Sigma Define, Measure, Analyze, Improve And Control Research Articles

Influencing factors of Six Sigma management in the construction of students mental health service system in the post-COVID-19 era

PurposeThis study aims to construct a mental health service system for middle school students in the post-COVID-19 era with the framework of Six Sigma DMAIC (define, measure, analyze, improve and control) and analyze the influencing factors of the mental health service system to study the implementation strategies of quality-oriented mental health services in middle schools.Design/methodology/approachThis study was conducted in Tianjin, China, from September to November 2022, and 350 middle school students from Tianjin Public Middle School were selected as subjects. A questionnaire survey was used to collect data. In this study, the Six Sigma DMAIC method, sensitivity analysis method, exploratory factor analysis and principal component analysis were used to analyze the mental health services provided to middle school students.FindingsBased on the Six Sigma DMAIC framework, this study indicates that the contribution rate of the mental health service process factor is the largest in the post-COVID-19 era. The mental health cultivation factor ranks second in terms of its contribution. Mental health quality and policy factors are also important in the construction of middle school students’ mental health service system. In addition, the study highlights the importance of parental involvement and social support in student mental health services during the post-COVID-19 era.Originality/valueTo the best of the authors’ knowledge, a study on middle school students’ mental health in the post-Covid-19 era has not yet been conducted. This study developed a quality-oriented mental health system and analyzed the influencing factors of mental health for middle school students based on data analysis and the Six Sigma DMAIC method.

Perioperative Risk Assessment for Skin Injury.

Hospital-acquired pressure injuries create a tremendous cost to health care organizations and negatively affect quality and patient safety. Surgical patients are at an increased risk for skin injury, particularly a pressure injury, because of a lack of sensation and immobility during a procedure. An interprofessional team at our facility identified factors that place surgical patients at risk for skin injury. We developed a risk assessment protocol in March 2021 using the Six Sigma DMAIC (define, measure, analyze, improve, and control) method. After data review and analysis, we identified age of 65 years or older, existence of a skin condition, and procedural duration greater than four hours as significant predictors for postoperative skin injury. Our findings reinforce the benefit of using an appropriate risk assessment protocol that alerts the perioperative team members to at-risk patients.

Operational excellence of the steel industry using the Lean Six Sigma approach: a case study

PurposeThis article aims to focus on implementing Lean Six Sigma (LSS) in steel manufacturing to enhance productivity and quality in the galvanizing process line. In recent trends, manufacturing organizations have expressed strong interest in the LSS since they attempt to enhance its overall operations without imposing significant financial burdens.Design/methodology/approachThis article used lean tools and Six Sigma's DMAIC (Define, Measure, Analyze, Improve and Control) with Yin's case study approach. This study tried to implement the LSS for the steel galvanizing process in order to reduce the number of defects using various LSS tools, including 5S, Value stream map (VSM), Pareto chart, cause and effect diagram, Design of experiments (DoE).FindingsResults revealed a significant reduction in nonvalue-added time in the process, which led to improved productivity and Process cycle efficiency (PCE) attributed to applying lean-Kaizen techniques. By deploying the LSS, the overall PCE improved from 22% to 62%, and lead time was reduced from 1,347 min to 501 min. DoE results showed that the optimum process parameter levels decreased defects per unit steel sheet.Practical implicationsThis research demonstrated how successful LSS implementation eliminates waste, improves process performance and accomplishes operational distinction in steel manufacturing.Originality/valueSince low-cost/high-effect improvement initiatives have not been adequately presented, further research studies on adopting LSS in manufacturing sectors are needed. The cost-effective method of process improvement can be considered as an innovation.

