J Korean Soc Emerg Med.  2003 Dec;14(5):630-637.

Six Sigma Quality Improvement Process for Cancellation of Reception in the Emergency Department

• Lee KW
• Lee JH

Abstract

PURPOSE
The rate of Cancellation of Reception (CR) in the emergency department (ED) is one scale to determine the quality of emergency care. We applied the six sigma (6sigma) method to emergency care as a quality improvement activity. 6sigma is a disciplined, data-driven approach and methodology for eliminating defects through DMAIC process (define, measure, analyze, improve, control). In fact, the 6sigma method improved process control and reduced customer dissatisfaction with business department in areas such as quality, cost, and service. We reviewed the availability of the 6sigma method for performing quality improvement activities in the ED.
METHODS
We surveyed all patients who visited the ED from Oct. 6, 2001, to Oct. 12, 2001 (Measure period). We calculated the rate of CR and evaluated the causes and processes by using the 6sigma method. From Nov. 5, 2001, to Nov. 25, 2001 (Improve period), we controlled the process in the ED, educated the ED healthcare providers, and co-worked with all hospital healthcare providers to reduce the CR rate.
RESULTS
During the Measure period, the mean CR rate was 8.5% (2.938 sigma level). We found that the cause of disease did not influence the CR rate. When the 6sigma method was applied, during the Improve period, the mean CR rate reduced to 6.29% (3.079 sigma level).
CONCLUSION
We can implement and evaluate quality improvement activities in the ED more scientifically and systematically by applying the 6sigma method. Although it is necessary to monitor the quality of emergency care continuously, we think the 6sigma method will be a useful way to improve quality in the ED.

Keyword

Quality; Improvement

MeSH Terms

Commerce
Emergencies*
Emergency Medical Services
Emergency Service, Hospital*
Health Personnel
Humans
Quality Improvement*