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2007, vol. 26, br. 3, str. 196-200
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Primena 'six sigma' u kontroli kvaliteta zdravstvenih laboratorija
Application of six sigma in control of health laboratories
Univerzitet u Beogradu, Medicinski fakultet, Institut za biohemiju, Srbija
e-adresa: itana@sbb.co.yu
Sažetak
Cilj svakog postupka ili proizvodnog sistema je dobijanje dobrog proizvoda Većina metoda kontrole kvaliteta je inicijalno razvijena da pomogne industrijsku proizvodnju. Ovo ne predstavlja iznenađenje s obzirom da masovna proizvodnja tipično zahteva mnogo ponavljanja koje uključuju kontrolisani redosled operacija. Nisu svi prilazi kontroli kvaliteta podjednako efikasni. Neusaglašenosti koje postoje u laboratorijskom određivanju su u osnovi uzrokovane kako prekomernim varijacijama u procesu, tako i greškama. Ključni nedostatak u primeni metoda statističke kontrole kvaliteta leži u činjenici da su neefikasne u detekciji i kontroli grešaka, a one danas predstavljaju najdominatniji uzrok neusaglašenosti većine organizacionih procesa. Statističkom kontrolom kvaliteta mogu efikasno da se kontrolišu varijacije u procesu, ali ne mogu da se detektuju ili spreče greške. "Six Sigma" pripada statističkoj kontroli kvaliteta koja pruža novu metodologiju za merenje karakteristika procesa, a takođe usavršava prethodne metodologije čime dolazi do unapređenja procesa. Menadžment zasnovan na "Six Sigma " kvalitetu polako ulazi u zdravstvene organizacije pri čemu nudi realnu nadu za unapređenje razmišljanja i procesa menadžmenta kvaliteta. Jedan od razloga je što se "Six Sigma" fokusira na defekte koji za uzvrat zahtevaju da ciljevi za dobar kvalitet budu definisani. "Six Sigma" pruža univerzalnu metodologiju kojom se meri kvalitet time što se broje defektni proizvodi, pri čemu se određuje stopa defektnih proizvoda kao "defekti na milion" ("defects per million" ili "DPM"), a koji se zatim konvertuju u "Sigma metriku" uz korišćenje standradnih tabela koje su dostupne u svakom tekstu vezanom za "Six Sigma". "Sigma metrikom" se "Six Sigma" pojednostavljuje i dobija univerzalni "reper" koji govori o karakteristikama procesa. Na ovaj način svi procesi mogu da se okarakterišu na "Sigma skali." Tipično se vrednosti nalaze između 2 i 6, pri čemu je cilj postizanje "svetske klase kvaliteta" koja iznosi 6. Na osnovu podataka koji potiču iz stvarnog sveta zdravstvenih laboratorija očigledno se može zaključiti da je izvođenje operacija na današnjim instrumentima dobro. Nova generacija kliničkih analizatora je postigla jako visoku "Sigma metriku". Korisnici zdravstvene zaštite mogu da uživaju u novoj eri napretka sa instrumentima i metodama nivoa 6 Sigma ili višim.
Abstract
The goal of every operation or production system is to generate a useful product. Most quality-control methods were initially developed to aid manufacturing. This is not surprising because high volume production typically requires many repetitions involving a controlled sequence of operations. Not all of the many approaches to quality control are equally effective. Nonconformities in laboratory testing are caused basically by excessive process variation and mistakes. A critical limitation of the statistical quality control - based methods is that they are ineffective in detecting and controlling mistakes, the dominant source of nonconformities in most organizations today. Statistical quality control can effectively control process variation, but it cannot detect or prevent most mistakes. Six Sigma belongs to statistical quality control and provides a new methodology for measuring process performance and refines earlier methodologies for making process improvements. Six Sigma Quality Management is slowly making inroads in healthcare organizations and offers a real hope for improving quality management thinking and processes. The reason is that Six Sigma focuses on defects, which in turn requires that goals for good quality be defined. Six Sigma provides a universal methodology for measuring quality by counting the defects, determining the defect rate as "defects per million" or "DPM", and then converting DPM to a sigma-metric (by use of standard tables available in any Six Sigma text). To reduce (and oversimplify) Six Sigma, there now are "Sigma metrics" that provide a universal benchmark for process performance. The performance of all processes can be characterized on the "Sigma scale." Values typically range from 2 to 6, where the goal for "world class quality" is 6. Based on the data from real-world health laboratory is an obvious statement that current instrumentation performs well. The new generation of clinical analyzers have achieved some high Sigma metrics. Customers in healthcare are going to enjoy a new era empowerment with instruments and methods that perform at 6 Sigma or higher.
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