Peningkatan Kualitas Produk Sempol Ayam Frozen Dengan Metode Sigma di UMKM XYZ, Gianyar-Bali

XYZ MSME is a frozen chicken abacus producer in Gianyar Regency. More and more competitors require companies to improve the quality of their products as a step to prevent consumers from moving to competing products. Quality problems have not been fully implemented by XYZ MSME as seen from the large number of defective products. The purpose of this study is to determine the factors that cause product defects and provide suggestions for improvements that are in accordance with the conditions of MSMEs so as to achieve zero defects. The method used is six sigma DMAIC (Define, Measure, Analyze, Improve, and Control) with Failure Modes and Effect Analysis (FMEA). The sigma value obtained is 2.821 while the %final yield is 81.358%. The contributing factors are man (33.33%), machine/equipment (16.67%), method (33.33%), and environment (16.67%). The proposed improvements given are additional employees, the use of alarms, the use of production equipment according to production capacity, and temporary closure of the selling place.

Use of a Lean Six Sigma approach to investigate excessive quality control (QC) material use and resulting costs

PurposeThe Eastern Health Clinical Biochemistry Laboratories cater to the province of Newfoundland and Labrador. Over the last ten years, a significant increase in annual expenses on quality control material and calibrator purchases was observed. Two major Clinical Chemistry Laboratories at the Health Sciences Centre (HSC) and St. Clare’s Mercy Hospital (STC), St. John’s, work as referral centers for the province. The study’s design was based on the Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) process and involved tests performed on ten automated Abbott Clinical Chemistry (CC) and Immunoassay (IA) analyzers. The cost of purchasing the QC material from Bio-Rad and Randox had increased due to defective QC and analyzer test assignment process design. The processes were modified. An Individualized Quality Control Plan (IQCP) was developed. ResultsModification in quality control processes helped in bringing down the cost and usage of both QC and calibrators. The cost and usage of individual control material were reduced by 25 to 52% depending on the type of quality control. Total annual expenditure on the purchase of different QC materials before modification was estimated as CAD 346,395(2019) which was reduced to CAD 255,267 with annual savings of 91,128 CAD (26%) after modification (2020). The average usage reduction for various calibrators was 40% with the highest reduction in the use of urine calibrators. The annual cost of calibrators was reduced from CAD 30,568.42 (2019-20) to CAD 17,517 (2020-21) with the saving of approximately 13,051 Canadian dollars (43 %) for the laboratory. ConclusionsThere is a constant compulsion in every industry to manage costs. Implementation of Lean and Six Sigma methodology in removing Muda of high costs in a Clinical Chemistry Laboratory is the most warranted strategy in developing a cost-effective laboratory framework.

Sustaining Improvements of Surgical Site Infections by Six Sigma DMAIC Approach.

SSIs (surgical site infections) are associated with increased rates of morbidity and mortality. The traditional quality improvement strategies focusing on individual performance did not achieve sustainable improvement. This study aimed to implement the Six Sigma DMAIC method to reduce SSIs and to sustain improvements in surgical quality. The surgical procedures, clinical data, and surgical site infections were collected among 42,233 hospitalized surgical patients from 1 January 2019 to 31 December 2020. Following strengthening leadership and empowering a multidisciplinary SSI prevention team, DMAIC (Define, Measure, Analyze, Improve, and Control) was used as the performance improvement model. An evidence-based prevention bundle for reduction of SSI was adopted as performance measures. Environmental monitoring and antimicrobial stewardship programs were strengthened to prevent the transmission of multi-drug resistant microorganisms. Process change was integrated into a clinical pathway information system. Improvement cycles by corrective actions for the risk events of SSIs were implemented to ensure sustaining improvements. We have reached the targets of the prevention bundle elements in the post-intervention period in 2020. The carbapenem resistance rates of Enterobacteriaceae and P. aeruginosa were lower than 10%. A significant 22.2% decline in SSI rates has been achieved, from 0.9% for the pre-intervention period in 2019 to 0.7% for the post-intervention period in 2020 (p = 0.004). Application of the Six Sigma DMAIC approach could significantly reduce the SSI rates. It also could help hospital administrators and quality management personnel to create a culture of patient safety.

Shifting Culture by Creating Synergy and Equity Through the Unification of Tenure Criteria.

