Using six sigma--to monitor improve laboratory performance

Introduction: The quality of healthcare is an emerging concern worldwide. However many problems in delivering quality healthcare persist and require urgent attention and solution. There is mounting pressure on lab now a days to improve & sustain the quality reporting. Worldwide most of the diagnosis is made on laboratory findings so accuracy is must to deliver appropriate treatment. A laboratory can make error at many steps i.e. preanalytical, analytical & Post analytical. However laboratory must have a system in place to track & minimize these errors. Usually a good laboratory performs internal quality control & Proficiency testing to measure precision & accuracy. Modem quality management tools like six sigma concept offer realistic solutions to reach practical levels of perfection. Six Sigma process is a helpful tool which finds facts about laboratory precision & accuracy performance & gives a clear direction to improve laboratory quality mainly in analytical phase. It is imperative that clinical diagnostic labs promote culture of safety with aid of quality management tools. Objective: The objective of Six sigma Analysis Is to analyse, monitor & find out facts about laboratory (Bio Chemistry) analytical process in the Department of pathology at Breach Candy hospital, Mumbai. Laboratory goal is to Measure, Analyze, improve & than control overall quality management system with the help of Modern day Quality assessment tool i.e. Six Sigma. Method & Material: At Breach candy hospital Bio chemistry test are analyzed on VITROS 4600 from Ortho Clinical Diagnostics. In the initial phase lab has selected few parameters to analyze Six sigma performance i.e. ALT, BUN, Creatinine, Glucose, Bilirubin, Sodium, Potassium, Chloride, Total Proteins and Albumin, and Creatinine kinase. Record CV% for above mentioned parameters was observed from VITROS 4600 (Instrument). % Bias was calculated using proficiency testing for clinical chemistry from Bio-Rad. Total error allowable was taken using the CLIA guidelines. Six Sigma was calculated using the formula Six Sigma = (TE (a)--Bias % / CV %). Monthly CV % and Bias was used to calculate monthly sigma levels for the above mentioned parameters. Results and conclusion: It was observed that six sigma concept is based on the factors bias and imprecesion. So Six Sigma analysis at Pathology of Breach candy hospital was a reflection of facts about the precision & accuracy & it increased the confidence of lab management as well. Howeve