Strengthening Hospital Capacity for the COVID-19 Pandemic: Implementation of Electronic Patient Discharge

Background: Increasing hospital capacity to cover the service demands is an important priority during an epidemic or a pandemic. The aim of this study was to increase hospital capacity using the Six Sigma method to improve the patient discharge process. Methods: This was a quantitative study. The Pre- and post-intervention study was conducted in a big hospital designated for COVID-19 patients. The patient discharge process was evaluated and improved based on seven sub-processes and following the Six Sigma model, including defining the problem, measuring time in each of the discharge stations, analysis times and process, improvement process, and control. Results: Implementation of the electronic patient discharge led to a 51.9% decrease in discharge time from 7.3 h during the pre-intervention period to 3.8 h post-intervention (P< 0.0001). According to the Sigma level, the yield and defects per million opportunities of the discharge process also improved to 55%. Conclusion: Increasing hospital capacity by improving the discharge time is a quick action to cover the demand created during pandemics. Also, about 32 beds can be obtained by applying the Six Sigma model to improve the discharge process in a short time and at a very low cost.

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Implementation of Electronic Patient Discharge: A Successful Strategy to Increase Hospital Bed Capacity During the COVID-19 Pandemic

10.32592/ircmj.2021.23.12.1505 ◽

2021 ◽

Keyword(s):

Six Sigma ◽

Patient Discharge ◽

Management Tool ◽

Discharge Process ◽

Care Hospital ◽

Discharge Time ◽

Post Intervention ◽

Hospital Bed Capacity ◽

Hospital Bed ◽

Bed Capacity

Background: The ongoing COVID-19 pandemic increased the need for inpatient beds, indicating the need for hospitals to increase the efficiency of beds. Objectives: This study aimed to increase hospital bed capacity using the implementation of Electronic Patient Discharge (EPD). Methods: This qualitative-quantitative study was conducted in a tertiary care hospital using the pre-and post-intervention designs, and the main outcome was patient discharge time. By applying the Six Sigma model, including definition, measurement, analysis, improvement, and control, the patient discharge process was assessed and improved by some interventions such as EPD. All hospitalized patients with COVID-19 from 21 March 2020 to 22 July 2021 were examined for the post-intervention. In addition, data were collected from the hospital information system (HIS). Results: By the use of EPD, patient discharge time decreased to 47.70% (from 10.19 h to 5.33 h) (P < 0.000). According to the Sigma level, the yield and defects per million opportunities of the discharge process also increased to 55%. Conclusion: Six Sigma methodology can be an effective change management tool to improve discharge time to cover the demand created during pandemics. According to the results of the present study and the obtained saved time, one bed is added to the hospital capacity for every five discharges.

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Implementation of Six Sigma Method To Improve Hospital Discharge Process: A Before-And- After Study With The Control Group In A Large Hospital

10.21203/rs.3.rs-731820/v1 ◽

2021 ◽

Author(s):

Somayeh Fazaeli ◽

Mehdi Yousefi ◽

Mohadeseh Sabethoseini Dokht ◽

Hamidreza Heidarian

Keyword(s):

Hospital Discharge ◽

Waiting Time ◽

Six Sigma ◽

Management Tool ◽

Control Group ◽

Discharge Process ◽

Control Groups ◽

Discharge Time ◽

Post Intervention ◽

And Control

Abstract Background: Delayed hospital discharge is a complex process that can impact hospital and service delivery capacity. The improvement of this process requires structural reforms and coordination with different wards, individuals, and the hospital.The present study aimed to use the Six Sigma method to reduce hospital discharge time. Methods: This pre-post study was conducted based on an experimental design from 2016 to 2020. A series of Six Sigma-driven interventions based on the Define-Measure-Analyze-Improve-Control (DMAIC) cycle was employed in a 1,000 bed tertiary care hospital to decrease discharge waiting time. Two wards in the hospital were allocated to the intervention and control groups. Three months of pre-intervention data were compared with 16 months of post-intervention in each group. The data were analyzed in Stata software (version 14.1). The level of statistical significance was set at 0.000.Results: There was a significant difference (P<0.000) between pre and post-intervention, as well as experimental and control groups. The discharge time points in the intervention and control groups before the intervention were reported as 438 and 411 min, respectively. After the intervention, the discharge time reached 246 min (3.20 h decrease) in the intervention group (P<0.000) and 475 min in the control group (P<0.574). The waiting time in stations 2, 3, and 4 reached zero after the intervention(P<0.000). The trend of discharge time after the intervention from October 2017 to March 2020 demonstrated that the changes were stable (184±25.56 min).Conclusions: As evidenced by the obtained results, the Six Sigma methodology can be an effective change management tool for the improvement of discharge time. The findings suggested that the use of electronic discharge and focusing on physician readiness for writing a discharge order would have the greatest impact.

