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Six Sigma technique: Root Cause Analysis of Death in Leptosp

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zeel kamdar

on 15 August 2014

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Transcript of Six Sigma technique: Root Cause Analysis of Death in Leptosp


Six Sigma technique:


Root Cause Analysis

of Death in Leptospirosis Patients



Kamdar ZN, Chawada BL, Chaudhri VP ,Kantharia SL, Kosambiya JK
Leptospirosis affects youth and productive tribal population with case fatality rate ranges from 10-30 % since 1994 in South Gujarat.
Root Cause Analysis
is a method of problem solving 
that tries to identify the root causes of faults
or problems that cause operating events.
To identify the event flows that lead to death of leptospirosis patient.

To identify the factors leading to mortality in leptospirosis patient by using the six sigma technique (Root Cause analysis).

Aims & Objectives
Mixed-method study ( Quantitative +Qualitative)
Current rainy season has reported confirmed 305 cases & 38 deaths.
Verbal autopsy - by pre designed semi structured questionnaire
Material & Methods:
Results
5
2
2
3
4
5
6
7
8
10
12
14
Interval in Days for Onset of Symptoms & 1st Dose of antibiotic
4
3
5
2
3
2
1
1
2
2
1
3
1
1
Six in-depth interview of spouse or relative
of diseased were conducted .
Written consent of relative was obtained.

The Six Sigma
Qualitative
3
4
5
6
7
8
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10
11
13
14
17
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21
26
15
1
1
1
1
5
2
1
2
2
3
2
3
1
5
1
1
1
1
2
1
1
Distribution of death cases according to time interval between onset of symptoms and time of death

Death of
Leptospirosis
Patient

Logistic
Drugs
Delays
Clinical Features
Occupation
Prophylaxis
Shortage Of Rapid Test Kit
Delays in reaching Health Care facility
“How come we know that he/ she were going to
suffer from leptospirosis and end up with death?
Patients -either farm worker (57.9 %) or farmer (34.2 %).

89.5% have occupational exposure in last 15 days before the onset of symptoms
Habits
Fear Of Health Care Facility
25
13
Cultural Factors

I don’t care whether
he has diseased or not,
better he will die so I feel relieve.”
Violence
Response of
Victimized wife
Alcohol
Conclusion:
Study identified factors-synergistically contributing to death of leptospirosis Patients

Scope of Root cause Analysis Technique
Thank
You

Department Of Community Medicine
Government Medical College, Surat
Reviewing Death Reports
1 Week
Source:Wikipedia
Onset
Days
(n=38)
PHCBuilding
60.52%
31.57%
15.78%
IEC
Iodine Application
100 Meter
Association of alcohol & death Chi square=11.83
p<0.0002
chi square=7.761 p=0.0026
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