 2006).
    Six Sigma methodology was developed by Motorola, Inc. to
    reduce the cost of products, eliminate defects, and decrease
    variability in processing.
    6 Six Sigma

    Is an approach that seeks to reduce variation using a


    powerful framework (DMAIC) and statistical tools to
    eliminate defects.
    7

    Control by standardising solution and Define the problem or opportunity.


    monitoring performance.
    Control Define

    Improve by implementing potential


    Improve
    6 Measure Measure the current performance
    solutions.
    and capability
    Analyse

    Analyse to identify root


    causes.
    8 Six Sigma Tool Box

    http://www.6ixsigma.org/downloads.aspx
    9 Sigma Metrics

    The sigma value indicates how often errors are likely to occur; the
    higher sigma value the less likely numbers of defects.
    10

    However, in the healthcare sector, the six-sigma level


    may not be adequate for many situations. For example, in
    blood banking, an error may cause fatal or irreversible
    results. Thus, the six-sigma level should not be accepted
    as the ultimate goal. We have to decrease the number of
    defects by as much as possible, and indeed, the sigma
    level should be higher than six.

    Our Slogan Should be ‘Zero Defects.’


    11 Measure the Quality on the Sigma Scale

    The first one: counting the errors or defects.


    This methodology is useful in evaluation of all errors in total
    testing process, except analytical phase.

    Sigma Calculator
    12

    http://www.isixsigma.com/process-sigma-calculator/
    13

    The second: using the following equation.


    Sigma = (TEa – bias)/CV
    Where:
     TEa: total error allowable (quality goal).
     bias and CV (coefficient of variation) are the indicator of
    systematic and random errors respectively.
    Analytical
    phase
    14

    For example, if a method has a bias of 2%, a CV of 2%, and TEa


    of 10%, the sigma value will be (10-2)/2 = 4.
    15 EZ Rules®

    Westgard QC Inc.,: http://www.westgard.com/software/ez-rules-3-qc-design-software.htm


    16
    Case Studies
    17
    1- North Shore University Hospital, New York

    • Define: Total Turnaround Time (TAT) taking too long


    • Measure: Target TAT set to 120 min. and upper specification limit set to 150
    min., defect defined as a TAT over 150 min., collected information on 195
    patients
    • Analyze: Use data to identify underlying , the underling problem was
    employees lacked proficiency with the hospitals bed tracking system (BTS)
    18
    1- North Shore University Hospital, New York
    • Improve: Improved communication within the staff by: documenting
    communication and Retraining employees on BTS.
    • Control: Monitoring the process (TAT continued to be monitored on a
    monthly basis)

    Results
    – Went from a slightly over one sigma process to a 3.1 sigma process
    – The average TAT went from 226 minutes to 69 minutes
    19 2- Blood Banking - Virtua Health, New Jersey

    • Define: blood was provided to patient who didn’t meet infusion guidelines
    “transfusion guidelines not followed”
    • Measure: blood order is considered a defect if not followed their guidelines -
    (defect rate for all blood products were 11.21%)
    • Analyze: Use data to identify root cause factors e.g. lack of documentations –
    patients volume
    20 2- Blood Banking - Virtua Health, New Jersey

    • Improve: overall decrease in the defect rate to 3.71 %


    • Control: plan was created to sustain gains

    Results
    – Defect rate went from a 11.21% to 3.71%
    – Reduce cost and generated a net saving of $ 121,000
    21 Key Success Factors

     Involvement of executive management.


     communicate the mission and vision clearly.
     Measure and hold people accountable.
     Select project carefully.
     Use change management tools to identify cultural barriers, gain acceptance.
     Recognize, reward and celebrate successes.
    22 Conclusion

    Six Sigma is not only a means to quantify analytical performance, but is also
    a management method that can improve the organization in an orderly way,
    with the target being to reach optimal quality characterized by a level of 3.4
    DPMO
    23 Conclusion

    The errors that we are interest are primarily analytical errors, which
    represent only the tip of the iceberg. However, the reality is quite different.
    When we see the whole iceberg and control it all, then it will be possible to
    reach Six Sigma level and even higher quality in clinical laboratories.
    24 Conclusion

    Once management has decided to invest in a Six Sigma project:


    - The first requirement is a project leader who is familiar with the Six Sigma
    concepts and who is accountable for obtaining improvement.
    - the second is the involvement of laboratory staff in the project through
    communication, introduction of core laboratory theories, and organized
    training sessions.
    25

    If we don’t measure, we don’t know, and if we don’t


    know , we can’t manage
    26 References

    1. Application of the Six Sigma concept in clinical laboratories: a review”, Gras, Jeremie
    M. and Philippe, Marianne. Clin Chem Lab Med. 46:6 2007. pages 789-790.
    2. Abdurrahman Coskun, Ibrahim Unsal, Mustafa Serteser and Tamer Inal (2010). Six
    Sigma as a Quality Management Tool: Evaluation of Performance in Laboratory
    Medicine, Quality Management and Six Sigma, Abdurrahman Coskun (Ed.), ISBN:
    978-953-307-130-5, InTech
    3. http://www.6ixsigma.org/training.aspx
    4. http://www.isixsigma.com
    5. http://www.asq.org
    27

    For Any Further Questions

    hagerasaleh@gmail.com

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