Improving Healthcare Referral System Using Lean Six Sigma

Alkinaidri, Atif; Alsulami, Hemaid; Al-Nafea, Ayman

doi:10.4236/ajibm.2018.82013

Cited by 9 publications

(7 citation statements)

References 9 publications

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“…Between 2014 and 2015, the number of referrals requested of and accepted by secondary healthcare providers increased by 13.6% and 11.5%%, respectively, illustrating the necessity of improving the referral system in Saudi Arabia (Alkinaidri & Alsulami, 2018). In 2018, Alkinaidri and Alsulami (2018) identified the following issues in the Saudi health referral system: delays in responding to referral requests, incomplete referral documents, lack of internal communication consultants, and lack of follow up by coordinators.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, the researchers applied Lean Six Sigma principles to the referral system in King Abdullah Medical City in Makkah. The results included a decrease from 28.1% to 21.5% in delayed responses to referral requests, reducing inappropriate referrals and improved compliance with response-time policies (Alkinaidri & Alsulami, 2018) gjhs.ccsenet.org Quality of primary care…”

Section: Resultsmentioning

confidence: 99%

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Assessing the Quality of the Saudi Healthcare Referral System: Potential Improvements Implemented by Other Systems

Shamsi¹,

Almutairi²,

Mashrafi³

2018

GJHS

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INTRODUCTION: The referral system authorizes and transfers the responsibility for healthcare services from one provider to another. A key component of the system is the communication between primary-care and specialist providers. Poor communication between them is detrimental to and can cause significant issues with coordination of effective care. OBJECTIVE: The purpose of this review was to evaluate current healthcare referral systems, focusing on the communication among providers, and to suggest practices that could make the Saudi healthcare referral system more effective. DESIGN: This systematic review identified published studies of the quality of the healthcare referral system in Saudi Arabia and other countries using two databases, Medline and PubMed. Data were summarized and extracted into two tables. RESULTS: The review included 12 studies that met its selection criteria. These studies were conducted in various regions of Saudi Arabia, but mostly the west and north. The 12 studies included 181,192 participants, with numbers of participants ranging from 21 to 138,484. The present review found that more than 50% of the referral documents and feedback reports in these studies had incomplete patient information. Implementation of electronic referrals (e-referrals) in several countries, including Australia, New Zealand and the United States, improved their referral systems, particularly by solving the problem of incomplete referral documents. In addition, the present review found that in some specialist clinics, referral cases contributed to increased workloads. One study reported on implementation of Lean Six Sigma principles in a military hospital in western Saudi Arabia, which reduced the number of referrals delayed, inappropriate referrals and the response time to referrals (7%). E-referrals and Lean Six Sigma principles may be applicable in Saudi Arabia as solutions to referral and response-time problems. CONCLUSIONS: An increase in healthcare referrals in Saudi Arabia has caused an increase in missing essential information in referral letters and feedback reports as well as overcrowding in specialist clinics. The results of the present review suggested that implementing e-referral and Lean Six Sigma principles may improve the quality of Saudi Arabia’s healthcare referral system.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Assessing the Quality of the Saudi Healthcare Referral System: Potential Improvements Implemented by Other Systems

Shamsi¹,

Almutairi²,

Mashrafi³

2018

GJHS

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“…Last phase is to develop the monitoring plan. Recommended tools are effective communication, long term solutions such as web based monitoring systems or control charts, awareness and others [27].…”

Section: Lean Six Sigma: Principle and Methodsmentioning

confidence: 99%

Optimization of software requirement process: An integrated conceptual model of lean six sigma and requirement planning

Salleh

Nohuddin

2019

IRASE

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Providing quality requirements in Software Engineering is vital to ensure the product developed is able to deploy and function to meet the operational objectives. Software Requirement Engineering is the most complex process because it involves the integration of human, logics and process. Extracting or capturing what customers need and want is called Requirement Elicitation (RE) and it is the most crucial process in requirement engineering. If handled poorly, the cost of the failures would be very expensive. Most of the software projects that failed were due to poor requirements which occurred at RE phase. Thus, enhancing and optimizing the RE methods have been subject to a long research debate to ensure quality requirements are captured. Recently, Lean Six Sigma (LSS) had emerged as part of a continuous improvement in Software Development Life Cycles (SDLC). LSS is known for a systematic and structure business improvement successfully deployed in many fields of industry that contributes a significant gain not only in quality of products and services but also in operational costs and delivery. The objective of the research is to develop an integrated conceptual framework of LSS principles with Software Requirement Engineering methodology to optimize RE process. The article will produce conceptual framework as the comprehensive guidelines to capture quality software requirements.

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“…(6) Waiting: activities awaiting completion and (7) Transportation: unnecessary waste in the process of transporting equipment or materials (Alkinaidri and Alsulami, 2018;Nabiyouni and Franchetti, 2019).…”

Section: Introductionmentioning

confidence: 99%

Implementing fast track surgery in hip and knee arthroplasty using the lean Six Sigma methodology

Latessa

Fiorillo

Picone

et al. 2021

TQM

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PurposeOne of the biggest challenges in the health sector is that of costs compared to economic resources and the quality of services. Hospitals register a progressive increase in expenditure due to the aging of the population. In fact, hip and knee arthroplasty surgery are mainly due to primary osteoarthritis that affects the elderly population. This study was carried out with the aim of analysing the introduction of the fast track surgery protocol, through the lean Six Sigma, on patients undergoing knee and hip prosthetic replacement surgery. The goal was to improve the arthroplasty surgery process by reducing the average length of stay (LOA) and hospital costsDesign/methodology/approachLean Six Sigma was applied to evaluate the arthroplasty surgery process through the DMAIC cycle (define, measure, analyse, improve and control) and the lean tools (value stream map), adopted to analyse the new protocol and improve process performance. The dataset consisted of two samples of patients: 54 patients before the introduction of the protocol and 111 patients after the improvement. Clinical and demographic variables were collected for each patient (gender, age, allergies, diabetes, cardiovascular diseases and American Society of Anaesthesiologists (ASA) score).FindingsThe results showed a 12.70% statistically significant decrease in LOS from an overall average of 8.72 to 7.61 days. Women patients without allergies, with a low ASA score not suffering from diabetes and cardiovascular disease showed a significant a reduction in hospital days with the implementation of the FTS protocol. Only the age variable was not statistically significant.Originality/valueThe introduction of the FTS in the orthopaedic field, analysed through the LSS, demonstrated to reduce LOS and, consequently, costs. For each individual patient, there was an economic saving of € 445.85. Since our study takes into consideration a dataset of 111 patients post-FTS, the overall economic saving brought by this study amounts to €49,489.35.

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Improving Healthcare Referral System Using Lean Six Sigma

Cited by 9 publications

References 9 publications

Assessing the Quality of the Saudi Healthcare Referral System: Potential Improvements Implemented by Other Systems

Assessing the Quality of the Saudi Healthcare Referral System: Potential Improvements Implemented by Other Systems

Optimization of software requirement process: An integrated conceptual model of lean six sigma and requirement planning

Implementing fast track surgery in hip and knee arthroplasty using the lean Six Sigma methodology

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