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NUR 630 Topic 4 DQ 2

Sample Answer for NUR 630 Topic 4 DQ 2 Included After Question

You are the nurse leader on an obstetrics unit. You have been tasked to utilize a Six Sigma approach for standardizing the discharge process. Where do you start? 

A Sample Answer For the Assignment: NUR 630 Topic 4 DQ 2

Title: NUR 630 Topic 4 DQ 2

LATRICE 

“Six sigma approach is used in healthcare to reduce defects that can result in medical error, improve process efficiency, and eliminate waste.”( Purdue University, 2022) As a nurse leader of an obstetrics unit I would use the six sigma approach for standardizing the discharge process. The six sigma approach uses 5 principles to help improve patient care. The principles include define, measure, analyze, improve, and control. I would first start by assessing the current discharge system. I would define what should included in the discharge process. For example, making sure that patients have received their medication and follow up appointments scheduled before leaving the facility. I would then measure the current system in place by looking at the patients that are being discharged and following up to see what actions was not performed and what actions were omitted. I would then analyze the information found about the discharge process. I would then come up with ways to improve the discharge system. For example, I would create a template to use to help make sure that patients have received everything that they need to continue care at home. I would have checklist that should be performed before discharging patients to ensure that the proper ;process was followed. I would come with ways to improve the discharge system or change the system in its entirety. I would use surveys to obtain information from patients and follow up by addressing the areas identified from the survey. Lastly, I would develop a control system. This system would include having the pharmacist sign discharge instructions regarding the medication, the provider signing the discharge instructions stating that they explained the discharge to the patient and made sure that they understood and comprehended. The nurse would be responsible for providing patient education teachings before discharge. All entities would be required to sign off on the discharge template. In general the basics of discharge plan should include, “evaluation of the patient by qualified personnel, discussion with the patient and or their representative and involving them in the planning, Reconciling medications, planning, for the homecoming or transfer to another care facility, determine the need for caregiver training or any other support, and referrals to a home care agency and or appropriate support organizations in the community, arranging for follow-up appointments or tests, and who to contact if you need help.” (Levine, 2022) 

Advance in Healthcare with Lean Six Sigma. (2022). Purdue University. http://purdue.edu 

Levine, C. (2022). Hospital Discharge Planning: A Guide for Families and Caregivers. http://caregiver.org 

Response 

Hello Latrice! Thank you for sharing. Your post is detailed and interesting to read.  Discharge process in obstetrics unit is challenging for many organizations. The discharge process is often tedious and inefficient and patients are forced to spend considerable time to complete all the required discharge procedures (Cadel et al., 2021). As a result, delays in discharge process cause adverse events such as frustrations and dissatisfaction among the patients and their families. As such, the Six Sigma approach is a critical tool in addressing the challenges with discharge process such as delays. The approach entails scientific principle that helps in estimating all activities in health care setting using various statistical tools (Molla et al., 2018). It is characterizes a set of tools and a way of comprehending how to evaluate and study clinical operations more effectively to realize better results for health care givers, patients, and health care delivery systems (Arafeh et al., 2018). Successful implementation of the Sigma approach is crucial in increasing quality of care, patient satisfaction, and accessibility of beds for admissions in obstetrics unit.  

References 

Arafeh, M., Barghash, M. A., Haddad, N., Musharbash, N., Nashawati, D., Al-Bashir, A., & Assaf, F. (2018). Using six sigma DMAIC methodology and discrete event simulation to reduce patient discharge time in king hussein cancer center. Journal of healthcare engineering, 2018. https://www.hindawi.com/journals/jhe/2018/3832151/ 

Cadel, L., Guilcher, S. J., Kokorelias, K. M., Sutherland, J., Glasby, J., Kiran, T., & Kuluski, K. (2021). Initiatives for improving delayed discharge from a hospital setting: a scoping review. BMJ open, 11(2), e044291. http://dx.doi.org/10.1136/bmjopen-2020-044291 