Tenure requirements within universities vary; however, most focus on excellence in teaching, service, and scholarship. Within our university, faculty with either research or clinical doctorates were on both tenure and clinical tracks, with reported marginalization from clinical track faculty. A task force was convened in 2018 to develop a unified single track that included a single set of criteria for all College of Health Professions faculty to obtain tenure. The Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) Roadmap was used to guide the work of the task force. The implementation of a single track has influenced discourse around previous notions regarding what is considered "tenure worthy" and has opened the door to contractual equity among faculty. Internal structures, such as implementation of a single track, can support cohesion and productivity that facilitates collaborations among faculty of all ranks and degree backgrounds, promoting a culture that continues to embrace intellectual discourse and unity. [J Nurs Educ. 2022;61(8):455-459.].

Practical application of six SIGMA methodology to reduce defects in a Pakistani manufacturing company

All over the world six sigma is being adopted as a quality improvement approach towards zero defects. Unfortunately, the adoption of six sigma methodology in manufacturing companies is very rare in developing countries due to various challenges. This study demonstrates the practical use of the six sigma Define, Measure, Analyze, Improve and Control (DMAIC) cycle by conducting a case study at a manufacturing company in Pakistan. The potential problem was the external leakage defect in the refrigerator during its production stage. The objective of this study was to improve the process by adopting six sigma DMAIC approach to identify and eliminate the root causes that produce defects in the final product. Project charter, Pie chart, Bar chart of faults, Suppliers Input Process Output (SIPOC), Voice of Customer (VOC) and flow process map were used to define the problem, its scope and process routing. Pareto chart was used to identify sub defects and sigma level was calculated for the existing process. Feed rate, capillary action of filler material, cleanliness, visual inspection and unsuitable heat input were the major causes of external leakage. Cause and effect matrix was used to rank the identified causes. Further, design of experiment (DoE) was performed to improve the process by conducting different alterations in the parameters. In order to control the process, failure mode and effect analysis (FMEA) sheet was prepared to sustain the process improvements. The FMEA control plan needed to be revised at specific time intervals to attain continuous process improvement. This six sigma DMAIC cycle produced a 30% overall reduction of external leakage defect and service call rate (SCR) was improved with lower complaints from customers.

Implementation of Six Sigma DMAIC methodology for increasing the competitiveness of SMEs in Ethiopia

Six Sigma has gained wide acceptance as an improvement methodology to enhance the organization competitiveness in market. For SMEs building a competitive advantage is a difficult task. Changes in the economic environment affect the way such entities perceive factors which could help them not only survive on the market but shape their competitiveness. In the period of significant economic turbulence, the factors that play a major role in shaping the competitive market position are company image (product brand) and lower product price. This study uses Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) approach as a framework to identify, quantify, and eliminate sources of variation in Meseret Gabi Machinery Metal Works Enterprise in Dessie (Ethiopia). This helps to improve the competitiveness of the enterprise in the market place by addressing the complaints and requirements of the customer continuously.

Improving campus dining operations using capacity and queue management: A simulation-based case study

With growing consumer demand, dining facilities athigher education institutions have started to provide a wide assortment of food products catering to the needs of every individual. In developed countries like the United States, labor is an expensive asset, and campus dining facilities are struggling to utilize their employees efficiently and achieve service excellence. This research is motivated by a real-life case study of a campus dining service (CDS), which is an all-you-can-eat establishment with an annual influx of 500,000 students. The CDS has eight food stations but experiences long queues only at individual stations that prepare made-to-order (MTO) meals, thereby leading to excessive wait at the facility. Given the characteristics of the CDS, the objective of this paper is to evaluate the impact of capacity reallocation and queue management on customer waiting time. The methodology integrates the six sigma DMAIC (Define, Measure, Analyze, Improve, and Control) framework with a discrete event simulation modeling approach to understand, analyze, and improve the service responsiveness at CDS. Five different alternatives pertaining to capacity reallocation and queue management are proposed. The experimental analyses indicate that reallocating underutilized workers to high demand MTO stations can reduce the average waiting time by 29%. Besides, when adopting a combination of server reallocation and queue management, the CDS can curtail wait times by up to 45%. Finally, the alternatives are evaluated with respect to multiple criteria (cost and ease of implementation, responsiveness, and sustainability) to provide managerial insights to the CDS.

