Six Sigma Process Improvement Chart Abstraction Cycle Timescottcollegecsmr.com/pdf/Jason...
Transcript of Six Sigma Process Improvement Chart Abstraction Cycle Timescottcollegecsmr.com/pdf/Jason...
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Presentation Points
Overview of Quality Reporting Department
Define the problem
Taking measurements
Analyze collected data
Recommend improvements
Discuss control methods
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Abstracts for quality auditing from patients with the following conditions:
CHF, AMI, Stroke, CAP, SCIP, VTE, outpatient SCIP, outpatient AMI/Chest Pain
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Time from patient discharge to complete chart abstraction is known to exceed requirements.
◦ Board of Directors interested in getting more timely quality reporting.
◦ Patient care cannot adapt quickly if reporting is delayed.
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Requirements
Cycle time requested: 30 days
Maximum time: Abstracts completed by the 15th day of the month following discharge. (Maximum 45 days)
Allowances
Papers scanned into charts 2 days
Physicians to sign-off charts 30 days
IS to send reports to QR 30 days
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Designed small Ad-hoc query in quality
database system.
Exported needed data to Excel showing date
stamps of discharge date and completed
abstraction date.
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July August
ABSTRACTION DATE DISCHARGE_DATE Elapsed Days ABSTRACTION DATE DISCHARGE_DATE Elapsed Days
09/15/2011 07/01/2011 76 10/03/2011 08/03/2011 61
09/07/2011 07/12/2011 57 10/11/2011 08/30/2011 42
09/08/2011 07/07/2011 63 09/30/2011 08/04/2011 57
09/09/2011 07/01/2011 70 10/11/2011 08/11/2011 61
09/09/2011 07/09/2011 62 10/13/2011 08/10/2011 64
09/09/2011 07/13/2011 58 10/18/2011 08/04/2011 75
09/09/2011 07/02/2011 69 10/17/2011 08/17/2011 61
09/23/2011 07/13/2011 72 09/30/2011 08/04/2011 57
09/21/2011 07/07/2011 76 10/14/2011 08/02/2011 73
09/22/2011 07/06/2011 78 10/17/2011 08/02/2011 76
09/07/2011 07/19/2011 50 10/19/2011 08/10/2011 70
09/19/2011 07/08/2011 73 10/17/2011 08/07/2011 71
09/15/2011 07/08/2011 69 10/11/2011 08/05/2011 67
09/09/2011 07/09/2011 62 10/04/2011 08/18/2011 47
09/15/2011 07/16/2011 61 10/04/2011 08/04/2011 61
09/21/2011 07/02/2011 81 10/14/2011 08/01/2011 74
09/19/2011 07/07/2011 74 10/17/2011 08/02/2011 76
09/07/2011 07/05/2011 64 10/13/2011 08/01/2011 73
09/21/2011 07/06/2011 77 10/04/2011 08/10/2011 55
09/08/2011 07/06/2011 64 10/11/2011 08/03/2011 69
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Cycle time is outside of required limits
July ◦ Median days 60
◦ Maximum days 84
August ◦ Median days 56
◦ Maximum days 79
Nothing is happening within 30 days
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It was determined earlier that IS ran the reports sending the data from the charts into the reporting system only once per month.
Improvement: Increase frequency of reporting to once per week by pulling data from another system.
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Cycle time is just outside of required limits
August ◦ Median days 56
◦ Maximum days 79
September ◦ Median days 35
◦ Maximum days 54
21 day increase in cycle time
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In order to accurately chart and control this process the following 5 data points must be available to the Quality Department. ◦ Discharge date
◦ Paper charts scanned date
◦ Chart sign-off date
◦ Reports run / available for abstraction date
◦ Abstraction complete date
Currently only discharge date, and abstraction date are available to Quality Reporting.
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Days Elapsed 20 7 6 2
Percent 57.1 20.0 17.1 5.7
Cum % 57.1 77.1 94.3 100.0
C1
Pape
rs sca
nned
into cha
rt
Abstra
ction
Repo
rts G
enerated
Char
t Sign-
off
40
30
20
10
0
100
80
60
40
20
0
Da
ys E
lap
se
d
Pe
rce
nt
Pareto Chart by Department
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Days Elapsed 20 7 5 3
Percent 57.1 20.0 14.3 8.6
Cum % 57.1 77.1 91.4 100.0
C1
Pape
rs sca
nned
into cha
rt
Chart S
ign-off
Repo
rts G
enerated
Abstraction
40
30
20
10
0
100
80
60
40
20
0
Da
ys E
lap
se
d
Pe
rce
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Pareto Chart by Department
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121110987654321
70
60
50
40
30
Weeks
Sam
ple
Mean
__X=36.55
LC L=33.11
UC L=39.99
121110987654321
20
15
10
5
0
Weeks
Sam
ple
Ran
ge
_R=5.97
UC L=12.61
LC L=0
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
11
Control Chart of Weekly Cycle Times
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4321
50
40
30
Weeks
Sam
ple
Mean
__X=37.06
UC L=40.19
LC L=33.94
4321
16
12
8
4
0
Weeks
Sam
ple
Ran
ge
_R=8.38
UC L=15.63
LC L=1.14
1
1
1
Xbar-R Chart of September Only
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Institute checks of process using newly available data points to check for future conformance, and greatest bottleneck.
Six Sigma Future Project: ◦ Collect future data based on 5 data points, create
and maintain control and distribution and pareto charts.
◦ Identify any processes that need improvement to eliminate or smooth saw-tooth pattern based on future data collection.
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