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Motivators to Application of DMAIC in Patient Care Processes

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Advances in Production Management Systems. Artificial Intelligence for Sustainable and Resilient Production Systems (APMS 2021)

Part of the book series: IFIP Advances in Information and Communication Technology ((IFIPAICT,volume 631))

Abstract

Six Sigma comprises DMAIC which is a methodology that has attracted the attention of researchers in the field of Healthcare. This study aims to understand the motivators to apply DMAIC in process in the context of Six Sigma and Lean Six Sigma to be implemented in processes focused on direct patient care. The article covers literature on DMAIC from 1997 to October 2020. For such a purpose, a systematic literature review has been carried out based on empirical studies in Hospitals and Emergency units. A total of 21 articles were reviewed, and the topic Motivators were addressed in this article with the aim of performing DMAIC through Six Sigma/Lean Six Sigma. Based on the analyzed articles, the most frequent motivator to implement Six Sigma/Lean Six Sigma DMAIC in organizations lies in reducing process time (such as length of stay) and improving the quality of service. It was also noticed that DMAIC has been used in several health services, such as patient discharge and surgeries (femur surgeries, for instance. An application of DMAIC in 50 emergency care units (UPAs) corroborated the main motivators indicated in the literature.

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References

  1. Ahsan, K.B., Alam, M., Morel, D.G., Karim, M.: Emergency department resource optimisation for improved performance: a review. J. Ind. Eng. Int. 15(1), 253–266 (2019)

    Article  Google Scholar 

  2. Al Kuwaiti, A.: Application of six sigma methodology to reduce medication errors in the outpatient pharmacy unit: a case study from the king Fahd university hospital, Saudi Arabia. Int. J. Qual. Res. 10(2), 267–278 (2016)

    Google Scholar 

  3. Al Kuwaiti, A., Subbarayalu, A.V.: Reducing patients’ falls rate in an academic medical center (AMC) using six sigma “DMAIC’’ approach. Int. J. Health Care Qual. Assur. 30(4), 373–384 (2017)

    Article  Google Scholar 

  4. Aleem, S., Torrey, W.C., Duncan, M.S., Hort, S.J., Mecchella, J.N.: Depression screening optimization in an academic rural setting. Int. J. Health Care Qual. Assur. 28(7), 709–725 (2015)

    Article  Google Scholar 

  5. Allen, T.T., Tseng, S.H., Swanson, K., McClay, M.A.: Improving the hospital discharge process with six sigma methods. Qual. Eng. 22(1), 13–20 (2009)

    Article  Google Scholar 

  6. Antony, J., Sreedharan, R., Chakraborty, A., Gunasekaran, A., et al.: A systematic review of lean in healthcare: a global prospective. Int. J. Qual. Reliab. Manage. 36(8), 1370–1391 (2019)

    Article  Google Scholar 

  7. Arafeh, M., et al.: Using six sigma DMAIC methodology and discrete event simulation to reduce patient discharge time in king Hussein cancer center. J. Healthcare Eng. 2018 (2018)

    Google Scholar 

  8. Bhat, S., Gijo, E., Jnanesh, N.: Application of lean six sigma methodology in the registration process of a hospital. Int. J. Prod. Perform. Manage. 63(5), 613–643 (2014)

    Article  Google Scholar 

  9. Bhat, S., Jnanesh, N.: Application of lean six sigma methodology to reduce the cycle time of out-patient department service in a rural hospital. Int. J. Healthcare Technol. Manage. 14(3), 222–237 (2014)

    Article  Google Scholar 

  10. Black, J.: Transforming the patient care environment with lean six sigma and realistic evaluation. J. Healthcare Qual. 31(3), 29–35 (2009)

    Article  Google Scholar 

  11. Cheung, Y.Y., Goodman, E.M., Osunkoya, T.O.: No more waits and delays: streamlining workflow to decrease patient time of stay for image-guided musculoskeletal procedures. RadioGraphics 36(3), 856–871 (2016)

    Article  Google Scholar 

  12. Chiarini, A.: From total quality control to lean six sigma: evolution of the most important management systems for the excellence (2012)