Paediatric respiratory isolation: A challenge for a secondary care hospital! A service innovation project.

The aim of this project was to broaden the secondary care hospital's scope of services and provide safe, effective and quality care for the patient presenting with measles. Six Sigma DMAIC [define measure, analyze, improve, and control (DMAIC)] methodology was used in this quality improvement project. The quality project was started in October 2015 using a Gantt chart quality tool. The paediatric team with the support of administration of the hospital has established isolation rooms and devised a policy for the care and management of patient with airborne infection to avoid cross transmission. During six months period after establishment of isolation room there were sixty two suspected or confirmed measles cases who were admitted in our hospital, out of them only 4(6.4%) of patients were referred because of their sick condition and need of ventilator support. Further, the percentage of patient's satisfaction level also improved from 60 to 80%. After this clinical service innovation, there was significant reduction in referrals of measles patients to another hospital and consequently there was an increase in the patient's satisfaction.

Applying Lean Six Sigma to Reduce the Incidence of Unplanned Surgery Cancellation at a Large Comprehensive Tertiary Hospital in China.

Unplanned surgery cancellation (USC) was an important quality management issue in the course of medical care for surgical patients, which caused inappropriate use of hospital resources and had negative impacts on quality and safety. This study used Lean Six Sigma to reduce the incidence of USC. Following the Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) process, the main factors influencing the USC were identified, such as the time of informing patient admission, the time of submitting operation notice, and the management of test report follow-up. A series of measures were implemented including improving the health education content of virtual bed patients, standardizing the way of communication between the Admission Management Center and the patients, improving the timing of anesthesia evaluation, optimizing the process of operation notice with an information system, and implementing the regulations of virtual bed management. The incidence of USC reduced from 10.21% in Jan. 2016 to 3.8% in Dec. 2016, and the Z-score increased from 1.25 to 1.68, which improved patient safety and demonstrated that Lean Six Sigma was an effective method to solve cross-department issues in hospital.

Application of Six Sigma to minimize the defects in glass manufacturing industry

PurposeThe purpose of this paper is to improve the yield of a particular model of a car windshield, as the organization faces losses due to poor performance and rejection.Design/methodology/approachThe Six Sigma DMAIC (define, measure, analyze, improve and control) methodology is used to reduce variation and defects in the process. It is a methodology based on data-driven and fact-based analysis to find out the root cause of the problem with the help of statistical analysis. A worst performing model is selected as a case study through the scoping tree. The preprocess, printing, bending and layup process defects are reduced by analyzing the potential causes and hypothesis testing.FindingsThis paper describes Six Sigma methodology in a glass manufacturing industry in India for automotive applications. The overall yield of a car windshield achieved 93.57 percent against the historical yield of 88.4 percent, resulting in saving 50 lacs per annum. Due to no rework or repairing in the glass, low first-time yield causes major losses. Process improvement through focused cross-functional team reduces variation in the process. Six Sigma improves profitability and reduces defects in the automotive glass manufacturing process.Research limitations/implicationsThis case study is applied in automotive glass manufacturing industries. For service and healthcare industries, a similar type of study can be performed. Further research on the common type of processor industry would be valuable.Practical implicationsThe case study can be used as a problem-solving methodology in manufacturing and service industries. The tools and techniques can be used in other manufacturing processes also. This paper is useful for industries, researchers and academics for understanding Six Sigma methodology and its practical implementation.Originality/valueThis case study is an attempt to solve automobile glass manufacturing problems through DMAIC approach. The paper is a real case study showing benefits of Six Sigma implementation in the manufacturing industry and saving an annual cost of 50 lacs due to rejections in the process.

Important Elements in the Quality Improvement Curriculum for Orthopaedic Residents.

