six sigma for medical transcription
DESCRIPTION
Based in Louisville, Mediscribes is one of the fastest growing transcription & document management solution providers in United States. Mediscribes is an ISO 9000-2001 certified company, rendering cost-effective consolidated transcription solutions to major hospitals, clinics, and other healthcare facilities. The firm specializes in providing highly accurate transcription services, while adhering to the Association for Healthcare Document Integrity (AHDI) guidelines providing turnaround time service levels that are beyond industry reproach.TRANSCRIPT
Quality
TAT
Six Sigma for Medical Transcription
http://www.mediscribes.com
"If you can not measure it, you can not improve it.“
- Lord Kelvin
Case Study
Improvement of Operational Efficiency of Medical Transcription
Sampling of 10338 documents
Measure Turn Around Time
Measure Accuracy
48 Hrs (19.8% or
2.35 sigma)
24 Hrs (20.1% or
2.34 sigma)
12 Hrs (32.7% or
1.95 sigma)
4 Hrs (1.2% or 3.77 sigma)
Sigma Level 2.4
Measure Turn Around Time (TAT)
4 hrs TAT 12 hrs TAT
Data Distribution – Turn Around Time (TAT)
24 hrs TAT 48 hrs TAT
Data Distribution – Turn Around Time (TAT)
Data Collection – Turn Around Time (TAT)
Data Collection – Turn Around Time (TAT)
Measure Accuracy
Accuracy Sigma Levels
Data Distribution-Accuracy
Sigma Level 4.01
Error Types
FMEA (Failure Mode & Effect Analysis)
Cause & Effect Diagram
Analysis of Turn Around Time (TAT)
Control Chart of 48 hrs TAT
The current level of “not achieved TAT” is 6.8 ( avg) per day
Client wise Pareto
C 1
C2 C3 C4 C5 C6 C 7
C 8
C 9
C10
C11
C12
C13
Medical Transcriptionist wise Pareto
Control Chart of 24 Hr TAT - Achieved
Control Chart of 24 Hr TAT - Achieved
Process Statistics
68.8%
.011
-.304
.327
27.505
-.304
68.8%
Act. % Outside SL
CPa
CpLa
CpUa
K
CpKa
Capability Indices
Performance Indices
The normal distribution is assumed. LSL = 98.5 and USL= 100.
The estimated capability sigma is based on themean of the sample moving ranges.
a.
Control Chart of 48 Hr TAT - Achieved
Control Chart of 24 Hr TAT - Achieved
Process Statistics
39.3%
.013
-.278
.304
21.888
-.278
75.205
39.3%
Act. % Outside SL
CPa
CpLa
CpUa
K
CpKa
CRa
Capability Indices
Performance Indices
The normal distribution is assumed. LSL = 98.5 and USL= 100.
The estimated capability sigma is based on themean of the sample moving ranges.
a.
Analysis of Accuracy
Correlation-Accuracy
0 2 4 6 8 10 12 140.00
20.00
40.00
60.00
80.00
100.00
120.00
140.00
Lines Count vs. Defects
Trend Of Vendor (nehab) Accuracy
Trend Of Vendor (transtek) Accuracy
IMPROVE
PHASE
Improvement Actions Plan
Solution Prioritization MatrixSolution Easy to
ImplementQuick to get
benefitsTechnological/
Financial Feasibility
Impact on Bottle-line
Impact on Customer
Satisfaction
SUM
Weights 0.1 0.1 0.2 0.2 0.4 1.0
Three Shift Operations/
Sundays/ Holidays Working
7 8 3 5 8 6.3
User-based Bandwidth
Allocation to ensure EMR
insertions are done in time
6 5 3 4 9 6.1
Internal Communication/ Motivation and Admin Support
to ensure availability of
MT
8 3 4 4 8 5.9
Improvement in Turn Around Time (TAT)
Involvement Matrix-Production/ QA
PRODUCTION-TAT & ACCURACY IMPROVEMENTS INVOLVEMENT MATRIXTASK People Responsible
forPeople Involved in People Consulted
withPeople Informed about
Identifying Solutions Production ManagerTeam Lead-MTTeam Lead-Upload
Team Lead-QA Manager-ITManager-Admin
CEOVP-US Operations
Selecting Solutions Team Above Quality Improvement Team
Six Sigma Black Belt Head Operations
Planning the Implementation
Team Above As required As required Head Operations
Handling Potential Problems Production Manager As required As required CEO
Implementing Solutions Production Manager As required As required CEOVP-US Operations
Monitoring Results Team Lead-Upload Team Lead-QA As required CEOVP-US Operations
TAT performance
TAT after actions
Improvement in Accuracy
Accuracy Improvements
Client-wise Accuracy
Accuracy after actions
Sigma Level 4.59
Control Phase
Operational Policies-Defined
SOPs for all processes prepared
Apex manual defined
Responsibilities defined
Score Card Development
Score cards are developed for monitoring of key parameters of
each process.
The score card rules are decided to provide status colors every
two weeks.
Data is measured for each fortnight and status given.
Score Card
Before and After Sigma Levels
TAT
2.40
3.25
Accuracy
4.01
4.59
Tools used
• FMEA (Failure Mode & Effect Analysis)• CC (Control Plans)• Score Cards• Cause and Effect Diagrams• Control Charts• Pareto Charts• Process Capability Analysis• Anova (Analysis of Variance)
Mediscribes, Inc (ISO 9001, 27001) one of the fastest growing transcription & document management solution providers in United States.