Korean J Lab Med.  2009 Apr;29(2):171-177. 10.3343/kjlm.2009.29.2.171.

Reducing Patient Waiting Time for the Outpatient Phlebotomy Service Using Six Sigma

• Kim YK
• Song KE
• Lee WK

• KMID: 854982
• DOI: http://doi.org/10.3343/kjlm.2009.29.2.171

Abstract

BACKGROUND
One of the challenging issues of the outpatient phlebotomy services at most hospitals is that patients have a long wait. The outpatient phlebotomy team of Kyungpook National University Hospital applied six sigma breakthrough methodologies to reduce the patient waiting time. METHODS: The DMAIC (Define, Measure, Analyze, Improve, and Control) model was employed to approach the project. Two hundred patients visiting the outpatient phlebotomy section were asked to answer the questionnaires at inception of the study to ascertain root causes. After correction, we surveyed 285 patients for same questionnaires again to follow-up the effects. RESULTS: A defect was defined as extending patient waiting time so long and at the beginning of the project, the performance level was 2.61 sigma. Using fishbone diagram, all the possible reasons for extending patient waiting time were captured, and among them, 16 causes were proven to be statistically significant. Improvement plans including a new receptionist, automatic specimen transport system, and adding one phlebotomist were put into practice. As a result, the number of patients waited more than 5 min significantly decreased, and the performance level reached 3.0 sigma in December 2007 and finally 3.35 sigma in July 2008. CONCLUSIONS: Applying the six sigma, the performance level of waiting times for blood drawing exceeding five minutes were improved from 2.61 sigma to 3.35 sigma.

Keyword

6 Sigma; Customer; Waiting Time Reduction

MeSH Terms

Efficiency, Organizational
Humans
Outpatient Clinics, Hospital/*standards
*Phlebotomy
Process Assessment (Health Care)
Questionnaires
Time Factors
Total Quality Management

Figure

• 

  Fig. 1. Graphical display of analysis of defective details using Pare-to chart.

• 

  Fig. 2. Percentage distribution of patient satisfaction with time spent in the phlebotomy station.

• 

  Fig. 3. Changes of sigma performance (▴) and waiting time (▪).

• 

  Fig. 4. Changes of average waiting time of the day (♦, February 2007; ▪, December 2007; ▴, July 2008).

Reference

1.Harry M, Schroeder R, editors. Six sigma: the breakthrough management strategy revolutionizing the world's top corporations. 1st ed.New York: Doubleday Business;2000. p. 299.

2.Westgard JO. Six sigma quality: performance metrics vs. laboratory myths. AACC presentation. 2002. http://www.aacc.org/events/expert_access/2002/westgard/Pages/presentation.aspx.

3.Westgard JO., Klee GG. Quality management. Burtis CA, Ashwood ER, editors. , eds.Tietz textbook of clinical chemistry and molecular diagnostics. 4th ed.Philadelphia: Elsevier and Saunders;2006. p. 488–90.

4.Gras JM., Philippe M. Application of the six sigma concept in clinical laboratories: a review. Clin Chem Lab Med. 2007. 45:789–96.

5.Riebling NB., Tria L. Laboratory toolbox for process improvement: six sigma at north shore-long island jewish health system. Lab Med. 2008. 39:7–14.

6.Nevalainen D., Berte L., Kraft C., Leigh E., Picaso L., Morgan T. Evaluating laboratory performance on quality indicator with the six sigma scale. Arch Pathol Lab Med. 2000. 124:516–9.

7.Westgard JO., Westgard SA. The quality of laboratory testing today: an assessment of σ metrics for analytical quality using performance data from proficiency testing surveys and the CLIA criteria for acceptable performance. Am J Clin Pathol. 2006. 125:343–53.

8.Simmons JC. Using Six Sigma to make a difference in health care quality. Qual Lett Healthc Lead. 2002. 14:2–10.

9.Riebling N., Tria L. Six sigma project reduces analytical errors in an automated lab. MLO Med Lab Obs. 2005. 37:22–3.

10.Jackson J., Woeste LA. Using lean six sigma to reduce patient wait times. Lab Med. 2008. 39:134–6.