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Quality improvements on creative industry by using Six Sigma: a study case

MATEC Web of Conferences ◽

10.1051/matecconf/201815401088 ◽

2018 ◽

Vol 154 ◽

pp. 01088

Author(s):

Dwi Adi Purnama ◽

Riadho Clara Shinta ◽

Vembri Noor Helia

Keyword(s):

Six Sigma ◽

Textile Industry ◽

Fuzzy Ahp ◽

Creative Economy ◽

Creative Industry ◽

Quality Improvements ◽

Sigma Level ◽

Study Case ◽

And Control ◽

Hierarchy Process

Indonesia has several creative economy sectors that rapidly developed and potentially can be improved to 7% annually. One of them is textile industry specifically bag industry. This industry’s development could enhance the production of commodities and emerge other SMEs to initiate the similar field. Therefore, to raise its profit, customer’s satisfaction must be elevated by minimizing defected products. In order to support it, an improvement on production process is a must. This research employs Six Sigma methods integration with Fuzzy Analytical Hierarchy Process (Fuzzy AHP)-Failure Mode and Effect Anlysis (FMEA). Six Sigma is designated to analyze the level of products’ defect through Define, Measure, Analyze, Improve, and Control (DMAIC) stages and assess the factors that cause the defects by using Fuzzy AHP decision support system and FMEA in risk analysis on defect. The result of the research shows the shortage of defects that demonstrated by DPMO indicator and Sigma level. It is identified that the number of DPMO was being reduced from 20003.75 to 11185.73. While Six Sigma level demonstrated the enhancement from 3.61 to 3.86. Those suggest that the improvement solution provides has significant effect on the defects decreasing at the bag convection industry.

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QUALITY IMPROVEMENT ON CERAMIC TILES PROUCTION PROCESS WITH SIX SIGMA METHOD (DMAIC) AT PT ARWANA CITRAMULIA

Journal Industrial Manufacturing ◽

10.31000/jim.v3i2.857 ◽

2018 ◽

Vol 3 (2) ◽

pp. 101

Author(s):

Priskila Christine Rahayu ◽

Vanesa Darvin

Keyword(s):

Quality Improvement ◽

Production Process ◽

Six Sigma ◽

Ceramic Tiles ◽

Control Approach ◽

Sigma Level ◽

And Control

This study focused on quality improvement on ceramic tiles production process at PT Arwana Citramulia. This study used data defects for 12 months (May 2016 – April 2017) and only focus on one type of defect and it is chop corner. Six sigma with DMAIC (define, measure, analyze, improve, and control) approach was used to improve the process. Each step of DMAIC was conducted to carefully analyze and keep the process precisely. The ceramic tiles production process contains a number of 4375 products defects in million opportunities (DPMO), with sigma level of 4.13. In the improve step of DMAIC, FMEA form was used to propose some recommendations in order to improve the process, some of that that are provision of lubricant periodically by the operator, polishing on the surface of the liner to clean and clear, examination and maintenance periodically. Keyword : Quality, Six Sigma, DMAIC, Defects.

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ANALISIS KECACATAN KEMASAN PRODUK OKKY JELLY DRINK PERISA BLACKCURRANT SEBAGAI UPAYA PERBAIKAN KUALITAS DENGAN METODE DMAIC PADA PT. TRITEGUH MANUNGGAL SEJATI

Industrika: Jurnal Ilmiah Teknik Industri ◽

10.37090/indstrk.v3i1.129 ◽

2019 ◽

Vol 3 (1) ◽

Author(s):

Suharto Suharto ◽

Keyword(s):

Quality Control ◽

Production Process ◽

Six Sigma ◽

Cause And Effect ◽

Sigma Level ◽

Quality Control Tool ◽

And Control ◽

Cause And Effect Diagram ◽

Control Tool

Abstract This study aims to determine and identify the causes of defects in the production process of PT. Triteguh Manunggal Sejati and know the level of sigma level. This research uses the six sigma method with the DMAIC approach as a quality control tool, which includes the Define, Measure, Analyze, Improve and Control stages. Based on this study the results obtained are the level of sigma level at PT.Triteguh Manunggal Sejati is 4.96, which means that in the stage of sigma level the company has not reached the level of six sigma levels because in the production process at PT.Triteguh Manunggal Sejati still has product defects in the production process not yet achieved zero defect. The causes of product defects are based on cause and effect diagrams namely lid / seal defects are leaky lid, broken lid, and tilted lid. Kata kunci : Defect, Six Sigma, DMAIC, cause and effect diagram

