Reducing waiting time at an emergency department using design for Six Sigma and discrete event simulation

Design for Six Sigma (DFSS) has been implemented in different industries as a methodology to design or redesign processes. In this paper, DFSS is used to develop a triage process for an emergency department (ED) at a Jordanian hospital. Different performance measures, such as length of stay (LOS) and waiting time (WT), are employed to evaluate the hospital's ED performance before and after the triage process. Discrete event simulation (DES) models were developed using ProModel software. The models have been verified and validated. The results indicate that LOS will be reduced by 34% and WT by 61% after the triage system is implemented, without any additional staff. Moreover, as a result of the triage process, the WT sigma level is improved from 0.66 to 5.18, and the LOS sigma level is improved from 0.58 to 3.09.