Question

A lean six sigma team worked with one of the medical centers in the US to study the preoperational processes for patients experiencing kidney transplants. The aim of the study was reducing the cycle times, improving patient satisfaction, reducing the costs and streamlining the administrative processes. The main performance measure was the number of days required from the date a patient was referred to the transplant medical center to the date the patient is identified as suitable for the transplant process. The project was necessary and it was selected as a result of long waiting time for a large number of patients. The number of patients on the waiting list was about 500 patients, so it was expected that reducing the cycle time could potentially save lives in addition to improving patient satisfaction. For more than 30 years, the transplant medical center has performed kidney transplants for adult and pediatric patients as one of the treatment options for end-stage renal disease. Since 1972, the transplant medical center has done more than 1500 kidney transplant operations. The average patient survival rate is 98% and the graft survival rate is 94%. Advanced surgical methods are used including laparoscopic kidney donation, improved anti-rejection medications and high-quality patient care to make it one of the most successful programs in the country. There are various steps patients must finish before receiving a kidney transplant. Firstly, the patient registers to receive a kidney, then the medical center send out a letter to the patient as initial contact. After completing the registration process, the patient attends the medical center for orientation to make the patient familiar with the preoperational process of the kidney transplant. Then, a profile is created for the patient to be ready for the clinical evaluation. Generally, patient must complete necessary lab tests to figure out whether he or she is suitable for the transplant operation (similar tests are performed at other transplant centers). The tests are tuberculosis (TB) tests, dental clearance, colonoscopy, chest X-rays, electrocardiography tests, stool samples, blood work, mammograms, pap-smears, and diabetes tests. Once the patient does all the required tests, the results are reviewed by a committee to determine if the patient is a good candidate or not. The patient is then placed on the waiting list. This is often referred to as being “listed”, which means that the patient is allowed to receive a kidney. Usually the screening process takes up to nine months. Also, two additional years may pass after the patient is listed before a kidney transplant is performed. It is not possible to reduce the waiting time between being listed and receiving a kidney because it is dependent on the available and the needed kidneys. However, the improvements could be done for reducing the time required for a patient to become listed. The Six Sigma project team was composed of two surgeons, a psychologist, three transplant coordinators/registered nurses, a financial advisor and two industrial engineers. The Six Sigma team performed a brainstorming session to identify the causes of variation in the system. It is found that the major causes of variation are the lack of on-time data, scheduling conflict between staff and patient, lack of communication among staff, staff availability, lack of funds from the patient, and patients’ delays and cancellations. The team utilized the Define, Measure, Analyze, Improve and Control (DMAIC) approach in this project. The project goal was to reduce the cycle time from 227 days to 180 days or less. The primary metric was the average total preoperational process time (in days) for patients undergoing kidney transplants. Based on the past two years data, the process was baselined at an average of 227 days.

As a Lean Six Sigma Green Belt, answer the following question (you are welcome to state any assumptions that might be necessary to help you address any of the questions below):

1. Develop a Process Data Collection Plan

Answer 1

Lean Six Sigma is a combination of two popular Continous Quality Improvement method- Lean and Six Sigma-that pave the way for operational excellence

Data collection plan in Six Sigma for Kidney Transplant

A data collection plan is a detailed document.It describes the exact steps as well as the sequence that needs to be followed in gathering the data for the project

Aim of the study: Reducing the cycle times,improving patient satisfaction,reducing the costs and streamling the administrative process

Performance measures: The number of days required from the date a patient was referred to the transplant medical center to the date the patient is identified as suitable for the transplant process.

Goal: To reduce the cycle time from 227 days to days or less.

Steps involved before receiving a kidney transplant

1) Registration by the patient to receive a kidney

2) Medical center send out a letter to the patient as initial contact

3) Patient attends the medical center for orientation to make the patient familiar with the preoperational process

4) Profile created for clinical evaluations

5) Patient to complete lab test to figure out he/she suitable for transplant

6) Results reviewed by a committee to determine if the patient is a good candidate.

7) Patient is placed on wait list(“listed” means patient allowed to receive a kidney

Process Data Collection   

Process No.of days required Registration by the patient to receive a kidney MC to send letter to patient for initial contact Patient attend for orientation program Profile creation for clinical evaluation Patient completed lab tests Review by the committee to decide patient a good Patient is placed on wait list (listed)