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Reduction of Rejection Rate for High Gloss Plastics Product Using Six Sigma Method

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.606.141 ◽

2014 ◽

Vol 606 ◽

pp. 141-145

Author(s):

Che Ku Abdullah Che Ku Kairulazam ◽

M.I. Hussain ◽

Zuraidah Mohd Zain ◽

Nabilah A. Lutpi

Keyword(s):

Injection Molding ◽

Six Sigma ◽

Rejection Rate ◽

Injection Molding Process ◽

Molding Process ◽

Sigma Level ◽

Potential Factors ◽

High Rejection Rate ◽

And Control ◽

Plastic Injection

High gloss plastics part in injection molding industries were widely used in Malaysia. However the high rejection rate in this industries were major problem affecting the economic aspects. Therefore this paper presents an approach of implementing six sigma method to reduce the rejection rate in a plastic injection molding process for high gloss plastics part. Define, Measure, Analyze Improve and Control (DMAIC) methodology was applied as basis of the study. By using current process, the average of rejection is 40.6% and the aim of this study is to reduce the rejection rate to less than 10 % . All potential factors were taken into account to identify the significant factors. The improvement process was made base on the analysis output. This study was successful with increment in sigma level from 1.74 σ to 3.00 σ. .

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ANALISIS PERBAIKAN KUALITAS INJECTION PART DENGAN PENDEKATAN LEAN SIX SIGMA

EKOMABIS: Jurnal Ekonomi Manajemen Bisnis ◽

10.37366/ekomabis.v1i01.7 ◽

2020 ◽

Vol 1 (01) ◽

pp. 79-90

Author(s):

Miftakul Huda

Keyword(s):

Injection Molding ◽

Six Sigma ◽

Rejection Rate ◽

Lean Six Sigma ◽

Factorial Experiment ◽

Full Factorial Experiment ◽

Yield Rate ◽

Sigma Level ◽

And Control ◽

Full Factorial

Lean Six Sigma is a collective approach, which uses various techniques and tools for quality improvement. Here, Lean Six Sigma methodology was applied to a small injection molding unit (which can be taken as representative of small and medium-size industries) manufacturing casing of electronics part. The DMAIC (Define, Measure, Analyze, Improve and Control) approach of Lean Six Sigma was applied to reduce the rejection rate of the casing (child part of an electronic product) by changing setting parameters: mold temperature, injection pressure and injection speed in the injection mold process. The statistical techniques such as DOE full factorial experiment, and process capability analysis were done to finding the process capability before and after the Lean Six Sigma implementation. After implementing the Lean Six Sigma DMAIC approach it was found that injection molding firms can increase their profit by increase yield rate and deleting rejection rate of casing part. Lean Six Sigma implementation increase the process sigma level from 4,3σ to 4,7σ by a reduction in casing flow mark variation and transparency. This increase in sigma level will give defect cost reduction to the industry which is a good figure for such an industry. Abstrak Lean Six Sigma adalah pendekatan kolektif, yang menggunakan berbagai teknik dan alat untuk peningkatan kualitas. Di sini, metodologi Lean Six Sigma diterapkan pada unit injection molding kecil (yang dapat dianggap mewakili industri ukuran kecil dan menengah) manufaktur casing part. Pendekatan DMAIC (Define, Measure, Analyze, Improve and Control) Lean Six Sigma diterapkan untuk mengurangi tingkat penolakan casing part (bagian anak dari produk elektronik) dengan mengubah tiga setting parameter: suhu mold, tekanan dan kecepatan injection dalam proses cetakan injeksi. Teknik statistik seperti DOE full factorial experiment,dan analisis kemampuan proses dilakukan untuk menemukan kemampuan proses sebelum dan sesudah implementasi Lean Six Sigma. Setelah menerapkan pendekatan Lean Six Sigma DMAIC ditemukan bahwa perusahaan injection molding dapat meningkatkan keuntungannya dengan menaikan yield rate dengan mengendalikan tingkat penolakan casing part. Implementasi Lean Six Sigma meningkatkan tingkat sigma proses dari 4,3σ menjadi 4,8σ dengan mengurangi variasi flow mark dan transperancy. Kenaikan tingkat sigma ini akan memberikan pengurangan biaya akibat cacat ke industri yang merupakan contoh yang baik untuk industri semacam ini.

