Postoperative pain management quality improvement project using Six-Sigma methodology in Alexandria University Students Hospital, Egypt

Purpose This study aims to assess the effect of the implementation of the Six Sigma approach to improve the quality of post-operative pain management in patients attending Alexandria University Student Hospital. Design/methodology/approach A pre-post interventional study involving patients over the age of 16 years old who were proposed and planned for any surgical operation at Alexandria University Student Hospital. We used Six Sigma’s define, measure, analyze, improve and control (DMAIC) improvement process. Data were gathered from samples evaluated six months before the Six Sigma project’s implementation and seven months after the project’s implementation. The areas selected for improvement were using postoperative pain assessment and reducing postoperative pain management POPM defects. Findings There was a significant decrease in the overall mean (SD) of the worst pain score between the pre-intervention 7.5 (±2.4) and post-intervention 2.7 (±1.9) phases (p < 0.001). A significant decrease (p < 0.001) in the DPMO between pre-and post-intervention phases (580773.4, 78678.2 respectively). That decrease was followed by an improvement in the sigma level of the POPM process (from 1.375 to 3 sigma level). Practical implications This research underscores the efficacy of ongoing quality improvement initiatives, particularly through the Six Sigma DMAIC methodology, in enhancing surgical care by optimizing postoperative pain management. Implementing Six Sigma can significantly increase patient satisfaction by reducing discomfort and improve recovery outcomes by minimizing complications like blood clots, infections and chronic pain. Additionally, it promotes optimal resource utilization and cost efficiency in health-care systems by streamlining pain management procedures. Overall, the study confirms that Six Sigma effectively improves postoperative outcomes and reduces process defects in pain management. However, the research contains a few pitfalls which may be the exclusion of cancer patients, children under 16 years old and intensive care patients. These excluded groups might have different pain management needs and responses and different pain assessment tools, so the results may not apply to these populations. Besides, the research considered mainly general surgery and orthopedic operations for improvement. As they were the most prevalent types of surgeries in the research setting. Originality/value Health-care organizations can improve postoperative pain treatment by implementing the Six Sigma strategy, which incorporates technical integration, patient-centric measurements, customized programs and ongoing improvement. To the best of our knowledge, this is the first study in Egypt and worldwide to investigate the implementation of the Six Sigma strategy in post-operative pain management.