DuPree Erin, Martin Lisa, Anderson Rebecca, Kathuria Navneet, Reich David, Porter Carol, Chassin Mark R
Department of Obstetrics, Gynecology & Reproductive Science, The Mount Sinai Medical Center, New York City, USA.
Jt Comm J Qual Patient Saf. 2009 Jul;35(7):343-50. doi: 10.1016/s1553-7250(09)35048-5.
Patient satisfaction as a direct and public measure of quality of care is changing the way hospitals address quality improvement. The feasibility of using the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) methodology to improve patient satisfaction as it relates to pain management was evaluated.
This project used the DMAIC methodology to improve patients' overall satisfaction with pain management on two inpatient units in an urban academic medical center. Pre- and postintervention patient surveys were conducted. The DMAIC methodology provided a data-driven structure to determine the optimal improvement strategies, as well as a long-term plan for maintaining any improvements. In addition, the Change Acceleration Process (CAP) was used throughout the project's various DMAIC stages to further the work of the team by creating a shared need to meet the objectives of the project.
Overall satisfaction with pain management "excellent" ratings increased from 37% to 54%. Both units surpassed the goal of at least 50% of responses in the "excellent" category. Several key drivers of satisfaction with pain management were uncovered in the Analyze phase of the project, and each saw rating increases from the pre-intervention to postintervention surveys. Ongoing monitoring by the hospital inpatient satisfaction survey showed that the pain satisfaction score improved in subsequent quarters as compared with the pre-intervention period.
The Six Sigma DMAIC methodology can be used successfully to improve patient satisfaction. The project led to measurable improvements in patient satisfaction with pain management, which have endured past the duration of the Six Sigma project. The Control phase of DMAIC allows the improvements to be incorporated into daily operations.
患者满意度作为医疗质量的直接且公开的衡量标准，正在改变医院解决质量改进问题的方式。本研究评估了使用六西格玛DMAIC（定义、测量、分析、改进、控制）方法来提高与疼痛管理相关的患者满意度的可行性。
本项目采用DMAIC方法，以提高城市学术医疗中心两个住院科室患者对疼痛管理的总体满意度。在干预前后进行了患者调查。DMAIC方法提供了一个数据驱动的结构，以确定最佳改进策略，以及维持任何改进的长期计划。此外，在项目的各个DMAIC阶段都使用了变革加速流程（CAP），通过创造一种共同需求来推动团队工作，以实现项目目标。
对疼痛管理“优秀”评级的总体满意度从37%提高到了54%。两个科室都超过了“优秀”类别中至少50%的回复率这一目标。在项目的分析阶段发现了几个影响疼痛管理满意度的关键驱动因素，并且从干预前到干预后的调查中，每个因素的评级都有所提高。医院住院患者满意度调查的持续监测显示，与干预前相比，后续季度的疼痛满意度得分有所提高。
六西格玛DMAIC方法可以成功用于提高患者满意度。该项目使患者对疼痛管理的满意度得到了可衡量的提高，并且在六西格玛项目结束后仍持续存在。DMAIC的控制阶段允许将改进纳入日常运营。