    Google Scholar 

  13. Coughlin, K., Posencheg, M.A.: Quality improvement methods-part II. J. Perinatol. 39(7), 1000–1007 (2019)

    Article  Google Scholar 

  14. Dang, A., Gjolaj, L.N., Whitman, M., Fernandez, G.: Using process improvement tools to improve the care of patients with neutropenic fever in the emergency room. J. Oncol. Pract. 14(1), e73–e81 (2018)

    Article  Google Scholar 

  15. DelliFraine, J.L., Langabeer, J.R., Nembhard, I.M., et al.: Assessing the evidence of six sigma and lean in the health care industry. Qual. Manage. Healthcare 19(3), 211–225 (2010)

    Article  Google Scholar 

  16. Gijo, E., Antony, J., Hernandez, J., Scaria, J.: Reducing patient waiting time in a pathology department using the six sigma methodology. In: Leadership in Health Services (2013)

    Google Scholar 

  17. Goh, T.N., Tang, L.C., Lam, S.W., Gao, Y.F.: Six sigma: a SWOT analysis. Int. J. Six Sigma Competitive Adv. 2(3), 233–242 (2006)

    Article  Google Scholar 

  18. Goh, T., Xie, M.: Statistical control of a six sigma process. Qual. Eng. 15(4), 587–592 (2003)

    Article  Google Scholar 

  19. Henrique, D.B., Godinho Filho, M.: A systematic literature review of empirical research in lean and six sigma in healthcare. Total Qual. Manage. Bus. Excellence 31(3–4), 429–449 (2020)

    Article  Google Scholar 

  20. Improta, G., et al.: Lean six sigma in healthcare: fast track surgery for patients undergoing prosthetic hip replacement surgery. TQM J. 31(4), 526–540 (2019)

    Article  Google Scholar 

  21. Improta, G., et al.: Lean six sigma: a new approach to the management of patients undergoing prosthetic hip replacement surgery. J. Eval. Clin. Pract. 21(4), 662–672 (2015)

    Article  Google Scholar 

  22. Improta, G., et al.: Improving performances of the knee replacement surgery process by applying DMAIC principles. J. Eval. Clin. Pract. 23(6), 1401–1407 (2017)

    Article  Google Scholar 

  23. Improta, G., Ricciardi, C., Borrelli, A., D’Alessandro, A., Verdoliva, C., Cesarelli, M.: The application of six sigma to reduce the pre-operative length of hospital stay at the hospital Antonio Cardarelli. Int. J. Lean Six Sigma 11(3), 555–576 (2020)

    Article  Google Scholar 

  24. Kwak, Y.H., Anbari, F.T.: Benefits, obstacles, and future of six sigma approach. Technovation 26(5–6), 708–715 (2006)

    Article  Google Scholar 

  25. Lobo, C.V.F., Calado, R.D., da Conceicao, R.D.P.: Evaluation of value stream mapping (VSM) applicability to the oil and gas chain processes. Int. J. Lean Six Sigma 11(2), 309–330 (2018)

    Article  Google Scholar 

  26. Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Group, P.: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6(7), e1000097 (2009)

    Article  Google Scholar 

  27. Pande, P., Neuman, R., Cavanagh, R.: The Six Sigma Way Team Fieldbook: An Implementation Guide for Process Improvement Teams. McGraw Hill Professional, New York (2001)

    Google Scholar 

  28. Raval, S.J., Kant, R., Shankar, R.: Revealing research trends and themes in lean six sigma: from 2000 to 2016. Int. J. Lean Six Sigma 9(3), 399–443 (2018)

    Article  Google Scholar 

  29. Ricciardi, C., Balato, G., Romano, M., Santalucia, I., Cesarelli, M., Improta, G.: Fast track surgery for knee replacement surgery: a lean six sigma approach. TQM J. 32(3), 461–474 (2020)

    Article  Google Scholar 

  30. Ricciardi, C., Fiorillo, A., Valente, A.S., Borrelli, A., Verdoliva, C., Triassi, M., Improta, G.: Lean six sigma approach to reduce LOS through a diagnostic-therapeutic-assistance path at Aorna Cardarelli. TQM J. 31(5), 657–672 (2019)