Molla, M., Warren, D. S., Stewart, S. L., Stocking, J., Johl, H., & Sinigayan, V. (2018). A Lean Six Sigma quality improvement project improves timeliness of discharge from the hospital. The Joint Commission Journal on Quality and Patient Safety, 44(7), 401-412. https://doi.org/10.1016/j.jcjq.2018.02.006 

DEANNA 

As a manager of a Labor and Delivery unit the discharge process is very tedious as a nurse is attempting to teach a very tired mother about the care of her infant and herself. Most postpartum patients are not in an efficient learning mode at time of discharge and many teaching methods are necessary. As with any nursing unit efficiency is necessary to maintain productivity and efficiency. In the developing a discharge process it is necessary it is to be successful yet efficient. A key market used I improve discharge process form hospital settings is to decrease variations through preplanning discharges and use of workflow checklists (Rollinson et al., 2021).  

The Six Sigma process is a Lean strategy that focused on decreasing variation and has been used in multiple heath care settings to decrease waste. The Key concepts of Six Sigma are the DMAIC Or DMADV tools, these methods are translated into measurable responses to reduce variables and streamline (Fondahn et al., 2016)      

Using the DMADV process in implementing the discharge process, first you would Define the issue needing to be addressed. Set Measurements of the process such as decreased teaching time. Analysis of the data is required to set the design of the process, analysis of areas that gap development or identifying old systems. Design the process is the meat of the process to educate the nurses in a systematic fashion. Finally, to verify the process is effective, and them to continually address the process to ensure it is effective and adjust as necessary.  In any QI project following a set tool to address the identified problem will make the process go smother.  

Fondahn, E., Lane, M., &Vannucci, A. (2016). The Washington manual of patient safety and quality improvement [e-book]. Wolters Kluwer . 

Rollinson, T., Furnival, J., Goldberg, S., & Choudhury, A. (2021). Learning from lean: A quality improvement project using a lean-based improvement approach to improve discharge for patients with frailty in an acute care hospital. BMJ Open Quality, 10(4), e001393. https://doi.org/10.1136/bmjoq-2021-001393 

Response  

Hello Deanna! Thank you for sharing your post. You have given an in-depth and compelling post about the application of the Six Sigma approach to improve discharge process in the obstetrics unit. Indeed, discharge process is challenging. However, the Six Sigma approach is a vital change management tool to enhance discharge time (Improta et al., 2020). According to Arafeh et al., (2018), when using the concept of Six Sigma DMAIC process, the initial step is to define the issue through recognition of the essence of standardizing the process of discharge to reduce the whole turnaround time used on each patient in the unit. The next step is to measure the issue by judging the existing process and gathering data by breaking down the work composition in the discharge process from the time of approving discharge to time the patient leaves the unit. Consequently, analysis is conducted to identify and eradicate mistakes in all sub-processes in the discharge process. The next step involves improvement where the identified reasons for delays in the process of discharge are recognized and classified on the basis of priority. Finally, control is conducted by promoting programs identified to assist in maintaining the improvements in discharge process.  

References 

Arafeh, M., Barghash, M. A., Haddad, N., Musharbash, N., Nashawati, D., Al-Bashir, A., & Assaf, F. (2018). Using six sigma DMAIC methodology and discrete event simulation to reduce patient discharge time in king hussein cancer center. Journal of healthcare engineering, 2018. https://www.hindawi.com/journals/jhe/2018/3832151/ 

Improta, G., Guizzi, G., Ricciardi, C., Giordano, V., Ponsiglione, A. M., Converso, G., & Triassi, M. (2020). Agile six sigma in healthcare: Case study at santobono pediatric hospital. International journal of environmental research and public health, 17(3), 1052. https://doi.org/10.3390/ijerph17031052 

ANGELA 

Six Sigma employs a variety of quality tools including DMAIC. DMAIC is a five-step, problem-solving process which includes define, measure, analyze, improve, and control. The DMAIC method is appropriate for improving the discharge process in obstetrics because its goal is to improve existing processes by defining the problem or issue for improvement, measuring the performance of the process by collecting relevant data, analyzing the data to determine the root causes of the issue, improving the process by eradicating the root causes, and controlling improved processes through monitoring to ensure the better results are sustained (Fondahn et al., 2016, p. 81).  

