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What is sigma six

Randy L Granata, Karen Hamilton
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...
January 2015: Professional Case Management
Tomasz Grabowski, Anna Raczyńska-Pawelec, Marcin Starościak, Jerzy Jan Jaroszewski
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...
June 2014: Journal of Pharmacokinetics and Pharmacodynamics
(no author information available yet)
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...
December 2013: ED Management: the Monthly Update on Emergency Department Management
Nuala Calnan, Kevin O'Donnell, Anne Greene
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...
November 2013: PDA Journal of Pharmaceutical Science and Technology
Scheila de Avila e Silva, Franciele Forte, Ivaine T S Sartor, Tahila Andrighetti, Günther J L Gerhardt, Ana Paula Longaray Delamare, Sergio Echeverrigaray
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...
January 2014: Biologicals: Journal of the International Association of Biological Standardization
Mark R Chassin
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...
October 2013: Health Affairs
Angelic P McDonald, Randy Kirk
Within the hospital based imaging department at Methodist Willowbrook, outpatient, inpatient, and emergency patients are all performed on the same equipment with the same staff. The critical nature of the patient is the deciding factor as to who gets done first and in what order procedures are performed. After an aggressive adoption of Intentional Tools, the imaging department was finally able to move from a two year mean Press Ganey, outpatient satisfaction average score of 91.2 and UHC percentile ranking of 37th to a mean average of 92...
January 2013: Radiology Management
Sameer Kumar
PURPOSE: The author aims to assess the spread of avian flu, its impact on businesses operating in the USA and overseas, and the measures required for corporate preparedness. DESIGN/METHODOLOGY/APPROACH: Six Sigma DMAIC process is used to analyze avian flu's impact and how an epidemic could affect large US business operations worldwide. Wal-Mart and Dell Computers were chosen as one specializes in retail and the other manufacturing. FINDINGS: The study identifies avian flu pandemic risks including failure modes on Wal-Mart and Dell Computers global operations...
2012: International Journal of Health Care Quality Assurance
J J Pandit, M Pandit, J M Reynard
If surgical 'capacity' always matched or exceeded 'demand' then there should be no waiting lists for surgery. However, understanding what is meant by 'demand', 'capacity' and 'matched' requires some mathematical concepts that we outline in this paper. 'Time' is the relevant measure: 'demand' for a surgical team is best understood as the total min required for the surgery booked from outpatient clinics every week; and 'capacity' is the weekly operating time available. We explain how the variation in demand (not just the mean demand) influences the analysis of optimum capacity...
June 2010: Anaesthesia
Sameer Kumar, Marc Steinebach
PURPOSE: Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients every year, contributing to soaring healthcare costs. The purpose of this study is to examine what has been done to deal with the medical-error problem in the last two decades and present a closed-loop mistake-proof operation system for surgery processes that would likely eliminate preventable medical errors. DESIGN/METHODOLOGY/APPROACH: The design method used is a combination of creating a service blueprint, implementing the six sigma DMAIC cycle, developing cause-and-effect diagrams as well as devising poka-yokes in order to develop a robust surgery operation process for a typical US hospital...
2008: International Journal of Health Care Quality Assurance
Mark Gottfredson, Keith Aspinall
What's the number of product or service offerings that would optimize both your revenues and your profits? For most firms, it's considerably lower than the number they offer today. The fact is, companies have strong incentives to be overly innovative in new product development. But continual launches of new products and line extensions add complexity throughout a company's operations, and as the costs of managing that complexity multiply, margins shrink. To maximize profit potential, a company needs to identify its innovation fulcrum, the point at which an additional offering destroys more value than it creates...
November 2005: Harvard Business Review
(no author information available yet)
Detailed study of processes can reveal key problems and opportunities for improvement. Survey your customers to determine what they will tolerate, then keep staff within those boundaries. Analyze the data to discover the drivers of variation within the process you are targeting. First address those processes that are the exclusive purview of the ED and over which you have the greatest control.
July 2005: ED Management: the Monthly Update on Emergency Department Management
ManMohan S Sodhi, Navdeep S Sodhi
Many companies are now good at managing costs and wringing out manufacturing efficiencies. The TQM movement and the disciplines of Six Sigma have seen to that. But the discipline so often brought to the cost side of the business equation is found far less commonly on the revenue side. The authors describe how a global manufacturer of industrial equipment, which they call Acme Incorporated, recently applied Six Sigma to one major revenue related activity--the price-setting process. It seemed to Acme's executives that pricing closely resembled many manufacturing processes...
May 2005: Harvard Business Review
Joann Maklebust
Pressure ulcers are a common and frustrating problem. Pressure ulcers increase demands on health care resources and are sometimes a source of malpractice litigation. Skin breakdown, often an iatrogenic complication of hospitalization, increases the length of stay and contributes to mortality and morbidity. Long-term care facilities are under increasing regulatory pressure to reduce rates of pressure ulcer occurrence. The process-outcome link continues to escape us. Processes of care seem disjointed. Numerous studies show a failure to implement what we know...
June 2005: Nursing Clinics of North America
James A Bahensky, Janet Roe, Romy Bolton
The manufacturing industry has been using Lean Sigma for years in pursuit of continuous improvement to obtain a competitive advantage. The objectives of these efforts are to use the Lean techniques for reducing cycle times and the Six Sigma concepts for reducing product defects. The Iowa Business Council with several advocates worked with the University of Iowa Hospital and Clinics (UIHC) and two other Iowa hospitals to determine whether Lean Sigma is adaptable in healthcare. A team of 15 people at UIHC used the Kaizen Breakthrough Methodology over a five-day period in an aggressive identification and elimination of non-value added activities in Radiology CT scanning...
2005: Journal of Healthcare Information Management: JHIM
Anthony R Benedetto
Six Sigma is an excellent quality and performance improvement tool. Like any tool, the results of using it are highly dependent on whether you use it with competence and on the right problem. This article will help you decide if your problem is well-suited for a Six Sigma approach and will suggest the optimum approach for planning and implementing Six Sigma methodology. Performance improvement methods can be grouped into two broad categories, based on the problem to be addressed. When the problem is relatively minor and localized, "evolutionary" methods may be suitable (e...
March 2003: Radiology Management
D Scalise
Many hospitals are looking for a way to improve their quality performance to improve outcomes, increase patient satisfaction and lower costs. Frustrated by the slow gains from traditional quality programs, some executives have turned to Six Sigma, the statistical quality method made famous by Motorola and General Electric. But Six Sigma can be a difficult concept to grasp. Our toolkit will serve as a primer for health care executives to find out what Six Sigma is, how it can be applied to health care organizations, and how some hospital executives have made it work for them...
December 2001: Hospitals & Health Networks
S Tuli, B O'Hayon, J Drake, M Clarke, J Kestle
OBJECTIVE: The multicenter, randomized pediatric cerebrospinal fluid shunt valve design trial found no difference in the rate of shunt failure between a standard valve, a siphon-reducing valve (Delta; Medtronic PS Medical, Goleta, CA), and a flow-limiting valve (Orbis Sigma; Cordis, Miami, FL); however, the valves were expected to have different effects on ultimate ventricular size. Also, the catheter position or local environment of the ventricular catheter tip might have affected shunt failure...
December 1999: Neurosurgery
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