Lean and six sigma process consists
of five phages described by DMAIC (Define, Measure, Analyze, Improve, and
Control).
Define:
This
process involves determining who uses the service or products. E.g. physicians,
what are the user’s requirements and expectations? E.g. emergency department
will require fast turnaround time, what are the project boundaries? This might
involve establishing who might be involved in this project and what are the
areas covered. E.g. phlebotomy to draw the specimen. By the end of define
phase, both the project team and management have validated the project plans
and policies; this means that the team will have defined the overall purpose
and potential impact of project, the scope of the project, its resources (who
is in the team and how much money is available to implement changes), and
expectations-what will be delivered and when.
Measure:
The
performance of process in laboratory can be measured by
Collecting data – in lab, this might involve determining how long it
takes to report the results, what is the turnaround time, etc.
Determine defects – For e.g. this might include determining how often
specimens are collected in wrong tube, how much is the delay in receiving
specimen, random and systematic errors, etc.
Satisfaction of user – this might involve determining if the needs of
physicians or other users are being met.
In this phase the teams measures,
and assesses the baseline process. E.g. if the goal was to improve the time it
takes phlebotomist to get specimens from hospital inpatient population to the
laboratory then the measure phase would consist measuring the time it is taking
and assessing which step is defective. The measure phase allows the team to
measure the severity of the problem. This also measures the bias and errors in
laboratory results and methods.
Analyze:
Examine
the data collected during measure phase, regarding error in the process during
the measure phase. In this phase the team verifies the root cause of problem using
different QC programs and data analysis. The details of the process whether
they are running according to the guideline or given criteria are also analyzed
and verified.
Improve:
Improve the process by creative solutions to fix
problems and prevent future ones from occurring. At the end of this phase, a
team must demonstrate that a process change has been implemented that address
the error found in the analyze phase and solves the problem evaluated in the
measure phase.
Control:
This
may include continuous monitoring of the new plans. This phase ensures that the
quality is maintained by QC mechanisms. For this the QC charts can be used,
specimen collection and delivery should be monitored so that there is no delay
in delivery, collection of sample according to the guideline should be
monitored, etc. Proper functioning of instrument should be assured.
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