The first step in improving the discharge process is to define the problem; why does the discharge process need improving or what can be done to streamline the process? This is an opportunity for improvement and therefore specific goals and objectives must be established (Ahmed, 2019). The next step is to retrieve and measure data. The information must be clear and concise. Once data has been collected, Ahmed (2019) indicated it must be analyzed using value stream mapping (VSM) to find the cause(s) of the quality issue. Next, the discharge process must be changed or modified once the root cause(s) has been identified and eliminated. The last step is to establish a quality control plan to monitor the improved process performance (Ahmed, 2019). Utilizing the DMAIC method allows organizations to create a clear path to successfully achieve their goals.  

 References  

Ahmed, S. (2019). Integrating DMAIC approach of Lean Six Sigma and theory of constraints toward quality improvement in healthcare. Reviews on Environmental Health, 34(4), 427-434. https://doi.org/10.1515/reveh-2019-0003  

Fondahn, E., Fer, T. M., Lane, M., &Vannucci, A. (2016). Washington manual of patient safety and quality improvement. Lippincott Williams & Wilkins.  

Response 

Hello Angela! Thanks for sharing this impressive post. An extensive, disorganized discharge process is a common challenge for health care settings. It causes decrease in patient satisfaction, frustrations, and delays for patients that need admission (Jeffers, 2021). Moreover, the complexity of discharge process entails organization specific issues that restrict generalizability of solutions. The application of the six sigma approach can be a successful tool in enhancing discharge process in obstetrics unit. Six sigma approach characterizes a set of tools and a way of comprehending how to evaluate and study clinical operations more effectively to realize better results for health care givers, patients, and health care delivery systems (Improta et al., 2020). The primary objective of the six sigma approach is the utilization of measurement-based techniques that centers on improving processes and reducing variations by implementing improvement projects. This can be realized through the utilization of six sigma sub-methodologies of like DMAIC. DMAIC is ideal in standardizing discharge process in the obstetrics unit because it focuses on improving the available discharge processes that fall below specification, developing discharge processes at six sigma quality levels, and looking for incremental discharge enhancement (Ahmed, 2019).  

References 

Ahmed, S. (2019). Integrating DMAIC approach of Lean Six Sigma and theory of constraints toward quality improvement in healthcare. Reviews on environmental health, 34(4), 427-434. https://www.degruyter.com/document/doi/10.1515/reveh-2019-0003/html 

Improta, G., Guizzi, G., Ricciardi, C., Giordano, V., Ponsiglione, A. M., Converso, G., & Triassi, M. (2020). Agile six sigma in healthcare: Case study at santobono pediatric hospital. International journal of environmental research and public health, 17(3), 1052. https://doi.org/10.3390/ijerph17031052 

Jeffers, A. M. (2021). Safe transitions from the hospital to home: A review of the pediatric hospitalist’s discharge workflow. Current problems in pediatric and adolescent health care, 51(5), 101021. https://doi.org/10.1016/j.cppeds.2021.101021 

Topic 4 DQ 2  

You are the nurse leader on an obstetrics unit. You have been tasked to utilize a Six Sigma approach for standardizing the discharge process. Where do you start? 

