What is sigma six

OBJECTIVES: This study aimed to develop the actual pathway to reporting and information transfer in operating theatres in relation to medical technology malfunction/failure. This with the aim of understanding the differences with the pathway published by NHS Improvement and identification of points for improvement. DESIGN: This is a qualitative study involving stakeholder interviews with doctors, nurses, manufacturers, medical device safety officer and Medicines and Healthcare products Regulatory Agency...

The purpose of this study is to obtain the reference range of peripheral perfusion index (PPI) of asymptomatic well newborns at 6 to 72 h of life at different altitudes. A population-based prospective cohort study was conducted in cities at different altitudes in China. Asymptomatic well newborns were enrolled consecutively from six hospitals with an altitude of 4 to 4200 m between February 1, 2020, and April 15, 2021. PPI was measured at 6, 12, 24, 48, and 72 h after birth on the right hand (pre-ductal) and either foot (post-ductal) using a Masimo SET Radical-7 oximeter...

In this chapter, we identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in health care organizations. We describe the unique components or tools that each approach uses to improve the delivery of health services. We also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews and recent studies published in the peer-reviewed literature. Based on examination of this research, we discuss what knowledge is still needed to strengthen the evidence for whole system transformation...

BACKGROUND: Tenure requirements within universities vary; however, most focus on excellence in teaching, service, and scholarship. Within our university, faculty with either research or clinical doctorates were on both tenure and clinical tracks, with reported marginalization from clinical track faculty. METHOD: A task force was convened in 2018 to develop a unified single track that included a single set of criteria for all College of Health Professions faculty to obtain tenure...

The health care delivery system in Pakistan is in a process of rapid growth, and it consists of public and private sectors. The provincial government is preliminarily responsible for providing health care facilities within its province except in federally administered areas. In Pakistan, there are three tiers of governmental healthcare delivery systems, which comprise government, semi-government, and parastatal organizations. The purpose of this study is to understand the rapid increase in influx of patients in major city hospitals of the Punjab province...

Slow waves are major pacemakers of NREM sleep oscillations. While slow waves themselves are mainly generated by cortical neurons, it is not clear what role thalamic activity plays in the generation of some oscillations grouped by slow waves, and to what extent thalamic activity during slow waves is itself driven by corticothalamic inputs. To address this question, we simultaneously recorded both scalp EEG and local field potentials from six thalamic nuclei (bilateral anterior, mediodorsal and ventral anterior) in fifteen epileptic patients (age-range: 17-64 years, 7 females) undergoing Deep Brain Stimulation Protocol and assessed the temporal evolution of thalamic activity relative to scalp slow waves using time-frequency analysis...

The limited resources allocated to the health area and the growing demands require leaders' qualified and committed performance in hospital management. In this perspective, the objective of this study is to reflect on the management practices that can be applied to hospital facilities to achieve better care and financial results. Among them, process-based management proposes an approach for continuous process improvement to achieve desired results; the method Lean Six Sigma allows identifying and eliminating waste in production processes; the continuous improvement model combines practical knowledge with the knowledge of how the system to be improved works, through observations and changes that allow its results measurement; and cost management and value-based healthcare provides for care mapping, from beginning to end, to assess what actually adds value to patients...

INTRODUCTION: Clinical laboratories usually have a quality management system such as ISO 15189, which provides a framework for quality and competence to perform medical testing and internal systems such as audit and nonconformance to ensure consistent processes. However, organizations need to have access to internal procedures and external competitors' performance to improve their operations. These are often seen as commercial or areas where it is difficult to agree on an acceptable goal...

A lack of fidelity to Lean Six Sigma's (LSS) philosophical roots can create division between person-centred approaches to transforming care experiences and services, and system wide quality improvement methods focused solely on efficiency and clinical outcomes. There is little research into, and a poor understanding of, the mechanisms and processes through which LSS education influences healthcare staffs' person-centred practice. This realist inquiry asks 'whether, to what extent and in what ways, LSS in healthcare contributes to person-centred care and cultures'...

