Development of a Six Sigma Infrastructure for Trabeculectomy Process

Abstract

The aim of this article is to show how an eye clinic of a Turkish public hospital initiated Six Sigma principles to reduce the number of complications encountered during and after trabeculectomy surgeries. Data were collected for ten years. To analyse the process, main tools of Six Sigma’s Define-Measure-Analyze-Improve-Control (DMAIC) improvement cycle such as SIPOC Table, Failure, Mode and Effect Analysis were implemented. Sources and root causes of ten types of complications were identified and reported. Patient’s eye anatomy, experience of ophthalmic surgeon, quality of surgical equipment, quality and type of suture, and experience of staff were identified to be Critical-to-Quality (CTQ) factors for a successful surgery. The most frequently occurring complication was found to be hypotony. The process sigma level of the process was measured to be 3.1391. The surgical team concluded that ten complications (out of twelve) should be significantly reduced by taking the necessary preventative measures.