A Health Technology Assessment in Maxillofacial Cancer Surgery by Using the Six Sigma Methodology

Abstract

Squamous cell carcinoma represents the most common cancer affecting the oral cavity. At the University of Naples “Federico II”, two different antibiotic protocols were used in patients undergoing oral mucosa cancer surgery from 2006 to 2018. From 2011, there was a shift; the combination of Cefazolin plus Clindamycin as a postoperative prophylactic protocol was chosen. In this paper, a health technology assessment (HTA) is performed by using the Six Sigma and DMAIC (Define, Measure, Analyse, Improve, Control) cycle in order to compare the performance of the antibiotic protocols according to the length of hospital stay (LOS). The data (13 variables) of two groups were collected and analysed; overall, 136 patients were involved. The American Society of Anaesthesiologist score, use of lymphadenectomy or tracheotomy and the presence of infections influenced LOS significantly (p-value < 0.05) in both groups. Then, the groups were compared: the overall difference between LOS of the groups was not statistically significant, but some insights were provided by comparing the LOS of the groups according to each variable. In conclusion, in light of the insights provided by this study regarding the comparison of two antibiotic protocols, the utilization of DMAIC cycle and Six Sigma tools to perform HTA studies could be considered in future research.

Analysis of Effect of Six Sigma Method Combined with CI Strategy on Improving of Nursing Quality in Outpatient Infusion Rooms

“…Nursing interventions are among the service interventions. Research has shown that adding the Six Sigma management model to the management of hospital service quality allows for an increase in the scientific nature of hospital care management and an increase in patient satisfaction [ 21 ]. Previous studies have shown that performing Six Sigma quality of nursing management in the labor and delivery office has been shown to promote standardized writing of nursing documents and cognitive education of nursing knowledge [ 22 ].…”

Reducing the Healthcare-Associated Infections in a Rehabilitation Hospital under the Guidance of Lean Six Sigma and DMAIC

“…Historically, its implementation has been only industry-based, as ascertained by the applications in different industrial context over years [ 24 , 25 , 26 , 27 ], among which one of the latest applications has been the food industry [ 28 ]; however, in more than a decade, LSS have also been employed in healthcare studies with a positive influence [ 29 , 30 ], as also shown by Patel et al in their recent critical review [ 31 ]. Recently, LSS has been proposed by researchers also in combination with health technology assessment [ 32 , 33 , 34 ] for different healthcare purposes.…”