Decrease Missed Dialysis Treatments through Six Sigma Approach

-Decrease Missed Treatments

  • For decades, the healthcare industry has been using Six Sigma method to improve patient safety and operational efficiency, while decreasing costs and increasing revenue. Missed dialysis treatments, a common problem among dialysis patients, is expensive for the facility and potentially fatal for the patients.

    The most common reasons for patients missing a treatment or reducing their time on dialysis are: health issues, boredom from the routine, transportation issues and schedule conflicts. With this in mind, here is how you could apply the Six Sigma DMAIC (Define, Measure, Analyze, Improve and Control) quality improvement model to tackle these issues and ensure patients are present for their treatments:

    Define: Assemble a team to define the problem – why are your patients missing treatment? Determine the patients’ reasons or concerns. Consider how clinic processes could be contributing to the problem. For example, patients experiencing long wait time before and after the treatments or poor customer service?

    Measure: Watch the patterns and trends in missed treatments. Are there only a few patients who are regularly missing treatments? Or is the issue that a high number of patients are not showing for treatment during particular days or months, such as on a Friday or Monday (making it a long weekend)?

    Analyze: Now that you have collected the data and watched the trend, analyze the information available for root causes. Talk to the patients who missed treatments to understand their concerns, and ALSO talk to those who always keep their appointment. What’s different between them and how can you use this information to make changes? Schedule it in your monthly QAPI meetings so that you get wide range of perspectives on the issues.  

    Improve: Plan corrective steps your team could take to improve the trend. Have the patients participate in your planning and implementation of corrective action steps. Keep them posted of the changes you made and seek their input. Again, develop the plan at QAPI meetings to use the team expertise and strengthen it by including input from others in the center.

    Control: Track the rate of missed treatment and watch for any new trends. Evaluate the impact of any changes you implemented and keep those changes that worked.

    One change that many offices are finding helpful in decreasing missed treatment is the use of telehealth. Telehealth supports healthcare providers in monitoring and intervening in patient compliance issues. For more information on this topic and to see how a telehealth approach decreased missed treatments, please click here.

    To learn more about Six Sigma DMAIC, click here.

For more ideas and information on decreasing missed treatments among your dialysis patients, please contact us by using the form below.


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