title: Improving inferior vena cava filter retrieval rates with the define, measure, analyze, improve, control methodology.
abstract: OBJECTIVE
  To design a sustainable process to improve optional inferior vena cava (IVC) filter retrieval rates based on the Define, Measure, Analyze, Improve, Control (DMAIC) methodology of the Six Sigma process improvement paradigm.
  
  
  METHODS
  DMAIC, an acronym for Define, Measure, Analyze, Improve, and Control, was employed to design and implement a quality improvement project to increase IVC filter retrieval rates at a tertiary academic hospital. Retrievable IVC filters were placed in 139 patients over a 2-year period. The baseline IVC filter retrieval rate (n = 51) was reviewed through a retrospective analysis, and two strategies were devised to improve the filter retrieval rate: (a) mailing of letters to clinicians and patients for patients who had filters placed within 8 months of implementation of the project (n = 43) and (b) a prospective automated scheduling of a clinic visit at 4 weeks after filter placement for all new patients (n = 45). The effectiveness of these strategies was assessed by measuring the filter retrieval rates and estimated increase in revenue to interventional radiology.
  
  
  RESULTS
  IVC filter retrieval rates increased from a baseline of 8% to 40% with the mailing of letters and to 52% with the automated scheduling of a clinic visit 4 weeks after IVC filter placement. The estimated revenue per 100 IVC filters placed increased from $2,249 to $10,518 with the mailing of letters and to $17,022 with the automated scheduling of a clinic visit.
  
  
  CONCLUSIONS
  Using the DMAIC methodology, a simple and sustainable quality improvement intervention was devised that markedly improved IVC filter retrieval rates in eligible patients.
authors: Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390.. Electronic address: Patrick.Sutphin@utsouthwestern.edu.
authors: Patrick D
authors: PD
authors: Sutphin
authors: Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors: Stephen P
authors: SP
authors: Reis
authors: Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors: Angie
authors: A
authors: McKune
authors: Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors: Maria
authors: M
authors: Ravanzo
authors: Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors: Sanjeeva P
authors: SP
authors: Kalva
authors: Division of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390.
authors: Anil K
authors: AK
authors: Pillai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways / Q000592:standards; D020878:Device Removal / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017064:Process Assessment, Health Care / Q000592:standards; D011655:Pulmonary Embolism / Q000517:prevention & control*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D058996:Quality Improvement / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D016306:Vena Cava Filters / Q000592:standards*; D055815:Young Adult