Six Sigma to Improve Rural Kids' Flu Shot Clinic in Hawaii

My proposed project would be to utilize six sigma principals to improve the Flu Shot Clinic for Rural School Age Children here in Hawaii. This is a six sigma project because it involves a problem, an opportunity in the community, a process that we use to make the clinic work, and measures of vaccination procedures and data collection. We would implement the ability to analyze what happens in the clinics, and after the clinics are complete create improvements to the process.

We use the DMAIC process to achieve the goals in this project. The first step is to define and identify the problem in the community, statistically, for the 2015 school year at one rural school on Oahu, only 10% of students received a flu shot in school (stats from the 2015 clinic). In Hawaii, 47% of 0-24-year-old children who were tested, tested positive for influenza based on 2015-2016 influenza data collected (Resource). The problem in this case is that the children in the rural communities are under-vaccinated and not protected from influenza.

The opportunity is to improve school based mass vaccination clinic rates ultimately with the goal of decreasing rates of influenza within the community. The process in which we do that includes more social advertisement to the parents, students, and school staff about vaccines and the importance of having them to prevent influenza from spreading in the community. Additionally, for this project, education and feedback from stakeholders, community leaders, churches, doctors, and health centers would be valuable in shaping the clinics. Logistical requirements which include ordering vaccines, hiring staff nurses nurse aides, training staff, securing a work site at the school, and partnering with the school and community would be key Clinic set up and implementation would be a large step that would include how to get students to the site, managing life flow, managing the vaccination area, and post-vaccination areal.

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Finally a reassessment of clinic problems would be conducted with the brainstorming of how to improve the process for next year. The customer requirements are included to ensure that the children get vaccinated safely and efficiently which in this case includes that the students get the appropriate documentation to let their parents know that the students received their flu shot in school. The measures in this project account for the total number of children that received the vaccination, time per child, and time per clinic. Also, adverse reactions to the vaccine should be tracked which may include but not limited to anaphylactic shock, respiratory distress, nausea, vomiting, and fainting, medication errors incident reports should also be tracked for quality purposes.

Examples of medication errors and potential incident reports are having the wrong child vaccinated, having the wrong type of vaccination given to a child, the child pulls away during the administration of the vaccine, or there was a defect with the syringe. In an effort to analyze and improve we would analyze what went wrong in the project. So in this example, where the child got the wrong shot, we will make sure that the child wears the right name tag and staff is screening the child by making sure that their name, bitthdate, and ID card matches their form at every level of contact.

To improve on the adverse reactions, we need to make sure that the staff are screening each child for allergies to eggs. Staff may also look at the forms and prescreen before the clinic, to improve success, we may want to have a teacher at the clinic so that they can correctly identify the child‘s name and ID information. We may implement stricter rules where students cannot get their vaccine without proper identification and proper documentation from the parents. In conclusion, this project uses the six sigma system to achieve its goals of vaccinating more children for influenza by obtaining critical information throughout the project. Through the process of quality assurance, the clinics can be assessed with specific measures, problems can be identified, and improvements can be made for the entire process.

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Six Sigma to Improve Rural Kids' Flu Shot Clinic in Hawaii. (2023, Feb 17). Retrieved from

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