Student Dissertation

Agency : Six Sigma; Quality Assurance; Radiology Department

Objective : Basically the objective of this project was: To study the current process flow of radiology department, find out the gaps, modify and streamline the same in such a way that maximum efficiency can be achieved by reducing the turnaround time of reports. Six-sigma approach is one of a quality tools through which we find value added and non value added activities. This approach aided in reducing the non value added time, improved the process flow and finally reduced the report turnaround time.As a management trainee, my role in this project was to understand the process flow. Further, design a study pattern which included identification of key problem area(s), data collection, analysis followed by generating possible solutions and implementing them and finally monitoring the results.

Background : Increased focus is being placed on the quality of care provided by hospital healthcare systems around the country. In the face of changing healthcare system and increased competition, radiology department in a hospital needs to become efficient. Even the largest facilities face the need for increased efficiency. One measurement of efficiency is promptness in producing a final report with minimum wastage. Reducing turnaround time for radiology reports with minimal film wastage improves the efficiency, quality of patient care, as well as satisfaction of patients. For this an integrated system should be developed that allows continual monitoring of radiology work flow and thus of opportunities to apply interventions. Application of Six Sigma can form an important component of the quality management process in the radiology department. Six sigma has developed a reputation as the mother of all quality initiatives. It is a quality initiative based on rigorous statistical process control. It augments traditional quality tools with exacting statistical analysis and a systematic problem solving approach, targeting the root cause of variations and redefining process for long term results. The point of deploying six sigma in healthcare is not to diminish the authority of radiologist, physician or nurse, but enhance the predictability of positive outcomes, whether clinical or operational. And it’s an approach that is flexible and scaleable. It can be used to improve a single process in a single department within a small, rural medical centre, or it can be deployed throughout an entire multi hospital system.

Methodology : In the methodology research design was descriptive retrospective study, data size covered was for 20 days (including 95cases of CT scan, 165 cases of ultrasound 503 cases of X-ray), method of data collection was from the hospital records registers, and quality tool used was six sigma (DMAIC).

Findings : The radiology project began by establishing a framework to identify why the project needed to be done. A problem statement was defined followed by a SIPOC (supplier, input, process, output, and customer) diagram. Further factors critical to quality (CTQ) were established by examining voice of customer (VOC-Customer Feedback). In the measure phase a total data of 20 days was collected for the three different investigations (CT Scan-95cases, USG.-211 cases, X-Ray-503 cases). Analysis of the data showed an average TAT for CT-3.17hrs, USG.-2.71hrs, X-Ray-4.97hrs. In the analysis phase, process analysis, fishbone analysis data analysis was done. In data analysis, data was compared with the standard protocols followed at hospital. It showed that 66% of cases did not follow the guidelines of Standard Operating Procedures followed at PAN Sterling. 31% cases did not follow the guidelines Sterling Hospital, Rajkot. Improvement phase included a data collection of 7 days which showed a significant improvement.

Recommendations : The project on “Implementing Six Sigma Methodologies for Quality Assurance in the Department of Radiology at Sterling Hospitals, Rajkot” was started around 3 months back. In the initial phase, the main problem statement was defined using voice of customer internal departmental assessment. Later data was collected for 20 days average TAT was calculated for CT scan (OP: 2.73hrs, IP: 3.43hrs), Ultrasound (OP: 2.28hrs, IP: 3.27hrs), X-Ray (OP: 1.83hrs, IP: 6.69hrs). In the analysis phase calculated.

Increased focus is being placed on the quality of care provided by hospital healthcare systems around the country. In the face of changing healthcare system and increased competition, radiology department in a hospital needs to become efficient.


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