Development of a Six Sigma Infrastructure for Trabeculectomy Process
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Date
2014Author
Kagan, Gamze
Bayraktar, Sukru
Taner, Mehmet Tolga
Karaarasi Ozturker, Zeynep
Ozturker, Can
Sahbaz, Ibrahim
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The aim of this article is to show how an eye clinic of a Turkish public hospital initiated Six Sigma
principles to reduce the number of complications encountered during and after trabeculectomy
surgeries. Data were collected for ten years. To analyse the process, main tools of Six Sigma’s Define-
Measure-Analyze-Improve-Control (DMAIC) improvement cycle such as SIPOC Table, Failure,
Mode and Effect Analysis were implemented. Sources and root causes of ten types of complications
were identified and reported. Patient’s eye anatomy, experience of ophthalmic surgeon, quality of
surgical equipment, quality and type of suture, and experience of staff were identified to be Critical-
to-Quality (CTQ) factors for a successful surgery. The most frequently occurring complication
was found to be hypotony. The process sigma level of the process was measured to be 3.1391. The
surgical team concluded that ten complications (out of twelve) should be significantly reduced by
taking the necessary preventative measures.