“Six sigma approach is used in healthcare to reduce defects that can result in medical error, improve process efficiency, and eliminate waste.”( Purdue University, 2022) As a nurse leader of an obstetrics unit I would use the six sigma approach for standardizing the discharge process. The six sigma approach uses 5 principles to help improve patient care. The principles include define, measure, analyze, improve, and control. I would first start by assessing the current discharge system. I would define what should included in the discharge process. For example, making sure that patients have received their medication and follow up appointments scheduled before leaving the facility. I would then measure the current system in place by looking at the patients that are being discharged and following up to see what actions was not performed and what actions were omitted. I would then analyze the information found about the discharge process. I would then come up with ways to improve the discharge system. For example, I would create a template to use to help make sure that patients have received everything that they need to continue care at home. I would have checklist that should be performed before discharging patients to ensure that the proper ;process was followed. I would come with ways to improve the discharge system or change the system in its entirety. I would use surveys to obtain information from patients and follow up by addressing the areas identified from the survey. Lastly, I would develop a control system. This system would include having the pharmacist sign discharge instructions regarding the medication, the provider signing the discharge instructions stating that they explained the discharge to the patient and made sure that they understood and comprehended. The nurse would be responsible for providing patient education teachings before discharge. All entities would be required to sign off on the discharge template. In general the basics of discharge plan should include, “evaluation of the patient by qualified personnel, discussion with the patient and or their representative and involving them in the planning, Reconciling medications, planning, for the homecoming or transfer to another care facility, determine the need for caregiver training or any other support, and referrals to a home care agency and or appropriate support organizations in the community, arranging for follow-up appointments or tests, and who to contact if you need help.” (Levine, 2022) 

Advance in Healthcare with Lean Six Sigma. (2022). Purdue University. http://purdue.edu 

Levine, C. (2022). Hospital Discharge Planning: A Guide for Families and Caregivers. http://caregiver.org 

Hello Latrice! Thank you for sharing. Your post is detailed and interesting to read. Discharge process in obstetrics unit is challenging for many organizations. The discharge process is often tedious and inefficient and patients are forced to spend considerable time to complete all the required discharge procedures (Cadel et al., 2021). As a result, delays in discharge process cause adverse events such as frustrations and dissatisfaction among the patients and their families. As such, the Six Sigma approach is a critical tool in addressing the challenges with discharge process such as delays. The approach entails scientific principle that helps in estimating all activities in health care setting using various statistical tools (Molla et al., 2018). It is characterizes a set of tools and a way of comprehending how to evaluate and study clinical operations more effectively to realize better results for health care givers, patients, and health care delivery systems (Arafeh et al., 2018). Successful implementation of the Sigma approach is crucial in increasing quality of care, patient satisfaction, and accessibility of beds for admissions in obstetrics unit. 

References 

Arafeh, M., Barghash, M. A., Haddad, N., Musharbash, N., Nashawati, D., Al-Bashir, A., & Assaf, F. (2018). Using six sigma DMAIC methodology and discrete event simulation to reduce patient discharge time in king hussein cancer center. Journal of healthcare engineering, 2018. https://www.hindawi.com/journals/jhe/2018/3832151/ 

Cadel, L., Guilcher, S. J., Kokorelias, K. M., Sutherland, J., Glasby, J., Kiran, T., & Kuluski, K. (2021). Initiatives for improving delayed discharge from a hospital setting: a scoping review. BMJ open, 11(2), e044291. http://dx.doi.org/10.1136/bmjopen-2020-044291 

Molla, M., Warren, D. S., Stewart, S. L., Stocking, J., Johl, H., & Sinigayan, V. (2018). A Lean Six Sigma quality improvement project improves timeliness of discharge from the hospital. The Joint Commission Journal on Quality and Patient Safety, 44(7), 401-412. https://doi.org/10.1016/j.jcjq.2018.02.006 

As a manager of a Labor and Delivery unit the discharge process is very tedious as a nurse is attempting to teach a very tired mother about the care of her infant and herself. Most postpartum patients are not in an efficient learning mode at time of discharge and many teaching methods are necessary. As with any nursing unit efficiency is necessary to maintain productivity and efficiency. In the developing a discharge process it is necessary it is to be successful yet efficient. A key market used I improve discharge process form hospital settings is to decrease variations through preplanning discharges and use of workflow checklists (Rollinson et al., 2021).  

