Acceptance of Right from the Start Program in High Risk Patients in a Women's Medicine Center Clinic in Residency Training

Abstract

The objective of this study was the application of Six-Sigma methodology, specifically, the Define-Measure-Analyze-Improve-Control (DMAIC) and Lean tool to improve acceptance among expectant mothers into a governmental assistance program, Right from the Start. This program provides care coordinators for pregnant mothers, to help them stay healthy during pregnancy and obtain medical coverage both for themselves and their new babies. The focus was on high risk patients in an outpatient obstetric clinic serviced by a hospital based residency-training program. **Study Design** This was an observational study of changes resulting from the application of Six Sigma principles to the clinic process with particular attention to improving acceptance of the Right from Start program. **Methods** Using cohort analysis and Six Sigma principles, we compared the baseline process from 1 January 2013-30 June 2013 with our implemented intervention from 1 January 2014-30 June 2014. **Results** Using Lean and DMAIC tools (including voice of the customer) and team focused approach; involvement in the Right from the Start program increased from 26% to 98%. **Conclusion** We applied Six Sigma principles facilitating an interdisciplinary team approach to improve involvement in the Right from the Start program. Through focused problem assessment, verification of process, and validation of outcomes we improved patient participation in a program that helps pregnant women and their babies.