Six Sigma 활동을 통한 중증외상환자의 응급실 체류시간 개선 활동

The Effect of Six Sigma Activity in Major Trauma Patients on the Time Spent in the Emergency Department

  • Kim, Hyun-Soo (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Kim, Ok-Jun (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Choi, Sung-Wook (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Kim, Eui-Chung (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Park, Young-Tae (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Ko, Tae-I (Department of Emergency Medicine, CHA Gumi Medical Center, CHA University) ;
  • Cho, Yun-Kyung (Division of Cardiology Department of Internal Medicine, CHA Gangnam Medical Center, CHA University)
  • 투고 : 2010.05.07
  • 심사 : 2010.09.15
  • 발행 : 2010.12.30

초록

Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

키워드

참고문헌

  1. Korea national statistical office. Annual report of cause of death in Korea 2005. Seoul: Korea national statistical office. 2006.
  2. Kug Jong Lee. The Necessity for a Trauma Surgeon and the Trauma Surgeon's Role in the Trauma Care System. The Korean Soc of Traumatology 2008;21:1-7.
  3. Whan Sik Kim, Min Su Cho, Keum Seok Bae, Seong Joon Kang, Kang Hyun Lee, Keum Hwang. Clinical Analysis of Death in Trauma Patients. The Korean Soc of Traumatology 2007;20:96-100.
  4. Available at: http://www.mw.go.kr/front/al/sal0301vw. jsp?PAR_MENU_ID=04&MENU_ID=0403&BOAR D_ID=140&BOARD_FLAG=00&CONT_SEQ=211 613&page=1
  5. Available at: http://en.wikipedia.org/wiki/Six_sigma
  6. Jin Kun Bae, Ok Jun Kim, Sung Wook Choi. Reducing Length of Stay in Emergency Department through Six Sigma Improvement Process. The Journal of the Korean Society of Emergency Medicine 2008;19;131-137.
  7. Yates DW. Scoring systems for trauma. BMJ 1990;301:1090-94. https://doi.org/10.1136/bmj.301.6760.1090
  8. Champion HR, Sacco WJ, Caranazzo AJ, Cop-es W, Fauty WJ. Trauma Score. Crit Care Med 1981;9:672-76. https://doi.org/10.1097/00003246-198109000-00015
  9. Available at: http://www.mw.go.kr/front/al/sal0101vw. jsp?PAR_MENU_ID=04&MENU_ID=040102&BOA RD_ID=110&BOARD_FLAG=01&CONT_SEQ=41 343&page=1
  10. Available at: http://www.sixsigmatraining.org/PDF/ DMAIC.pdf
  11. Available at: http://www.nemc.go.kr/include/_config _/down.jsp?file=nemc_2_1253673174760.pdf&boardLe ftMenuFlag=7&sub_boardLeftMenuFlag=null
  12. Hankins Judy. Infusion Therapy in Clinical Practice 2001;42.
  13. Nancy R. Tague. Seven Basic Quality Tools, The Quality Toolbox. Milwaukee, Wisconsin : American Society for Quality 2004;15.
  14. Available at: http://www.nets.org.au/PDF/MIST% 20Trauma%20Triage%20Tool.pdf
  15. S. K. D'Amours, M. Sugrue, S. A. Deane. Initial Management of The Poly-Trauma Patient: A Practical Approach in Australian Major Trauma Service. Scandinavian Journal of Surgery 2002; 91:23-33. https://doi.org/10.1177/145749690209100105