Reducing Data Entry Errors and Costs in a Clinical Laboratory in Uganda: Utilizing Six Sigma Quality Improvement Tools

Abstract

The Makerere University-Johns Hopkins University Core Laboratory at the Infectious Disease Institute, Kampala, Uganda, provides clinical laboratory support to more than 70 research protocols, clinics, and hospitals in Kampala and surrounding rural areas. With increased numbers of clients and testing volume, the manual requisition data entry errors, at the preanalytic phase, have steadily increased, prompting laboratory management to use Six Sigma methodology to evaluate and reduce data entry errors. The Six Sigma Quality Improvement (QI) project followed a sequence of steps, starting with defining the project goals and laboratory customer requirements. Then, the project team measured data entry error indicators to assess current performance, analyzed the data, and determined the root causes of data entry errors. Finally, the team implemented changes to address the performance defects' root causes. In a 12-month period after initiating the Six Sigma project, there was a 59% reduction in data entry errors from 423 errors per month (ie, 4.34 Six Sigma) in the first month of the QI project, down to 174 errors per month (ie, 4.57 Six Sigma) in the last month of the project. In a period of 12 months, the project has achieved a reduction of an average 166 errors per month. The team estimated the average cost of identifying and fixing a data entry error is about $16.25 per error. Thus, reducing the number of errors by an average of 257 per month for a year period saved the laboratory an estimated $50,115 per year. The Six-Sigma QI project provides a replicable framework for laboratories in Uganda and other resource-limited settings to promote a quality conducive environment for laboratory staff to take action in delivering care excellence at a lower cost, by applying QI principles in clinical laboratory settings.