six sigma for medical transcription

47
Quality TAT Six Sigma for Medical Transcription http://www.mediscribes.com

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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.

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Page 1: Six sigma for medical transcription

Quality

TAT

Six Sigma for Medical Transcription

http://www.mediscribes.com

Page 2: Six sigma for medical transcription

"If you can not measure it, you can not improve it.“

- Lord Kelvin

Page 3: Six sigma for medical transcription

Case Study

Improvement of Operational Efficiency of Medical Transcription

Page 4: Six sigma for medical transcription

Sampling of 10338 documents

Measure Turn Around Time

Measure Accuracy

Page 5: Six sigma for medical transcription

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

Page 6: Six sigma for medical transcription

Measure Turn Around Time (TAT)

Page 7: Six sigma for medical transcription

4 hrs TAT 12 hrs TAT

Data Distribution – Turn Around Time (TAT)

Page 8: Six sigma for medical transcription

24 hrs TAT 48 hrs TAT

Data Distribution – Turn Around Time (TAT)

Page 9: Six sigma for medical transcription

Data Collection – Turn Around Time (TAT)

Page 10: Six sigma for medical transcription

Data Collection – Turn Around Time (TAT)

Page 11: Six sigma for medical transcription

Measure Accuracy

Page 12: Six sigma for medical transcription

Accuracy Sigma Levels

Page 13: Six sigma for medical transcription

Data Distribution-Accuracy

Sigma Level 4.01

Page 14: Six sigma for medical transcription

Error Types

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FMEA (Failure Mode & Effect Analysis)

Page 16: Six sigma for medical transcription

Cause & Effect Diagram

Page 17: Six sigma for medical transcription

Analysis of Turn Around Time (TAT)

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Control Chart of 48 hrs TAT

The current level of “not achieved TAT” is 6.8 ( avg) per day

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Client wise Pareto

C 1

C2 C3 C4 C5 C6 C 7

C 8

C 9

C10

C11

C12

C13

Page 20: Six sigma for medical transcription

Medical Transcriptionist wise Pareto

Page 21: Six sigma for medical transcription

Control Chart of 24 Hr TAT - Achieved

Page 22: Six sigma for medical transcription

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.

Page 23: Six sigma for medical transcription

Control Chart of 48 Hr TAT - Achieved

Page 24: Six sigma for medical transcription

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.

Page 25: Six sigma for medical transcription

Analysis of Accuracy

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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

Page 27: Six sigma for medical transcription

Trend Of Vendor (nehab) Accuracy

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Trend Of Vendor (transtek) Accuracy

Page 29: Six sigma for medical transcription

IMPROVE

PHASE

Page 30: Six sigma for medical transcription

Improvement Actions Plan

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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

Page 32: Six sigma for medical transcription

Improvement in Turn Around Time (TAT)

Page 33: Six sigma for medical transcription

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

Page 34: Six sigma for medical transcription

TAT performance

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TAT after actions

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Improvement in Accuracy

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Accuracy Improvements

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Client-wise Accuracy

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Accuracy after actions

Sigma Level 4.59

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Control Phase

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Operational Policies-Defined

SOPs for all processes prepared

Apex manual defined

Responsibilities defined

Page 42: Six sigma for medical transcription

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.

Page 43: Six sigma for medical transcription

Score Card

Page 44: Six sigma for medical transcription

Before and After Sigma Levels

TAT

2.40

3.25

Accuracy

4.01

4.59

Page 45: Six sigma for medical transcription

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)

Page 46: Six sigma for medical transcription

Mediscribes, Inc (ISO 9001, 27001) one of the fastest growing transcription & document management solution providers in United States.

Page 47: Six sigma for medical transcription

Thank you.

http://www.mediscribes.com