NUR 630 Topic 4 DQ 2

Sample Answer for NUR 630 Topic 4 DQ 2 Included After Question

You are the nurse leader on an obstetrics unit. You have been tasked to utilize a Six Sigma approach for standardizing the discharge process. Where do you start?

Knowledge Check

Identify one step of the Six Sigma approach that you find critical; why did you choose this step?

A Sample Answer For the Assignment: NUR 630 Topic 4 DQ 2

Title: NUR 630 Topic 4 DQ 2

  I think the most crucial step in the Six Sigma process is defining the correct problem.  I’ve seen leaders within my own organization guess at what the problem may be, and put forth so much effort into addressing that problem, only to have little or no results when comparing data.  While these guesses may have been very educated, they were still guesses, and they got it wrong.  Defining the problem should begin with gathering a team of subject matter experts who analyze current data to discover the root problem so that the actual cause of your issue is addressed (Six Sigma Global Institute, 2018).  For example, I was once on a CLABSI prevention team that was investigating recent increases in CLABSI rates.  Instead of using a root cause analysis approach to uncover the root cause of the increase in rates, they guessed at things like switching CHG bathing to every other day instead of daily, or using alcohol impregnated caps on central line ports instead of “scrubbing the hub” with an alcohol wipe. 

All of those things could have very well been the cause of the increase, but there were so many more possibilities.  The group was convinced that these two issues were the cause, so we reverted back to the practice of daily CHG bathing and using alcohol wipes instead of caps, and our CLABSI rate actually went up, suggesting that those interventions were actually helping to keep the CLABSI rate where it was.  It was only after this discovery that the group decided to dive deeper into all possible causes for the increase in CLABSIs that they discovered many inconsistencies in both the dressing change and blood culture draw processes.  Once these two issues were addressed, we began to see positive results, but at the expense of those who acquired CLABSIs while the team worked to figure it out.  If you don’t identify the correct problem, your efforts will be wasted.


Six Sigma Global Institute. (2018, August). The most important step in DMAIC. Retrieved from Six Sigma Global Institute:

A Sample Answer 2 For the Assignment: NUR 630 Topic 4 DQ 2

Title: NUR 630 Topic 4 DQ 2

Standardizing a discharge process can seem like a daunting task for any nurse leader, but this can be especially true on an obstetrics unit where you have two patients to prepare for discharge instead of just one.  To accomplish this goal, nurse leaders can apply the five step process of DMAIC (define, measure, analyze, improve, and control) to the current problem so that discharges can be completed in a timely and efficient manner, with little to no risk of readmission by either the mother or baby (Bandyopadhyay & Coppens, 2005). 

Before work can begin on the process, a team would need to be assembled with key stakeholders that know and understand the needs of the patient population, as well as those who know and understand the needs of the staff completing the discharge process.  Once your team is assembled, work can begin on defining the process, including needs of the patient(s), staff capabilities, and the goal of the process, which in this case would be a safe discharge where caregivers have the resources they need to safely care for their baby once they leave the hospital.  We’ll then need to determine how progress would be measured and compared to historical data so that we can see if our efforts are working. 

This can be accomplished by gathering subjective data from patient satisfaction surveys with specific questions about the discharge process and the information provided to them, along with more objective data like readmission rates of mothers or newborn babies.  We can then analyze the process, determine if we have accomplished our goal of streamlining and standardizing the process so that everyone receives the same experience and resources they need, and decide whether to implement or make changes to the process to address any opportunities. 

Once implemented there should be constant work to help sustain the process, including regular check-ins with staff to see how the process is going and if both staff and patients are finding that needs are being met and if the process is feasible and easy to follow.  If a new process is too hard to follow or manage, too time-consuming, or doesn’t address the needs of the customer it’s intended to serve, it’s set up for failure almost immediately.  Identifying and addressing these issues early on will ensure sustainment of the new process well into enculturation.


Bandyopadhyay, J., & Coppens, K. (2005, December). SIx Sigma approach to healthcare quality and productivity management. International Journal of Quality & Productivity Management, 5(1). chrome-extension:http://efaidnbmnnnibpcajpcglclefindmkaj/

A Sample Answer 3 For the Assignment: NUR 630 Topic 4 DQ 2

Title: NUR 630 Topic 4 DQ 2

The discharge process in healthcare is a multifaceted system that involves many steps and different healthcare professionals. However, various challenges can arise during this process, such as delays in discharge, patient dissatisfaction, and readmissions. Adhering to effective approaches to address these challenges is crucial to achieving optimal patient outcomes. One such approach is implementing the Six Sigma methodology, which provides a structured framework to identify, measure, analyze, improve, and control various process issues. This approach ensures consistency and minimizes variability in the discharge process, leading to more efficient, safe, and quality healthcare services.

Standardizing the discharge process using the Six Sigma methodology plays a crucial role in promoting an efficient and uniform workflow. In the obstetrics unit, a standardized discharge process can help establish best practices by ensuring a collaborative, consistent application of resources, education, and approach. The Six Sigma methodology, which is typically used in manufacturing, has proven to be a valuable data-driven tool that can be adapted to drive process improvement in the healthcare industry. This approach enables organizations to reduce defects, improve employee morale, raise product/service quality, and increase profits. The DMAIC approach, has five key steps: Define, Measure, Analyze, Improve, and Control (El-Eid et al., 2015). This approach can be effective in identifying issues in the discharge process and finding solutions to those problems.

We start by defining the problem, identifying the issue in the discharge process that’s causing problems. Then, we measure the current process, analyze performance, improve, and control the outcome by identifying the root cause and suggesting solutions. Brainstorming with the team helps us gain different perspectives and find solutions. Our primary goal is to provide our patients with the best quality of care.  By applying the DMAIC approach, we can identify and address any issues in our process, leading to better performance and improved patient satisfaction (Hopen & Rooney, 2018). If the problem persists, we start the process again until we find a solution.

The process involves a team approach to problem solving which promotes, shared learning and ownership of the process. In conclusion, implementing Six Sigma in the discharge process is essential to ensuring that our patients receive the highest quality of care possible. It not only leads to better outcomes for patients but also helps to boost staff morale and efficiency, which ultimately leads to higher profits for our organization. A knowledgeable team built on experience and patient-centered goals in conjunction with the Six Sigma methodology, will continue to lead to success in fostering best practice guidelines for discharging patients.


El-Eid, Ghada R. DHA, MBA; Kaddoum, Roland MD; Tamim, Hani PhD; Hitti, Eveline A. MD, MBA. Improving Hospital Discharge Time: A successful Implementation of Six Sigma Methodology. Medicine 94(12):p e633, March 2015. | DOI: 10.1097/MD.0000000000000633

Hopen, D., & Rooney, J. (2018, November). What is Lean Six Sigma? Excellence Through Quality.