# Effectiveness of Six Sigma in Managing Medical Errors in the Electronic Drug Administration Record (EDAR) System

## TL;DR

This study shows that using Six Sigma methods can significantly reduce medication errors in hospital systems, improving patient safety.

## Contribution

The study demonstrates the successful application of Six Sigma to reduce medication errors in an electronic drug administration system.

## Key findings

- Implementing Six Sigma reduced prescribing errors from 2.1% to 1.3%.
- Process performance improved with a Sigma level increase from 3.5 to 3.7.
- Stakeholders reported better communication and satisfaction with the system.

## Abstract

Introduction: Medication errors can occur at any stage of the medication process, including prescribing, preparing, dispensing, or administering the medication by nurses. Any of these medication errors will impact patient safety and healthcare quality.

Aim: This study aimed to evaluate the effectiveness of the Six Sigma methodology in reducing medication errors within the Electronic Drug Administration Record (EDAR) system at the Armed Forces Hospital in Dhahran, Saudi Arabia.

Methods: An assessment and the key elements of the Institute for Safe Medication Practices for medication use system were applied to the medication system to identify our pain points. A multidisciplinary team utilized the Six Sigma methodology following the phases of Define, Measure, Analyze, Improve, and Control framework over a 12-month period. Before intervention, data on prescribing errors were collected from the incident report system and compared retrospectively to all inpatient prescriptions from the EDAR pharmacy system. Prescribing errors analysis revealed a baseline error rate set at 2.1%. Key performance indicators were established to measure the effectiveness of implemented interventions.

Results: Implementing targeted interventions resulted in a significant reduction in inpatient prescribing errors, achieving a new error rate of 1.3% and surpassing the initial target of ≤1.9%. The observed errors decreased from 2.1% to 1.3%, and the Sigma level improvement from 3.5 to 3.7 indicates a substantial enhancement in process performance, suggesting a true impact of the intervention. The defects per million opportunities improved from 20,532 to 13,760, reflecting a shift in the Sigma level from 3.5 to 3.7. Feedback from stakeholders indicated improved communication and user satisfaction with the EDAR system.

Conclusion: The study demonstrates that Six Sigma methodology effectively reduces medication errors and enhances patient safety within healthcare settings. Continued investment in optimizing pharmacy systems and fostering a culture of safety is crucial for sustaining these improvements and advancing the quality of patient care.