Six Sigma has been widely used in the health field for process or quality improvement, constituting a quite profusely investigated topic. This paper aims at exploring why some studies have more academic and societal impact, attracting more attention from academics and health professionals. Academic and societal impact was addressed using traditional academic metrics and alternative metrics, often known as altmetrics. We conducted a systematic search following the PRISMA statement through three well-known databases, and identified 212 papers published during 1998-2019...

The main purpose of this study was to examine how personal and organizational drivers influence the utilization of management tools aimed at supporting organizational working in Industry 4.0 settings. We built our research upon the recognized importance of management tools for organizational working under Industry 4.0 settings and explored the key personal and organizational drivers of management tool usage. Calculations were performed based on the responses of 222 employees working in organizations across Europe...

Identifying areas for workflow improvement and growth is essential for an interventional radiology (IR) department to stay competitive. Deployment of traditional methods such as Lean and Six Sigma helped in reducing the waste in workflows at a strategic level. However, achieving efficient workflow needs both strategic and tactical approaches. Uncertainties about patient arrivals, staff availability, and variability in procedure durations pose hindrances to efficient workflow and lead to delayed patient care and staff overtime...

Lean management is a set of principles aimed at improving processes by identifying and eliminating steps that do not add value to the consumer. Such steps lead to wasted time, resources, and expenses and result in customer and employee dissatisfaction. Although initially invented and perfected for factory assembly lines in the automobile industry, it has since disseminated extensively and has repeatedly proven a powerful "engine" for improving quality and quantity in the health-care setting. Lean implementation benefits include improved safety, reduced waiting times, increased patient satisfaction, and cost reduction...

PURPOSE: The purpose of this paper is to examine the competencies that US healthcare organizations require for quality and performance improvement positions. DESIGN/METHODOLOGY/APPROACH: A US healthcare improvement job posting content analysis was conducted using the HQ Essentials competency framework. FINDINGS: The HQ essentials competencies most desired for improvement positions include project management, training, data analysis and applied performance improvement methods...

PURPOSE/OBJECTIVES: Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process...

Key elements of pharmacokinetics (PK) studies include both, the number of sampling points (NSP) as well as the spacing between the sampling points (SSP). Optimization of the SSP is discussed in guidelines of all key regulatory agencies (RA). Those however, provide only very general rules on how to properly distribute the NSPs in proposed PK studies. Here we demonstrate that the six sigma (SX) method can be effectively used to assess the quality of SSPs. We have tested a modified SX method analyzing 466 PK profiles from 16 studies including a total of 368 healthy volunteers...

To move hospitals toward what it terms high-reliability, The Joint Commission (TJC) is urging administrators to use a framework that it has developed to push their organizations through stages of maturity, ultimately creating environments in which there is zero patient harm. To get to this point, TJC leaders say hospitals will have to commit to transparency, promote and reward error reporting, and seize upon opportunities to improve. The Joint Commission has tested its high-reliability framework in seven hospitals, and it is now working on an assessment tool that will enable hospitals to measure their level of maturity across the framework's 14 components...

UNLABELLED: This article is the first in a series of articles that will focus on understanding the implementation essentials necessary to deliver operational excellence through a International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) Q10-based pharmaceutical quality system (PQS). The authors examine why, despite the fact that the ICH Q10 guideline has been with us since 2008, the transformation of the traditional Quality Management Systems QMS in use within the pharmaceutical industry is a work in progress for only a few forward-thinking organisations...

The advent of modern high-throughput sequencing has made it possible to generate vast quantities of genomic sequence data. However, the processing of this volume of information, including prediction of gene-coding and regulatory sequences remains an important bottleneck in bioinformatics research. In this work, we integrated DNA duplex stability into the repertoire of a Neural Network (NN) capable of predicting promoter regions with augmented accuracy, specificity and sensitivity. We took our method beyond a simplistic analysis based on a single sigma subunit of RNA polymerase, incorporating the six main sigma-subunits of Escherichia coli...

Nearly fourteen years ago the Institute of Medicine's report, To Err Is Human: Building a Safer Health System, triggered a national movement to improve patient safety. Despite the substantial and concentrated efforts that followed, quality and safety problems in health care continue to routinely result in harm to patients. Desired progress will not be achieved unless substantial changes are made to the way in which quality improvement is conducted. Alongside important efforts to eliminate preventable complications of care, there must also be an effort to seriously address the widespread overuse of health services...