Six sigma approach for neonatal jaundice patients in an Indian rural hospital – a case study

Abstract

Purpose The purpose of this paper is to implement Six Sigma approach to decrease the length of stay (LOS) of neonatal jaundice patients in an Indian government rural hospital situated in northern hill region. Design/methodology/approach Six Sigma’s Define–Measure–Analyse–Improve–Control procedure is applied in order to decrease the LOS of neonatal jaundice patients. The mean and standard deviation have been computed as 34.53 and 20.01 h, respectively. The cause and effect diagram is used in the “Analyse” phase of the Six Sigma. The regression analysis and GEMBA observation techniques are used to validate the causes identified through cause and effect diagram. Findings The waiting time for registration, waiting time for tests, waiting time for phototherapy and time for discharge implementation are the main factors that are responsible for longer LOS. Based on the identified root causes, some recommendations are suggested to the hospital administration and staff members in order to reduce the LOS. Research limitations/implications The present research is limited to provide recommendations to the hospital administration to reduce LOS and it entirely depends upon the implementation of the administration. However, target of administration is to reduce the LOS up to 24 h. Practical implications Six Sigma model will reduce bottlenecks in LOS and enhance service quality of hospital. The developed regression model will help the doctors and staff members to assess and control the LOS by controlling and minimising the independent variables. Social implications The project will directly provide benefits to society, as LOS will decrease and patients’ satisfaction will automatically increase. Originality/value Six Sigma is a developed methodology, but its application in paediatric department is very limited. This is the first ever study of applying Six Sigma for neonatal jaundice patients in India.

Lean six sigma and stroke in rural hospital – The case of Baruch Padeh Medical Center

“…The intervention was grounded on the LSS methodology, integrating the lean approach into the five phases of the Six Sigma DMAIC method (Sullivan et al, 2020) and was implemented in September 2017. The DMAIC adoption provides a roadmap (Niemeijer et al, 2010) for the lean intervention, supporting the definition of the project objectives, the development of a root cause analysis (Prajapati and Suman, 2019) and the identification and implementation of focused improvement actions (Toledo et al, 2013).…”

“…These methodologies are particularly suited to overcome the institution-related barriers affecting IV-tPA administration. Nevertheless, the LSS implementation for healthcare quality improvement projects is only widely adopted in developed regions, with most of its application in the USA and Europe (Prajapati and Suman, 2019). Evidence is still scarce on its application in rural areas, where improving process efficacy and efficiency is a priority of healthcare institutions in order to manage limited resources.…”

“…Six Sigma is a rigorous methodology structured on a data-driven process based on the DMAIC cycle (Kuwaiti and Subbarayalu, 2017). The LSS drastically reduces process waste and variation (Ahmed et al, 2018) and improves hospital quality performance (Jacobson and Johnson, 2006), generating innovative and efficient solutions for the healthcare sector (Prajapati and Suman, 2019). These methodologies indirectly impact the level of patient care by improving the quality of the process (Holden, 2011).…”

“…Similarly Ahmed et al (2019) pointed out that LSS and workforce management have a significant impact on quality performance of the Malaysian hospitals. Concerning the six sigma, Prajapati and Suman (2019) presented a successful application aimed to reduce the length of stay for neonatal jaundice patients in an Indian rural hospital. Similarly, Ishijima et al (2019) noticed that the dissemination of the Lean and Total Quality Management approach positively influenced the Egyptian health sector and its sustainability.…”

Effects of Six Sigma methodology on depression and anxiety of patients with end-stage renal disease

“…These are definition, measurement, analysis, improvement, and control, and they aim to eliminate unnecessary steps and process variabilities to reduce errors and improve quality in treatment procedures and nursing care. Six Sigma methodology has been found to reduce the length of hospital stay by minimizing the possible variabilities (9). The rate of cesarean section in pregnancy was reported to decrease from 41.83% to 32% by Six Sigma methodology (10).…”