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SIX SIGMA AND LEAN CONCEPT IN LABORATORY MEDICINE

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Title: SIX SIGMA AND LEAN CONCEPT IN LABORATORY MEDICINE


1
SIX SIGMA AND LEAN CONCEPT IN LABORATORY MEDICINE
  • Abdurrahman COSKUN, MD
  • Düzce University, School of Medicine, Department
    of Clinical Biochemistry
  • Düzce-TURKEY

2
Six Sigma
  • The Six Sigma was developed in the early 1980s by
    Motorola Corp. to improve the products
    reliability
  • The methodology represents an evolution in
    quality management that is being widely
    implemented in business and industry in the new
    millennium

3
The Six Sigma strategy
  • The Six Sigma strategy measures the degree to
    which any process deviates from its goal
  • The sigma value indicates how often errors are
    likely to occur the higher the sigma value, the
    less likely it is that the process will produce
    errors.

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Sigma metrics
  • Sigma metrics are being adopted as a universal
    measure of quality and the performance of all
    processes can be characterized on the "Sigma
    scale."
  • Any process can be evaluated in terms of the
    number of sigma metrics that fit acceptable
    limits.

6
  • The process Sigma level can be calculated by
    dividing the allowable tolerance for the process
    by twice the process SD
  • Sigma Total process tolerance /
    (2process
    SD).

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  • However in clinical laboratory measurements, it
    is straightforward to measure the sigma
    performance of analytical methods as formulated
    below
  • Sigma (TEa-bias)/CV
  • where TEa is the total error allowable and
  • CV is the coefficient of variation.
  • Ideally, Six Sigma, or six SD, should fit within
    the acceptable limits of a process

9
-6s -5s -4s -3s -2s -1s
0s 1s 2s 3s 4s 5s 6s
10
T
  • -6s -5s -4s -3s -2s -1s
    0s 1s 2s 3s 4s 5s 6s

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  • The best or world class processes have a
    level of 6 sigma, which means that in this
    process fewer than 3.4 errors occur per million
    products or tests (with 1.5 standard deviation
    (SD) shift)

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6.8
3.4
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  • In clinical laboratories, Sigma is usually
    calculated for the analytical phase of testing
    process
  • However the entire medical loop of the total
    testing process, i.e. from the clinician to the
    laboratory and back to the clinician consist 5
    phases
  • Pre-pre-analytical,
  • Pre-analytical,
  • Analytical,
  • Post-analytical and
  • Post-post-analytical phases.

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Lean Concept
  • In patient focused quality management high level
    of quality itself is not adequate, the result of
    patients tests should be reported within the
    given time and in communication with the
    physicians.

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  • For that reason we should combine the Lean
    concept with Six Sigma to make the work faster
    (using Lean principles) and better (using Six
    Sigma principles)
  • Traditionally the Six Sigma focused more on
    quality than the speed and the Lean focused on
    the flow speed than quality improvement

21
  • The four keys of Lean Six Sigma could be
    defined as
  • Delight patients with speed and quality,
  • Improve methods and processes,
  • Work together for maximum gain, and
  • Base decision on data and facts

22
  • Clinical laboratories, which have been used Lean
    Six Sigma in total quality management, decreased
    errors and contributed patients safety more than
    most other healthcare sectors
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