The Six Sigma process is a Lean strategy that focused on decreasing variation and has been used in multiple heath care settings to decrease waste. The Key concepts of Six Sigma are the DMAIC Or DMADV tools, these methods are translated into measurable responses to reduce variables and streamline (Fondahn et al., 2016)      

Using the DMADV process in implementing the discharge process, first you would Define the issue needing to be addressed. Set Measurements of the process such as decreased teaching time. Analysis of the data is required to set the design of the process, analysis of areas that gap development or identifying old systems. Design the process is the meat of the process to educate the nurses in a systematic fashion. Finally, to verify the process is effective, and them to continually address the process to ensure it is effective and adjust as necessary.  In any QI project following a set tool to address the identified problem will make the process go smother.  

Fondahn, E., Lane, M., & Vannucci, A. (2016). The Washington manual of patient safety and quality improvement [e-book]. Wolters Kluwer . 

Rollinson, T., Furnival, J., Goldberg, S., & Choudhury, A. (2021). Learning from lean: A quality improvement project using a lean-based improvement approach to improve discharge for patients with frailty in an acute care hospital. BMJ Open Quality, 10(4), e001393. https://doi.org/10.1136/bmjoq-2021-001393   

I agree that the discharge process is critical. Although complex and sometimes lengthy, it is necessary in aiding patients to manage their care at home successfully. Hence, the need to ensure the discharge is comprehensive, timely, and effective. As health care continues to evolve, health care organizations are tasked with improving quality and efficiency and are therefore adopting lean process improvement strategies to accomplish this goal (Nicosia et al., 2018). However, it is important that these strategies are designed to be patient-centered to enhance patient satisfaction and engagement. I believe the lean approach is beneficial in the discharge process and should be widely employed in the health care setting.  

References  

Nicosia, F. M., Park, L. G., Gray, C. P., Yakir, M. J., & Hung, D. Y. (2018). Nurses’ perspectives on lean redesigns to patient flow and inpatient discharge process efficiency. Global Qualitative Nursing Research, 5, 233339361881065. https://doi.org/10.1177/2333393618810658  

Hello Deanna! Thank you for sharing your post. You have given an in-depth and compelling post about the application of the Six Sigma approach to improve discharge process in the obstetrics unit. Indeed, discharge process is challenging. However, the Six Sigma approach is a vital change management tool to enhance discharge time (Improta et al., 2020). According to Arafeh et al., (2018), when using the concept of Six Sigma DMAIC process, the initial step is to define the issue through recognition of the essence of standardizing the process of discharge to reduce the whole turnaround time used on each patient in the unit. The next step is to measure the issue by judging the existing process and gathering data by breaking down the work composition in the discharge process from the time of approving discharge to time the patient leaves the unit. Consequently, analysis is conducted to identify and eradicate mistakes in all sub-processes in the discharge process. The next step involves improvement where the identified reasons for delays in the process of discharge are recognized and classified on the basis of priority. Finally, control is conducted by promoting programs identified to assist in maintaining the improvements in discharge process. 

References 

Arafeh, M., Barghash, M. A., Haddad, N., Musharbash, N., Nashawati, D., Al-Bashir, A., & Assaf, F. (2018). Using six sigma DMAIC methodology and discrete event simulation to reduce patient discharge time in king hussein cancer center. Journal of healthcare engineering, 2018. https://www.hindawi.com/journals/jhe/2018/3832151/ 

Improta, G., Guizzi, G., Ricciardi, C., Giordano, V., Ponsiglione, A. M., Converso, G., & Triassi, M. (2020). Agile six sigma in healthcare: Case study at santobono pediatric hospital. International journal of environmental research and public health, 17(3), 1052. https://doi.org/10.3390/ijerph17031052 

Six Sigma employs a variety of quality tools including DMAIC. DMAIC is a five-step, problem-solving process which includes define, measure, analyze, improve, and control. The DMAIC method is appropriate for improving the discharge process in obstetrics because its goal is to improve existing processes by defining the problem or issue for improvement, measuring the performance of the process by collecting relevant data, analyzing the data to determine the root causes of the issue, improving the process by eradicating the root causes, and controlling improved processes through monitoring to ensure the better results are sustained (Fondahn et al., 2016, p. 81).  