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Usulan Penurunan Tingkat Kecacatan Produk Pelat Baja dengan Metode Six Sigma

Jurnal INTECH Teknik Industri Universitas Serang Raya ◽

10.30656/intech.v3i2.877 ◽

2017 ◽

Vol 3 (2) ◽

pp. 41

Author(s):

Muhamad Bob Anthony

Keyword(s):

Production Process ◽

Six Sigma ◽

Standard Operating Procedures ◽

Maintenance Scheduling ◽

Sigma Level ◽

Standard Operating ◽

Main Factors ◽

And Control ◽

Developing Knowledge

This study aims to maximize the decline in the level of product defects to lead to zero defects. Researchers use the six sigma method through 5 stages of completion, namely, define, measure, analyze, improve, and control. Based on the results of the study it can be concluded that the sigma level and the value of DPMO (Defect per Million Opportunities) of the company amounted to 3.47 with possible damage of 24,239 sheets for one million productions. After further analysis using the Pareto diagram, it found that the cutting fault transfer defect was the most common with a percentage of damage of 43%. And based on the results of the analysis of fishbone diagrams, it can be seen that the main factors causing contamination in the production process come from the worker factor (human), followed by machine factors, material, and work methods. The proposed improvements that can be made by the company include updating existing methods and SOPs (standard operating procedures) and monitoring the operator's performance and developing knowledge and planning proper maintenance scheduling.

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A new lean Six Sigma hybrid method based on the combination of PDCA and the DMAIC to improve process performance: Application to clothing SME

Industria Textila ◽

10.35530/it.070.05.1595 ◽

2019 ◽

Vol 70 (05) ◽

pp. 447-456 ◽

Cited By ~ 1

Author(s):

ABBES NEDRA ◽

SEJRI NÉJIB ◽

CHAABOUNI YASSINE ◽

CHEIKHROUHOU MORCHED

Keyword(s):

Six Sigma ◽

Lead Time ◽

Success Factors ◽

Lean Six Sigma ◽

Process Performance ◽

Combination Technique ◽

Sigma Level ◽

Quality Certification ◽

Tools And Techniques ◽

And Control

This paper proposes a new Lean Six Sigma (LSS) methodology to improve process for clothing small- and medium-sized enterprise SME. The methodology is based on combination of two approaches which are the PDCA (Plan, Do, Check, and Act) and the DMAIC (Define, Measure, Analyze, Improve, and Control). The combination technique consists in applying the PDCA to continuously improve and control every DMAIC steps. The DMAIC approach has included Lean Six Sigma tools and techniques, as well as the success factors obtained from a survey, to improve its efficiency. The proposed approach is applied to improve the performances indicators such as Z sigma, Cp, cycle time, and lead time for the case of clothing SME in Tunisia. As an example, the Z-sigma has increased from the sigma level was improved from 1.45 to 3.85. The process capability Cp from 0.5 to 1.3 and the lead time was decreased from 39.47 days to 30.23 days. Finally, the study is concluded by sorting out the effects of the type of produced articles and the presence or not of the quality certification on the application of the proposed approach. The effectives from using PDCADMAIC technique are better when it’s applied with certified company, than non-certified one.

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Penerapan Metoda Six Sigma DMAIC untuk Mengurangi Cacat Pakaian 514 (Studi Kasus di CV Jaya Reksa Manggala)

Jurnal Rekayasa Sistem Industri ◽

10.26593/jrsi.v7i1.2716.31-40 ◽

2018 ◽

Vol 7 (1) ◽

pp. 31

Author(s):

Sugih Sudharma Tjandra ◽

Nixon Setia Utama ◽

Hanky Fransiscus

Keyword(s):

Quality Improvement ◽

Initial Data ◽

Six Sigma ◽

Sigma Level ◽

Control Stage ◽

Improvement Method ◽

And Control ◽

Dmaic Method

<em>CV Jaya Reksa Manggala (JRM) is one of clothing company. With increasing competition in this clothing company, the companies are required to keep improving the quality of clothing products. One of the important things in quality is reduction of product defects. One of the proven methods of quality improvement is the Six Sigma DMAIC method, which is a continous improvement method that aims to achieve the best quality. One of the products of CV JRM which is still have a lot of defects is 514 products. From the initial data obtained, DPMO value for process I and II for 514 products is 10,768.52 and 27,341.42 with sigma level 3.79 and 3.43. The steps undertaken in this Six Sigma DMAIC method include define, measure, analyze, implementation and control. Several proposed improvements were then made to reduce the problem of these defects and from the data at the control stage, the DPMO values of processes I and II became 2,941.76 and 1,812.69 with sigma levels of 4.25 and 4.41. From this result it can be said that with Six Sigma DMAIC method, there is improvement of quality for product 514 at CV JRM. </em>

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