Define

The first step is to define the problem. In this case, the problem is perioperative hemorrhage or hematoma, which is defined as bleeding that occurs during or after surgery. This can be a serious complication that can lead to death.

Measure

The next step is to measure the current state of the process. This can be done by collecting data on the number of patients who experience perioperative hemorrhage or hematoma. This data can be collected from the hospital’s electronic health record (EHR).

Analyze

The third step is to analyze the data to identify the root causes of the problem. This can be done by using a variety of tools, such as root cause analysis (RCA) and fishbone diagrams.

Improve

Once the root causes of the problem have been identified, the next step is to develop and implement improvement solutions. These solutions should be designed to address the root causes of the problem.

Control

The final step is to implement control measures to ensure that the improvements are sustained. This can be done by monitoring the process and taking corrective action as needed.

Here are some specific improvement solutions that could be implemented to reduce the incidence of perioperative hemorrhage or hematoma:

• Standardize the way that blood transfusions are ordered and administered.
• Use checklists to ensure that all of the necessary steps are taken to prevent bleeding.
• Educate healthcare providers about the risks of perioperative hemorrhage or hematoma.
• Implement a blood conservation program.
• Use tranexamic acid, a drug that can help to prevent bleeding.

By implementing these improvement solutions, hospitals can reduce the incidence of perioperative hemorrhage or hematoma and improve patient safety.

Here is a more detailed outline of the DMAIC process for PSI 09:

Define

• Define the problem: Perioperative hemorrhage or hematoma is a serious complication that can lead to death.
• Define the customer: The customer is the patient who is at risk of experiencing perioperative hemorrhage or hematoma.
• Define the requirements: The requirements are to reduce the incidence of perioperative hemorrhage or hematoma and improve patient safety.

Measure

• Collect data on the number of patients who experience perioperative hemorrhage or hematoma.
• Calculate the incidence rate of perioperative hemorrhage or hematoma.
• Compare the incidence rate to national benchmarks.

Analyze

• Identify the root causes of perioperative hemorrhage or hematoma.
• Use RCA and fishbone diagrams to identify the root causes.

Improve

• Develop and implement improvement solutions to address the root causes.
• Monitor the process to ensure that the improvements are sustained.

Control

• Implement control measures to prevent the recurrence of perioperative hemorrhage or hematoma.
• Monitor the process to ensure that the control measures are effective.