Six Sigma in a Dutch Hospital: Does It Work in the Nursing Department?

Abstract

The Red Cross Hospital is a medium-sized general hospital with 385 beds, located in Beverwijk, The Netherlands. It also has a freestanding National Burn Care Centre. The Red Cross Hospital was the first hospital in The Netherlands with a quality system based on ISO 9000. At the end of 2001 the hospital started implementing Six Sigma. The process began with Executive Training for management and Green Belt (GB) training for 16 middle managers and other staff. Seven GB projects were started in the areas of accounts receivable, patient logistics, invoicing, medication, temporary workers, and length of stay in hospital. In February 2003 the final review of the first group was done and savings appeared to be three times higher than estimated beforehand. At present (May 2004) the fourth group of Green Belts has been trained. In this paper we briefly explain that Six Sigma was the next logical step in the quality approach of the hospital. We also discuss how it was implemented and we describe some case studies in the nursing departments.

Lessons from Sweden’s first large-scale implementation of Six Sigma in healthcare

“…Numerous articles have described experiences from Six Sigma in patient care in a general sense (Boaden et al 2008), including a review of areas in which it has been applied. Other Six Sigma applications have been reported from radiology (Bahensky et al 2005;Cherry and Seshadri 2000), nursing (van Heuvel et al 2004;Simmons et al 2004), medication errors (Revere and Black 2003), and decreasing turnaround time between surgery cases (Adams et al 2004). Woodard (2005) andFrings andGrant (2005) have described further practical applications.…”

“…In many of the early healthcare applications of Six Sigma, improvements were targeted against administrative processes in the organization (van Heuvel et al 2004). Many of these are not unique for healthcare and are not part of the hospital's main processes.…”

El papel de la Estadística en la metodología Seis Sigma: una propuesta de actuación en servicios sanitarios = The key role of statistical methods in Six-Sigma: a proposal of implementation in health care services

“…Encontramos también propuestas de aplicación de la metodología seis sigma en hospitales chilenos (Ramírez, Pinto, Serpell y Enberg, 2007) en un enfoque donde se plantean las ventajas y consecuencias de incorporar esta metodología en el sector servicios y más concretamente en el de la salud. Otras aplicaciones interesantes muestran las posibilidades para reducir errores médicos (Buck, 2001) y del mismo modo en los hospitales alemanes se ha implementado esta metodología en casos concretos del departamento de enfermería (Van den Heuvel, Doess y Vermaat, 2004). Por su parte, Jiménez et al (2007) la aplican en la mejora de la logística sanitaria.…”

“…Ramirez, Pinto, Serpell and Enberg (2007) discuss the advantages and consequences derived from the adoption of Six-Sigma methods in the services sector in general, and in health care services in particular, and suggest its adoption in Chilean Hospitals. Buck (2001) focuses on the possibilities of Six-Sigma in reducing medical errors, while Van den Heuvel, Doess and Vermaat (2004) describe its implementation in the nursery department of a Dutch hospital, and Jiménez et al (2007) propose their adoption to improve healthcare logistics.…”

Generic Project Definitions for Improvement of Health Care Delivery

“…The project focused on both the cost of hiring temporary workers and the number of correct invoices. 34 The following actions were chosen to diminish the number of mistakes: a standardized work sheet for every temporary worker was introduced; requests for temporary personnel were centralized; an administrative system to check the irregularity bonus and the invoice was introduced; and the number of temporary agencies was reduced.…”