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Indian Journal of Emergency Medicine 12(1):p 07-18, Jan. March 2026. | DOI: https://doi.org/10.21088/ijem.2395.311X.12126.1
Original Article
Reducing Length of Stay in Emergency Department through Implementation of Six Sigma DMAIC in a Tertiary Care Hospital
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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Emergency Medicine 12(1):p 07-18, Jan. March 2026. | DOI: https://doi.org/10.21088/ijem.2395.311X.12126.1
How Cite This Article:
Ray A, Das P. Reducing Length of Stay in Emergency Department through Implementation of Six Sigma DMAIC in a Tertiary Care Hospital. Indian J Emerg Med. 2026;12(1):7-18.Timeline
Received : July 29, 2025
Accepted : September 05, 2025
Published : March 30, 2026
Abstract
Emergency Departments (EDs) are critical to delivering timely care, yet they often face operational inefficiencies that result in extended patient Length of Stay (LOS). This dissertation explores the application of Six Sigma’s DMAIC (Define, Measure, Analyze, Improve, Control) methodology to reduce LOS in the Emergency Department of The Mission Hospital, Durgapur. The study identifies key contributors to prolonged LOS, including exit block due to bed unavailability, delays in diagnostics and ancillary services, communication gaps, and infrastructural limitations. A mixed-method research design was adopted, analyzing data from 7,380 patients over a six-month period. Root cause analysis tools such as Fishbone diagrams and Pareto charts were used to identify process inefficiencies. Targeted interventions including triage optimization, diagnostic prioritization, and workflow redesign were implemented durng the Improve phase. These efforts led to a statistically significant reduction in average LOS from 321 minutes in January 2025 to 164 minutes by March 2025, marking a 49% improvement. The study demonstrates that structured, data-driven interventions using the DMAIC framework can lead to measurable and sustainable improvements in ED efficiency. The findings provide actionable insights for healthcare administrators seeking to enhance patient flow, reduce wait times, and improve overall service delivery in emergency care settings.
References
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- 4. Graves, J. (2012). Lean Six Sigma applied to a hospital emergency department. Quality Engineering, 24(1), 1–13.
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Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
No conflicts of interest in this work.
About this article
Cite this article
Ray A, Das P. Reducing Length of Stay in Emergency Department through Implementation of Six Sigma DMAIC in a Tertiary Care Hospital. Indian J Emerg Med. 2026;12(1):7-18.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| July 29, 2025 | September 05, 2025 | March 30, 2026 |
DOI: https://doi.org/10.21088/ijem.2395.311X.12126.1
Keywords
Emergency Length of Stay and DmaicSearch for Similar Articles
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Timeline
| Received | July 29, 2025 |
| Accepted | September 05, 2025 |
| Published | March 30, 2026 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
