An application of DMAIC methodology for reducing voluntary departures from an Emergency Department

The Emergency Department (ED) is a zone of a hospital where usually the healthcare staff has to face sudden and serious heathy problems. On the other side, patients find themselves in a situation of great emotion, discomfort and anxiety, aggravated by the expectation that, in cases of lesser severity, it can be long and badly tolerated. Furthermore, during access, patients and caregivers must undertake visits, assessments, consultations and bureaucratic procedures that can be long and complicated, due to inadequate or inaccurate information. In these conditions, waiting times can often be very long and / or patients can decide to abandon the ED. In this work, a combination of important managerial methodologies, Lean Six Sigma and DMAIC cycle (Define, Measure, Analyse, Improve, Control) are employed at an important hospital of South Italy in order to improve the emergency care process as well as the patient experience. It is a retrospective study, for which the historical times of access to the ED were analysed for the years 2015 and 2016. During this period, to improve the reception of patients and to reduce voluntary departures, two digital monitors were being designed and installed in the waiting room of the ED, which allow the visualization of the overall situation at the ED itself. The visualization is of course totally dynamic, i.e. the layout varies according to the data taken into consideration. In conclusion, the adopted approach impacts on the entrance and waiting times of patients in the ED and improves the general patient experience.