PurposeDelays, measurement and medical errors and variability often undermine the delivery of safe, effective patient care. However, it is possible to minimize them by applying six‐sigma. This methodology aims to focus on the root causes of healthcare problems, analyses them by flowcharts and fishbone diagrams and produces near‐perfect healthcare services.Design/methodology/approachFive case studies in healthcare are designed to show the performance improvement accomplished by six sigma. The DMAIC (Define‐Measure‐ Analyse‐Improve‐Control), i.e. a road‐map for problem solving and service/process improvement, is implemented.FindingsThe findings in this paper show that the healthcare organization has a greater ability to address challenges across the system. Resource utilization has been maximized. Fewer redundancies, waste and rework have been observed. Bottle‐necks related to scheduling have diminished. Working conditions have improved for healthcare personnel. Increased patient and physician satisfaction as well as cost savings have been achieved. These will enable the healthcare organization to increase its market share in the long run.Originality/valueThe application of six sigma in healthcare services is relatively new topic and very little research has been performed in this area. The paper will be extremely valuable to researchers and practitioners who are currently engaged in six sigma research.

PurposeThe aim of this study was to report normative values and ranges of interpupillary distance (IPD) in different age groups of a Turkish population.MethodsA total of 756 healthy subjects were included in this prospective study. After a complete ophthalmic evaluation, subjects were divided into four age groups to assess differences between age groups in relation to IPD. The age groups were 20–30, 31–50, 51–70, and 71–89 years. Far IPD measurements were performed using an autorefractometer (Topcon RM-8800).ResultsThe mean age was 48.42±20.55 years, ranging from 19 to 89 years. The mean IPD was calculated as 62.5±4.1 mm (range 49–76). The mean IPD value was observed to be significantly higher among males compared to females (P<0.001). The difference among groups in terms of mean IPD was statistically significant (P<0.001). IPD increased by 4.19 mm in males and 3.11 mm in females from the young adults (20–30 years) to older adults (51–70 years), and then a decrease (2.6 and 0.19 mm for males and females, respectively) occurred between 70 and 89 years of age.ConclusionThe current study offers the population-specific normative data on far IPD in different age groups. Our study showed that sex and age had a significant effect on IPD. Knowledge of normal values in this population subgroup may be useful in studying orbito-cranial growth patterns, syndrome diagnosis, surgical management of cranio-facial deformities and trauma, and manufactures of optical frames and lenses.

This study is one of the few papers in the literature that elaborates the turnover problem of doctors working in the emergency and paramedic backup services.

By setting these critical CAGE scores as the minimum detection levels of alcohol abuse, early intervention before the onset of serious alcohol-related problems is possible. This will decrease the health-care costs of the patient and, in addition, reduce the psychological and social burdens inherent to alcohol abuse both on the patient and society. Having its critical scores reliably identified and diagnostic accuracy fully determined, CAGE can now improve the detection rate of problem drinking individuals substantially.

A Feasibility Study for Six Sigma Implementation in Turkish Textile SMEsThis paper aims to investigate the Critical Success Factors (CSFs) for the successful introduction of Six Sigma in Small and Medium Sized Turkish Textile Enterprises. A survey-based approach is used in order to identify and understand the current quality practices of Small and Medium Sized Enterprises (SMEs). CSFs and impeding factors are identified and analyzed. The involvement and commitment of top management, linking quality initiatives to employee and information technology and innovation are found to be important CSFs for textile SMEs. The leadership and commitment of top management, strategic vision, and data collection and measurement, are found to be the most CSFs for the successful introduction of Six Sigma, whereas the lack of knowledge of the system to start the initiative and the presence of ISO-certification in the company are found to hinder its implementation. The lack of qualified personnel and incompetence with new technologies are found to lower the performance of Turkish textile SMEs.