    Article  Google Scholar 

  31. Silich, S.J., et al.: Using six sigma methodology to reduce patient transfer times from floor to critical-care beds. J. Healthcare Qual. 34(1), 44–54 (2012)

    Article  Google Scholar 

  32. Singh, A., Pradhan, S., Ravi, P., Dhale, S.: Application of six sigma and 5 s to improve medication turnaround time. Int. J. Healthcare Manage. 1–9 (2020)

    Google Scholar 

  33. Snee, R.D.: Lean six sigma-getting better all the time. Int. J. Lean Six Sigma 1(1), 9–29 (2010)

    Article  MathSciNet  Google Scholar 

  34. Sodhi, H.S., Singh, D., Singh, B.J.: An empirical analysis of critical success factors of lean six sigma in Indian SMES. Int. J. Six Sigma Competitive Adv. 11(4), 227–252 (2019)

    Article  Google Scholar 

  35. Taner, M.T., Sezen, B., Antony, J.: An overview of six sigma applications in healthcare industry. Int. J. Health Care Qual. Assur. 20(4), 329–340 (2007)

    Article  Google Scholar 

  36. Tlapa, D., et al.: Effects of lean healthcare on patient flow: a systematic review. Value Health 23(2), 260–273 (2020)

    Article  Google Scholar 

  37. Trakulsunti, Y., Antony, J., Dempsey, M., Brennan, A.: Reducing medication errors using lean six sigma methodology in a Thai hospital: an action research study. Int. J. Qual. Reliab. Manage. 38(1), 339–362 (2021)

    Article  Google Scholar 

  38. Vijay, S.A.: Reducing and optimizing the cycle time of patients discharge process in a hospital using six sigma DMAIC approach. Int. J. Qual. Res. 8(2), 169–182 (2014)

    Google Scholar 

  39. Yamamoto, J., Abraham, D., Malatestinic, B.: Improving insulin distribution and administration safety using lean six sigma methodologies. Hosp. Pharm. 45(3), 212–224 (2010)

    Article  Google Scholar 

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Acknowledgements

The authors would like to thank the Brazilian Ministry of Health, Fluminense Federal University and Euclides da Cunha Foundation. This Research is part of a “Lean Project in UPAs 24 h” that has been funded by the Brazilian Ministry of Health (TED 125/2019, number: 25000191682201908).

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Authors and Affiliations

  1. Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil

    Milena Reis

  2. Universidade Federal Fluminense, Rio das Ostras, Brazil

    Luis Viera, Laryssa Amaral, José Farias Filho & Robisom Calado

  3. Ministério da Saúde, DAHU-SAES-MS, Distrito Federal, Brazil

    Adriana Teixeira

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  1. Milena Reis
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  2. Luis Viera
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  3. Laryssa Amaral
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  4. José Farias Filho
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  5. Adriana Teixeira
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  6. Robisom Calado
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Corresponding author

Correspondence to Milena Reis .

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Editors and Affiliations

  1. IMT Atlantique, Nantes, France

    Alexandre Dolgui

  2. Centrale Nantes, Nantes, France

    Alain Bernard

  3. IMT Atlantique, Nantes, France

    David Lemoine

  4. ZF Friedrichshafen AG, Friedrichshafen, Germany

    Gregor von Cieminski

  5. Tecnológico de Monterrey, Mexico City, Mexico

    David Romero

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Reis, M., Viera, L., Amaral, L., Filho, J.F., Teixeira, A., Calado, R. (2021). Motivators to Application of DMAIC in Patient Care Processes. In: Dolgui, A., Bernard, A., Lemoine, D., von Cieminski, G., Romero, D. (eds) Advances in Production Management Systems. Artificial Intelligence for Sustainable and Resilient Production Systems. APMS 2021. IFIP Advances in Information and Communication Technology, vol 631. Springer, Cham. https://doi.org/10.1007/978-3-030-85902-2_29

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  • DOI: https://doi.org/10.1007/978-3-030-85902-2_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-85901-5

  • Online ISBN: 978-3-030-85902-2

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