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Using Six-Sigma Methodology for Practice Quality Improvement Projects


R Paden

R Paden1*, (1) Mayo Clinic, Phoenix, AZ

SU-E-I-35 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To illustrate the utility of Six-Sigma tools for Practice Quality Improvement Projects

Methods: Practice Quality Improvement (PQI) Projects are required as a component of Maintenance of Certification (MOC). The methodology of Define, Measure, Analyze, Improve, and Control (DMAIC) is particularly well suited for PQI. An example of the DMAIC approach is presented using the CT pulmonary embolism protocol. Within DMAIC the Define phase consists of stating the problem and the processes involved in the task. During Measure phase the baseline performance of the process is established. Analyze phase involves looking at the data collected and proposing methods to enhance the process. The Improve phase comprises the changes that are made to the process. Control phase consists of follow-up to insure that improvements are robust and remain in place over time.
For the CT pulmonary embolism example:
Define: For dose reduction purposes kV is switched from 120 to 100 resulting in higher mA values than desired by the Radiologist. Manual mA is utilized instead of mA modulation techniques.
Measure: Baseline CTDIvol values across patient sizes for pulmonary embolism.
Analyze: What modulation algorithm will result in similar doses?
Improve: Pilot studies with adjusted mA modulation parameters.
Control: Establish a database to continually monitor doses from pulmonary embolism protocol.


Results: Baseline measurements demonstrate four dose levels 2.1 mGy, 3.9 mGy, 4.9 mGy, and 10.9 mGy, depending on patient size measured laterally on a localizer radiograph. After a size-based protocol chart is implemented dose values are variable ranging from 1.02 mGy to 12.19 mGy.

Conclusion: The DMAIC approach can successfully be implemented during Practice Quality Improvement Projects.

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