Using Six Sigma tools to improve internal processes in a hospital center through three pilot projects

San Juan de Dios Hospital is a main private medical center in Córdoba (Spain). We have used Six Sigma methodology to help us find ways to improve processes.Objectives(1) Reduce the variability scheduling pre-anesthesia consultations, (2) reduce absenteeism of outpatients and reduce delays, and (3) increase the efficiency of Internal Medicine-Rehabilitation ward.Methods(1) We analyzed scheduled vs. performed pre-anesthesias. From September 2012 we introduced a new tool that estimated a maximum number of appointments for each day of the week. Periods: 15 November 2011 to 01 October 2012, vs. 01 September 2012 to 31 January 2013. (2) We calculated daily % absenteeism and average delay per visit. From September 2012 actions were taken with the administrative team, patients, and physicians more affected by this problem. Periods: 15 November 2011 to 01 October 2012, vs. 01 October 2012 to 31 January 2013. (3) From June 2012 we launched an interdisciplinary team. We discussed biweekly the clinical condition of the patients, and reached consensus regarding a potential discharge date, which was shared with referral center, a tertiary hospital in the area. Data of hospital stays, occupancy rates and discharges were studied.Results(1) Period 1: Standard deviation (9.63), daily average (35.45). Period 2: 7.54 (−22%), 37.95 (+7%). (2) Period 1: 11.4% absenteeism, average total delay 523.54 minutes. Period 2: 6.25% (−45%), 125.17 minutes (−76%). (3) Period 1: Admission per week 0.88, length of stay (LOS) 164.14 days, occupancy rate 63%. Period 2: 1.00 (+14%), 58.29 (−64%), 84% (+32%).ConclusionsSix Sigma methodology could be successfully used to improve processes and outcomes in hospitals, especially when several departments are involved.