title: Reduction of Complications of Local Anaesthesia in Dental Healthcare Setups by Application of the Six Sigma Methodology: A Statistical Quality Improvement Technique.
abstract: BACKGROUND
  Health care faces challenges due to complications, inefficiencies and other concerns that threaten the safety of patients.
  
  
  OBJECTIVE
  The purpose of his study was to identify causes of complications encountered after administration of local anaesthesia for dental and oral surgical procedures and to reduce the incidence of complications by introduction of six sigma methodology.
  
  
  METHODS
  DMAIC (Define, Measure, Analyse, Improve and Control) process of Six Sigma was taken into consideration to reduce the incidence of complications encountered after administration of local anaesthesia injections for dental and oral surgical procedures using failure mode and effect analysis. Pareto analysis was taken into consideration to analyse the most recurring complications. Paired z-sample test using Minitab Statistical Inference and Fisher's exact test was used to statistically analyse the obtained data. The p-value <0.05 was considered as significant value.
  
  
  RESULTS
  Total 54 systemic and 62 local complications occurred during three months of analyse and measure phase. Syncope, failure of anaesthesia, trismus, auto mordeduras and pain at injection site was found to be most recurring complications. Cumulative defective percentage was 7.99 in case of pre-improved data and decreased to 4.58 in the control phase. Estimate for difference was 0.0341228 and 95% lower bound for difference was 0.0193966. p-value was found to be highly significant with p= 0.000.
  
  
  CONCLUSIONS
  The application of six sigma improvement methodology in healthcare tends to deliver consistently better results to the patients as well as hospitals and results in better patient compliance as well as satisfaction.
authors.affiliation: Reader, Department of Oral and Maxillofacial Surgery, Daswani Dental College and Hospital Kota , Rajasthan, India .
authors.forename: Syed
authors.initials: S
authors.lastname: Akifuddin
authors.affiliation: Certified Six Sigma Black Belt, Director, Dentomax Dental and Maxillofacial Solutions , Hyderabad, Telangana, India .
authors.forename: Farheen
authors.initials: F
authors.lastname: Khatoon
keywords: Dentistry; Failure mode and effect analysis; Pareto analysis; Risk priority number
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