The first step in improving the discharge process is to define the problem; why does the discharge process need improving or what can be done to streamline the process? This is an opportunity for improvement and therefore specific goals and objectives must be established (Ahmed, 2019). The next step is to retrieve and measure data. The information must be clear and concise. Once data has been collected, Ahmed (2019) indicated it must be analyzed using value stream mapping (VSM) to find the cause(s) of the quality issue. Next, the discharge process must be changed or modified once the root cause(s) has been identified and eliminated. The last step is to establish a quality control plan to monitor the improved process performance (Ahmed, 2019). Utilizing the DMAIC method allows organizations to create a clear path to successfully achieve their goals.  

 References  

Ahmed, S. (2019). Integrating DMAIC approach of Lean Six Sigma and theory of constraints toward quality improvement in healthcare. Reviews on Environmental Health, 34(4), 427-434. https://doi.org/10.1515/reveh-2019-0003  

Fondahn, E., Fer, T. M., Lane, M., & Vannucci, A. (2016). Washington manual of patient safety and quality improvement. Lippincott Williams & Wilkins.  

Angela has a great posting. I love that in all of healthcare we are look outside of ourselves, outside of healthcare to find resources to improve care, safety and quality. Lean Six Sigma is a great demonstration of this. Here is a a great video explanation of Lean Six Sigma  

Why is it so important for healthcare to look outside of our profession for ideas for improvement? 

Hello Angela! Thanks for sharing this impressive post. An extensive, disorganized discharge process is a common challenge for health care settings. It causes decrease in patient satisfaction, frustrations, and delays for patients that need admission (Jeffers, 2021). Moreover, the complexity of discharge process entails organization specific issues that restrict generalizability of solutions. The application of the six sigma approach can be a successful tool in enhancing discharge process in obstetrics unit. Six sigma approach characterizes a set of tools and a way of comprehending how to evaluate and study clinical operations more effectively to realize better results for health care givers, patients, and health care delivery systems (Improta et al., 2020). The primary objective of the six sigma approach is the utilization of measurement-based techniques that centers on improving processes and reducing variations by implementing improvement projects. This can be realized through the utilization of six sigma sub-methodologies of like DMAIC. DMAIC is ideal in standardizing discharge process in the obstetrics unit because it focuses on improving the available discharge processes that fall below specification, developing discharge processes at six sigma quality levels, and looking for incremental discharge enhancement (Ahmed, 2019). 

References 

Ahmed, S. (2019). Integrating DMAIC approach of Lean Six Sigma and theory of constraints toward quality improvement in healthcare. Reviews on environmental health, 34(4), 427-434. https://www.degruyter.com/document/doi/10.1515/reveh-2019-0003/html 

Improta, G., Guizzi, G., Ricciardi, C., Giordano, V., Ponsiglione, A. M., Converso, G., & Triassi, M. (2020). Agile six sigma in healthcare: Case study at santobono pediatric hospital. International journal of environmental research and public health, 17(3), 1052. https://doi.org/10.3390/ijerph17031052 

Jeffers, A. M. (2021). Safe transitions from the hospital to home: A review of the pediatric hospitalist’s discharge workflow. Current problems in pediatric and adolescent health care, 51(5), 101021. https://doi.org/10.1016/j.cppeds.2021.101021 

Unread 

Six Sigma is a quality improvement (QI) framework that utilizes the “DMAIC” methodology involving five steps: “Define,” “Measure,” “Analyze,” “Improve,” and “Control.” A nurse leader on an obstetrics unit using the Six Sigma approach for standardizing the discharge process would need to start at the “Define” phase. One initial step includes forming a QI team to improve the discharge process (Purdue University, 2021). The team would complete a Project Charter during one of the first team meetings, including the following tasks: naming the problem with the discharge process, defining a goal to improve the discharge process, and assigning team member roles (Purdue University, 2021).  

