Six sigma principle as a medical laboratory quality evaluation tool: Experience at a tertiary care hospital

Abstract

Quality in the laboratory has a big impact on the diagnosis of laboratory tests. The identification of reliable QIs to quantify the quality of laboratory services is mandated by ISO15189. The use of QIs is an important laboratory tool to improve the process and guarantee patient safety. Hence we assess the performance of our laboratory through some QIs. The present study was conducted at Medanta-The Medicity Hospital, Gurgaon, Haryana India, from January 2015 till December 2016. The QIs were sample rejection rate (SSR) for pre-analytical, concordant proficiency testing (CPT) and equipment uptime for analytical, turnaround time (TAT), and critical alert callout for post-analytical phase respectively. The trend was observed for all QI for two years. SRR and TAT were evaluated with the sigma scale. A total of 1,414,244 (690,751 in 2015 and 723,493 in 2016) specimens were received for testing. 0.80% of specimens were rejected giving a sigma level of 4.0. There was an improvement in proficiency testing and equipment uptime. A total of 122,712 (8.68%) samples were reported to not meet the TAT with a sigma level of 2.90. For critical value communication improvements were also seen. A general improvement for most of the QIs was observed.

Keywords: Quality Indicators, six sigma, sample rejection rate, turnaround time, critical alert.