Application of Six Sigma methodology to a cataract surgery unit
Özet
Purpose – The article’s aim is to focus on the application of Six Sigma to minimise intraoperative
and post-operative complications rates in a Turkish public hospital cataract surgery unit.
Design/methodology/approach – Implementing define-measure-analyse-improve and control
(DMAIC) involves process mapping, fishbone diagrams and rigorous data-collection. Failure mode
and effect analysis (FMEA), pareto diagrams, control charts and process capability analysis are
applied to redress cataract surgery failure root causes.
Findings – Inefficient skills of assistant surgeons and technicians, low quality of IOLs used, wrong
IOL placement, unsystematic sterilisation of surgery rooms and devices, and the unprioritising
network system are found to be the critical drivers of intraoperative-operative and post-operative
complications. Sigma level was increased from 2.60 to 3.75 subsequent to extensive training of
assistant surgeons, ophthalmologists and technicians, better quality IOLs, systematic sterilisation and
air-filtering, and the implementation of a more sophisticated network system.
Practical implications – This article shows that Six Sigma measurement and process improvement
can become the impetus for cataract unit staff to rethink their process and reduce malpractices.
Measuring, recording and reporting data regularly helps them to continuously monitor their overall
process and deliver safer treatments.
Originality/value – This is the first Six Sigma ophthalmology study in Turkey.