Orthopaedic residency education requires trainees to participate not only in clinical and research endeavors but also in quality improvement (QI) projects. To our knowledge, little has been published on how to implement a structured QI curriculum as part of an orthopaedic residency program. This article describes a single institution's experience with developing a longitudinal, integrated, and collaborative resident QI curriculum. The Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) process was taught to residents as a formal curriculum at our institution beginning in 2014. A structured integrated process was developed for residents to work in teams and meet on a monthly basis. Since then, residents have developed multiple QI projects with measured outcomes. Serial surveys have been administered to the residents to collect feedback. Seven major QI projects have been implemented by residents since the program's initiation. The resident surveys revealed significant improvement in comfort level with organizing QI projects. Residents also reported being comfortable working in interprofessional teams and incorporating patient safety techniques into clinical practice. There are few guidelines that reflect how to initiate a formal QI curriculum in an orthopaedic residency program to promote a standardized and systematic way to approach QI projects. With a structured DMAIC education plan, an emphasis on graded responsibilities within a team setting, and responsiveness to resident feedback, orthopaedic programs can develop an effective QI program to allow residents to learn valuable patient safety practices, which allows residents to have a meaningful and impactful effect on QI initiatives that will serve them well as they enter clinical practice.

Using Lean Six Sigma to Improve Delayed Intracranial Hemorrhage Screening in a Geriatric Trauma Population.

Geriatric trauma patients taking preinjury anticoagulant or antiplatelet (ACAP) medications are at greater risk for delayed intracranial hemorrhage (DICH), a rare but potentially life-threatening condition. Routine repeat head computed tomography (RRHCT) scans can identify DICH. Our objective was to decrease the rate of missed RRHCT in a level 1 Midwest trauma center geriatric minor trauma population on preinjury ACAP medications. The objective of the quality improvement project was to identify the root cause of the missed RRHCTs and to implement a comprehensive solution to reduce rates of missed RRHCTs. Medical records from before and after the intervention were evaluated. Frequencies and percentages were calculated. In addition, χ and logistic regression were utilized. The Lean Six Sigma (LSS) DMAIC (Define, Measure, Analyze, Improve, and Control) process was used to drive process improvement. At baseline, 15% (41 of 267) of RRHCTs were missed. After solution implementation, missed RRHCTs dropped to 4% (2 of 50). Of the 2 that were missed, zero were clinically inappropriate misses, making the postimplementation rate effectively 0%. The LSS DMAIC process helped health care professional to facilitate improved adherence to the department's practice guideline with respect to RRHCT. Adherence with this guideline can help providers identify patients with DICH, a potentially life-threatening condition.

Reducing hospital-acquired infection rate using the Six Sigma DMAIC approach

Background:Hospital-acquired infection (HAI) is one of the most common complications occurring in a hospital setting. Although previous studies have demonstrated the application of data-driven Six Sigma DMAIC (Define, Measure, Analyze, Improve and Control) methodology in various health-care settings, no such studies have been conducted on HAI in the Saudi Arabian context.Objective:The purpose of this research was to study the effect of the Six Sigma DMAIC approach in reducing the HAI rate at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.Methods:Historical data on HAI reported at inpatient units of the hospital between January and December 2013 were collected, and the overall HAI rate for the year 2013 was determined. The Six Sigma DMAIC approach was then prospectively implemented between January and December 2014, and its effect in reducing the HAI rate was evaluated through five phases. The incidence of HAI in 2013 was used as the problem and a 30% reduction from 4.18 by the end of 2014 was set as the project goal. Potential causes contributing to HAI were identified by root cause analysis, following which appropriate improvement strategies were implemented and then the pre- and postintervention HAI rates were compared.Results:The overall HAI rate was observed as 4.18. After implementing improvement strategies, the HAI rate significantly reduced from 3.92 during the preintervention phase (first quarter of 2014) to 2.73 during the postintervention phase (third quarter of 2014) (P < 0.05). A control plan was also executed to sustain this improvement.Conclusion:The results show that the Six Sigma “DMAIC” approach is effective in reducing the HAI rate.

