Title: Six Sigma: Tool for Quality and Cost Effectiveness

Authors: Dr Chandana G, Dr Kavita P Rasalkar, K Nagaraju

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.33

Abstract

  

Introduction: The Six Sigma plan measures the degree to which any process deviates from its goal. Six-sigma is a metric that quantifies the performance of processes as a rate of Defects-Per-Million Opportunities, (DPM, or DPMO). Sigma works on a quality principle of DMAIC which stands for Define, Measure, Analyse, Improve and Control.

Aims and Objectives: To evaluate our laboratory performance from Jan 2019 to June 2019 by estimating six-sigma.

Methodology: We evaluated sigma metric for 35 parameters run in our auto analyzers from Jan 2019 to June 2019 (6 months).Coefficient of variation which represents lab precision and BIAS which represents accuracy is calculated by using standard formulas. Later average six sigma was calculated from Jan 2019 to June 2019. Average Total error also was calculated for 6 months. To know about the goals for improvement in our laboratory after estimating six sigma we calculated quality goal index.

Results and Discussion:  Out of 35 parameters, we observed > 3 sigma metrics for 19 parameters of all levels. Parameters (T3, T4, TSH, Troponin I) and Gem Premier Instrument (pO2, pCO2) failed to show > 3 six sigma. The QGI showed that the problem lied with inaccuracy with these parameters. Sigma ≥6 is practically impossible to achieve. Total Protein and albumin has failed to achieve > 3 sigma metrics and imprecision problem lied with these parameters. Highest sigma metric was observed in pH, triglyceride, and lipase.

Conclusion: Our laboratory has performed considerably well after assessing through the sigma metric. Application of six sigma in laboratory can be a considerable indicator for quality and reducing number of IQC runs which can be cost effective. The drawback of not achieving standard world class six sigma all the time is still existing in healthcare. However quality reports with cost effectiveness should always be a dictum as a health care professional.

Keywords: Six Sigma, Coefficient of Variation, Total Allowable Error, Quality Goal Index.

References

  1. Abdurrahman Coskun, Tamer Inal, Ibrahim Unsal and Mustafa Serteser. Six Sigma as a Quality Management Tool: Evaluation of Performance in Laboratory Medicine.intechopen.com
  2. Study material: Workshop on Implementation of Six Sigma Metrics in Clinical Laboratories Organized by Ortho Clinical Diagnostics.
  3. Sunil Kumar Nanda and Lopamudra Ray, Role. Quantitative Application of Sigma Metrics in Medical Biochemistry Journal of Clinical and Diagnostic Research. 2013 Dec, Vol-7(12): 2689-2691.
  1. A Kirsch, R Lesiv, Ortho Clinical Diagnostics Rochester, New York; M Barba Laboratory Diagnostics Consulting, Atlanta, Georgia Comparative Study of Six Sigma Assay Performance on VITROS® Systems
  2. Ricos C, Alvarez V, Cava F, Garcia-Lario JV, Hernandez A, Jimenez CV, Minchinela J, Perich C, Simon M. “Current databases on biologic variation: pros, cons and progress.” Scand J Clin Lab Invest 1999;59:491-500. Database updated in 2014.
  3. RCPA/AACB Chemical Pathology QAP ALPJAN11-Revision of allowable limits of performance.
  4. Srinivas Chakravarthy Satish Ramanathan, Smitha S, Vijayakumar KV, Thirumalai Nallathambi, Micheal S. Phoenix in the lab: The sigma metrics during Chennai’s worst disaster: Monitoring and management of the Quality Management System (QMS)  IJPLM 2017;3(1):1-7
  5. West Gard QC.www.westgard.com
  6. Kirankumar P. Chauhan et al. Six sigma in clinical biochemistry: It matters, measure it. International Journal of Clinical Biochemistry and Research 2017; 4(3):270-274
  7. Manchana Lakshman et al. Evaluation of sigma metrics in a Medical Biochemistry lab International Journal of Biomedical Research 2015; 6(03): 164-171.
  8. Shilpa M agharkar.Six Sigma and quality control design. Biorad.
  9. Link to access TEa : CLIA : https://www.westgard.com/clia.htm
  10. Link to access TEa: RICOS Desirable : https://www.westgard.com/biodatabase1.htm
  11. Link to access TEa: RCPA: https://www.westgard.com/rcpa-biochemistry.htm

Corresponding Author

Dr Kavita P Rasalkar

Department of Biochemistry, PES Institute of Medical Science and Research, Kuppam