Reducing Length of Stay in Emergency Department through Six Sigma Improvement Process

Bae, Jin Kun; Kim, Ok Jun; Choi, Sung Wook

Abstract

PURPOSE: The aim of this study was to improve overcrowding in an emergency department with the six sigma process. The authors evaluated possible factors that might delay patients' length of stay and suggest possible means for improvement.
METHODS
We measured time spent in each step of emergency clinic care and investigated possible reasons for delay. The time spent in each step was measured again after change were made to address possible causes of delay. The difference in time between before and after the change were analyzed.
RESULTS
According to the steps of 'measure' and 'analyze' in six sigma, greatest delays occurred in obtaining laboratory test results and explaining overall status to patients. After practicing an improvement plan, total time spent in the emergency department decreased from 467 minutes to 364 minutes (p=0.000), and the six sigma level increased from 1.145 to 1.450. Defects per million opportunities (DPMO) decreased from 638,554 to 520,095.
CONCLUSION
Through six sigma improvement, the length of stay in an emergency department can be reduced. This can not only bring more satisfaction to patients, but it can also improve overcrowding of emergency department clinics through increased hospital bed turnover.