A comprehensive insight into the Six Sigma DMAIC toolbox

Purpose As opposed to general literature reviews, by narrowing down the context only around the resources related to Six Sigma tools, this study aims to offer a strong discussion about Six Sigma toolbox which has a vital role in the success of Six Sigma. Design/methodology/approach Based on a comprehensive literature research, the most used tools; classification of tools; flow of tools with respect to define, measure, analyze, improve and control (DMAIC) steps; tools as critical success factors and reasons of ineffective use of tools are reviewed. To stay focused and not to diverge from the research aim, 60 articles which are suitable to the context and flow of the discussion are selected during the construction of the study. Findings The study provides a detailed and integrated review of Six Sigma articles about tools. The most used tools are listed from different perspectives and resources, and the role of these tools has been discussed. After a broad review, a more practical and combined classification of Six Sigma tools is proposed. Next, the issue of using which tools during which steps of DMAIC is systematically addressed. Finally, emergence of tools as a critical success factor and the gaps in the literature related to tools of Six Sigma are pointed out. Practical implications Addressing important statistics and the facts related to the tools of Six Sigma helps new practitioners in particular to build a strategic filter to select the most proper tools throughout their projects. Originality/value This study is unique in investigating only Six Sigma toolbox and providing a literature review on this subject.

No More Waits and Delays: Streamlining Workflow to Decrease Patient Time of Stay for Image-guided Musculoskeletal Procedures

Long wait times limit our ability to provide the right care at the right time and are commonly products of inefficient workflow. In 2013, the demand for musculoskeletal (MSK) procedures increased beyond our department's ability to provide efficient and timely service. We initiated a quality improvement (QI) project to increase efficiency and decrease patient time of stay. Our project team included three MSK radiologists, one senior resident, one technologist, one administrative assistant/scheduler, and the lead technologist. We adopted and followed the Lean Six Sigma DMAIC (define, measure, analyze, improve, and control) approach. The team used tools such as voice of the customer (VOC), along with affinity and SIPOC (supplier, input, process, output, customer) diagrams, to understand the current process, identify our customers, and develop a project charter in the define stage. During the measure stage, the team collected data, created a detailed process map, and identified wastes with the value stream mapping technique. Within the analyze phase, a fishbone diagram helped the team to identify critical root causes for long wait times. Scatter plots revealed relationships among time variables. Team brainstorming sessions generated improvement ideas, and selected ideas were piloted via plan, do, study, act (PDSA) cycles. The control phase continued to enable the team to monitor progress using box plots and scheduled reviews. Our project successfully decreased patient time of stay. The highly structured and logical Lean Six Sigma approach was easy to follow and provided a clear course of action with positive results. (©)RSNA, 2016.

Leveraging Six Sigma Tools and Methodology to Improve Student English Language Performance at Elementary School

Purpose: The purpose of this paper is to discuss how the Six Sigma (SS) methodology can be used to improve the performance of students in English as a second language and enhance the teaching process by utilizing quality tools in an educational environment. Design/Methodology/Approach: The paper uses the different quality improvement tools within the Define, Measure, Analyze, Improve and Control (DMAIC) phases to improve student performance in an English language class at a private school. Findings: Quality tools, such as cause and effect diagrams and quality function deployment, have been successfully applied within the Six Sigma DMAIC framework in the educational sector to improve the performance of students and enhance the teaching process. Practical Implications: This paper helps school administrations to analyze student performance and implement improvement actions to improve their performance. Originality/Value: The principal objective of this paper is to demonstrate how quality improvement tools can be introduced and successfully applied in an elementary school to improve student performance and communication between the school administration, teachers and parents.

Pragmatic adaptation of the ISO 31000:2009 enterprise risk management framework in a high-tech organization using Six Sigma

Purpose– This case study aims to present a viable solution to how organizations can adapt and customize the ISO 31000:2009 enterprise risk management framework to suits its needs and requirements.Design/methodology/approach– Approach used for this case study is via adopting Six Sigma DMAIC (Define, Measure, Analyze, Improve and Control phases) methodology.Findings– Key finding is the importance of stakeholders’ feedbacks which are taken into consideration during the designing of the new customized enterprise risk management framework, integrated with all supporting processes, tools and resources.Originality/value– The ISO 31000:2009 enterprise risk management framework dictates that it is not a one-size-fits-all. Rather, organizations who wish to adapt this framework need to customize accordingly, but there is no indication on how organizations can do it. This case study presents a viable solution to this challenge.