Using Six Sigma DMAIC Methodology and Discrete Event Simulation to Reduce Patient Discharge Time in King Hussein Cancer Center

Abstract

Short discharge time from hospitals increases both bed availability and patients' and families' satisfaction. In this study, the Six Sigma process improvement methodology was applied to reduce patients' discharge time in a cancer treatment hospital. Data on the duration of all activities, from the physician signing the discharge form to the patient leaving the treatment room, were collected through patient shadowing. These data were analyzed using detailed process maps and cause-and-effect diagrams. Fragmented and unstandardized processes and procedures and a lack of communication among the stakeholders were among the leading causes of long discharge times. Categorizing patients by their needs enabled better design of the discharge processes. Discrete event simulation was utilized as a decision support tool to test the effect of the improvements under different scenarios. Simplified and standardized processes, improved communications, and system-wide management are among the proposed improvements, which reduced patient discharge time by 54% from 216 minutes. Cultivating the necessary ownership through stakeholder analysis is an essential ingredient of sustainable improvement efforts.

Process mapping in healthcare: a systematic review

“…The identification of actual constraints and opportunities within local systems helped assessment of problem areas and development of improvement solutions grounded in research evidence and local knowledge [ 65 , 76 , 79 , 81 , 92 , 96 , 108 – 110 , 149 , 151 ]. The use of PM before the implementation of Information Systems (IS) has been shown to support project members with diverse backgrounds achieve a shared understanding of the system and has been reported as crucial for solving design challenges [ 88 , 111 – 115 ].…”

Process Mapping in Healthcare: A Systematic Review

“…[64,94,[96][97][98][98][99][100][101][102][103][104] (ii) Inform scope, design, development and evaluation of interventions The identi cation of actual constraints and opportunities within local systems helped assessment of problem areas and development of improvement solutions grounded in research evidence and local knowledge. [68,72,74,80,86,90,[105][106][107] The use of PM before the implementation of information systems (IS) to help project members with diverse backgrounds achieve a shared understanding of the system has been reported as crucial for solving design challenges. [82,[108][109][110][111][112] Some studies describe how PM has also been used to assess actual care processes against recognized evidence-based standards.…”

A Review Paper on Simulation Based Six Sigma Approach in Quality Assurance

“…Six sigma quality management approaches is used to reduce the distinction, evaluating defects and to improve the quality of products, processes, and facilities [7]. Due to the increasing complexity of electronic designs the "EDA" tools turn into more refined and able to face unbelievable tasks to conduct with developing technology.…”

“…As the discharge process creates problems in nature so simulation provides exciting platform that capture the complex features and also predict significances of potential improvement efforts. For this purpose (discrete event simulation) DES approach that combined with six sigma DMAIC frameworks is used that focuses on managing bed ability, enhanced patient flow, scheduling the staff, and handling patient scheduling processes [7]. For the testing of EDA tools our main focus is to reduce the weightage of defects before the product launching through this we can save money and also its better to remove the defects before the product launching rather than after launching of product [8] .…”