When naming the problem, it would be essential to look at baseline data and identify national benchmarks. Other initial tasks in the “Define” phase include assessing the voice of the customer (VOC). Surveys could be utilized to evaluate the VOC and completed by nursing staff, physicians, and any other ancillary staff involved in the discharge process. The QI team could utilize complaints and grievances to establish the VOC for the patients since they are also customers in the process. Any data obtained from the surveys should be compiled in a VOC Matrix tool for further trending and assessments by the QI team.  

Another vital tool in the “Define” phase is the Suppliers, Inputs, Process, Outputs, and Customers (SIPOC) diagram (Six Sigma Daily, 2017). The SIPOC diagram is a type of process map completed by the QI team that aids in understanding the steps of the discharge process (Six Sigma Daily, 2017). Determining potential stakeholder barriers is another vital step in the “Define” phase (Purdue University, 2021). Since barriers may exist, it is essential to anticipate them, so the team does not become frustrated if they arise; barriers may be unique and specific to each facility (Molla et al., 2018). The discharge process in an obstetrics unit is cumbersome; however, Six Sigma is an effective tool that could streamline the process and sustain improvement.  

References:  

Molla, M., Warren, D. S., Stewart, S. L., Stocking, J., Johl, H., & Sinigayan, V. (2018). A lean six sigma quality improvement project improves timeliness of discharge from the hospital. The Joint Commission Journal on Quality and Patient Safety, 44(7), 401–412. https://doi.org/10.1016/j.jcjq.2018.02.006 

Purdue University. (2021). DMAIC vs. DMADV. Purdue.Edu. https://www.purdue.edu/leansixsigmaonline/blog/dmaic-vs-dmadv/#:~:text=DMAIC%20(Define%E2%80%94Measure%E2%80%94Analyze%E2%80%94Improve%E2%80%94Control),-DMAIC%20is%20the&text=Collect%20data%20from%20the%20process,solutions%20to%20improve%20the%20proces. 

Six Sigma Daily. (2017). What is a SIPOC diagram? Sixsigmadaily.Com. https://www.sixsigmadaily.com/what-is-a-sipoc-diagram/ 

Discharge delays can slow down hospital and emergency department (ED) efficiency. The discharge process is complicated, because it entails posing specific obstacles that limit the answers’ generalizability. The major result when employed over a ten-month period was discharge time. The percentage of patients whose discharge order was made before noon, the percentage of patients leaving the room before noon, hospital length of stay (LOS), and the LOS of admitted ED patients were all secondary end variables. Discharge time was reduced by 22.7 percent, from 2.2 hours before the intervention to 1.7 hours afterward (El-Eid et al., 2019). Although there was no significant change in before noon discharge in the post intervention period, a higher majority of individuals departed their room before noon. 

After the intervention, the average length of stay in the hospital was reduced from 3.4 to 3.1 days. In the post-intervention period, the ED means LOS of hospitalized patients was considerably lower (McClay et al., 2020). To optimize discharge time, the Six Sigma technique might be a useful change management tool. Rather of focusing on individual interventions that may be institution-specific, institutions desiring to reduce discharge delays should adopt the essential concepts of Six Sigma. 

El-Eid, G. R., Kaddoum, R., Tamim, H., & Hitti, E. A. (2019). Improving hospital discharge time. Medicine, 94(12), e633. https://doi.org/10.1097/md.0000000000000633 

McClay, M. A., Swanson, K., & Yuan, C. (2020). Improving the hospital discharge process with six sigma methods. ResearchGate. https://www.researchgate.net/publication/233135958_Improving_the_Hospital_Discharge_Process_with_Six_Sigma_Methods 

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