Analysis of Turnaround Timings for Emergency Department of Government Hospital of Hyderabad-A Six Sigma Approach

Post LPG, the service sector predominantly occupied a pivotal role in the society. Unlike the primary agricultural sector or secondary industrial sector, which is concerned with production of tangible goods, the service is basically intangible and perishable, in the sense that neither the service provider nor the service receiver can store a service. Healthcare industry which is one of the most crucial components of service sector unlike banking, insurance, hotel, transportation and education is one of the world's largest and fastest-growing industries. Healthcare includes many subsectors in it comprising of Hospitals, Medical Infrastructure, Medical Devices, Clinical Trials, Outsourcing, Telemedicine, Health Insurance all of which delivers goods and services to treat patients on preventive, curative, rehabilitative, and palliative care basis. Leading the healthcare from the front is the hospital segment and its significance has been broadened and organizationally they dominate the rest of the health care system. Since service delivery in hospitals is a matter of patient lives which is highly intangible in nature and can't be physically viewed or touched like a manufactured product and since hospitals are becoming more complex the opportunities for errors abound and as the patients are also demanding for better services, most of the hospitals are now incorporating Six Sigma approach. In the hospital context, six sigma is been applied in the improvement of business processes (Administrative and Logistics) and the medical outcome processes (Clinical and Patient Safety). The overall strategy is to achieve excellence in health care by aligning and optimizing processes and by the removal of process-generated errors and defects. This study was conducted in the Casualty Department of a Government Hospital of Hyderabad and follows the Six Sigma DMAIC methodology. The objective of the study was to measure the baseline Sigma level of Casualty process and further streamlining the entire process, finding root causes of waiting time in Casualty, suggesting recommendations in the existing process flow and finding out constraints that limit the department efficiency and productivity, which when removed would improve patient satisfaction and resulting in efficient service delivery. A total sample size of 225 patients was taken for both Emergency and Medico Legal cases by adopting convenience sampling technique. In the study it was found that in a sample size of 225, the range of Turn Around Time was between 5–15 minutes where there were 115 subjects in this interval. The researchers also performed root cause analysis of delayed waiting time and it was found that the process contributing to the maximum delay in waiting time was attributed to man power with 80.6% of total defects followed by methods attributing to 10.7% of total defects. Control Phase of DMAIC methodology was not implemented due to several constraints. Changes were proposed that would ultimately improve the overall effectiveness of the Casualty Department leading to increased Patient satisfaction and an efficient delivery of service quality.