Title: Reducing unplanned endotracheal extubation in hospital ICU through Six Sigma and HQIC

Authors: Feng-Chuan Pan, Mei-Yuh Shiau, Shen-Jih Chen

Addresses: Department of Healthcare Business Administration, Tajen University, 20 Weixin Road, Yanpu, Pingtung, 907 Taiwan. ' Department of Healthcare Business Administration, Tajen University, 20 Weixin Road, Yanpu, Pingtung, 907 Taiwan. ' Paochien Hospital, Taiwan

Abstract: Six Sigma is a managerial philosophy for detecting the error rate of particular (or a set of) activities. This research applies the process DMAIC (define, measure, analyse, improve, control) of the Six Sigma concept in dealing with troublesome Unplanned Endotracheal Extubation (UEE) events that frequently occur in a hospital. Grounded on Continuous Quality Improvement-Total Quality Management (CQI-TQM), this research attempts to combine Six Sigma and the Health Quality Improvement Circle (HQIC) to guide the complete participation of the Intensive Care Unit (ICU) of the case hospital. The project suggests taking several actions, including establishing standard operations and on-the-job training on the nursing staff for this particular purpose. The result shows that the focal events decreased significantly from 11.3% to 4.1% monthly, while the standard error improved from 2.7069 σ to 3.2437 σ. Although the case has proven the usefulness of Six Sigma, continuous efforts with a similar approach to this specific process and others within the hospital will be needed.

Keywords: six sigma; quality control; healthcare quality; DMAIC; quality circles; HQIC; organisational learning; continuous quality improvement; CQI; intensive care units; ICU; unplanned endotracheal extubation; UEE; Taiwan; total quality management; TQM; hospitals.

DOI: 10.1504/IJSSCA.2008.022950

International Journal of Six Sigma and Competitive Advantage, 2008 Vol.4 No.4, pp.382 - 394

Published online: 04 Feb 2009 *

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