Improving the Hospital Discharge Process with Six Sigma Methods

ABSTRACT

This article describes the application of a five-phase Six Sigma define, measure, analyze, improve, and control (DMAIC) approach to streamline patient discharge at a community hospital. Within the context of the five phases, the team applied statistical process control (SPC) charting, process mapping, Pareto charting, and cause-and-effect matrices to make decisions. The findings suggested that focusing on physician preparation for discharge order writing would have the greatest impact. A significant reduction in the average discharge time from 3.3 to 2.8 h was realized (p = 0.06) and missing chart data was reduced by 62%.

KEYWORDS:

• cause and effect matrices
• control charting
• individuals charts
• lean sigma
• moving range
• pareto charts

ACKNOWLEDGEMENTS

We thank Stan Jonas for leadership and support. We also thank Nicole Yanik and Miya Sunamoto for facilitating communication and data collection. In particular, the leadership of Stan Jonas made the entire project possible. We thank Diane Hunter and Pamela Power for helpful discussions and idea sharing. Anne Keene and the entire medical records staff provided valuable information in a timely and professional manner. Also, the information technology staff made the new form possible with impressive efficiency. Finally, Emily Patterson and the reviewers provided helpful suggestions on drafts of this article.