TITLE:
Elimination of Post-Operative Complications in Penetrating Keratoplasty by Deploying Six Sigma
AUTHORS:
İbrahim Şahbaz, Mehmet Tolga Taner, Üzeyir Tolga Şahandar, Gamze Kağan, Engin Erbaş
KEYWORDS:
Six Sigma, Ophthalmology, Penetrating Keratoplasty Surgery, Post-Operative Complications
JOURNAL NAME:
American Journal of Operations Research,
Vol.4 No.4,
July
9,
2014
ABSTRACT: This
paper shows how a public eye and research hospital in Turkey initiated Six
Sigma principles to reduce the number of complications occurring after
penetrating keratoplasty surgeries. Data were collected for nine years. To
analyse the complications among 55 patients (59 eyes) underwent penetrative
keratoplasty, main tools of Six Sigma’s Define-Measure-Analyze-Improve-Control
(DMAIC) improvement cycle such as SIPOC table and Failure, Mode and Effect
Analysis (FMEA) were implemented. Sources and root causes of eleven types of
complications were identified and reported. For a successful penetrating
keratoplasty surgery patient’s anatomy, suitability of donor cornea, experience
of ophthalmic surgeon, sterilization and hygiene, and performance of the
equipment were determined to be the “critical-to-quality” factors. The
complication with the highest hazard score was found to be the glaucoma. The
process sigma level of the process was measured to be 3.1418. The surgical team
concluded that all types of post-operative complications should be
significantly reduced by taking the necessary preventive measures.