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Six Sigma and Statistical Process Control in Clinical Pathway Management: An Evaluation Using Coefficient of
Ke-Cheng Li1, Weiwei Zeng1, Kangkang Su1
1Quality Control Office, Ruian People's Hospital, Wenzhou, Zhejiang, People's Republic of China.
Six Sigma metrics effectively improved clinical pathway management for cholecystectomy, significantly reducing hospitalization costs and length of stay. This quantitative approach enhances healthcare quality and efficiency under Diagnosis-Related Group (DRG) payment systems.
Area of Science:
- Healthcare Management
- Quality Improvement
- Medical Economics
Background:
- Clinical pathway management is vital for cost control and quality improvement within Diagnosis-Related Group (DRG) frameworks.
- Hospitals lack systematic, quantitative tools to assess clinical pathway implementation and impact.
- This study addresses the need for robust assessment methods in clinical pathway management.
Purpose of the Study:
- To explore the application value of Six Sigma-related metrics in clinical pathway management.
- To quantitatively assess the impact of clinical pathway implementation on hospitalization costs and length of stay.
- To demonstrate the utility of Six Sigma tools for improving healthcare delivery efficiency.
Main Methods:
- Utilized Six Sigma metrics: coefficient of variation, Statistical Process Control (SPC) control charts, and process performance indices.
- Assessed hospitalization costs and length of stay as key evaluation indicators.
- Compared pre- and post-implementation data for cholecystectomy clinical pathways.
Main Results:
- Significantly decreased average total cost (¥10,509 to ¥9998.4) and mean length of stay (4.64 to 3.90 days).
- Improved process stability with reduced coefficient of variation for cost and length of stay.
- Enhanced process capability (Ppk) and reduced defective rates (from 82,101.71 to 21,779.86 PPM).
- SPC charts indicated narrowed control limits and suppressed clinical variability.
Conclusions:
- Integrating Six Sigma into clinical pathway management offers a robust strategy for enhancing healthcare delivery under DRG constraints.
- Six Sigma tools like SPC charts enable real-time monitoring and improved care consistency.
- This approach bridges industrial quality control with healthcare, promoting system efficiency and equity.
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