RESEARCH ARTICLE Open AccessA contrast between DEMATEL-ANP and ANPmethods for six sigma project selection: a casestudy in healthcare industryMiguel A Ortíz 1* , Heriberto A Felizzola 2† , Santiago Nieto Isaza 3†AbstractBackground: The project selection process is a crucial step for healthcare organizations at the moment ofimplementing six sigma programs in both administrative and caring processes. However, six-sigma projectselection is often defined as a decision making process with interaction and feedback between criteria; so that it isnecessary to explore different methods to help healthcare companies to determine the Six-sigma projects thatprovide the maximum benefits. This paper describes the application of both ANP (Analytic Network process) andDEMATEL (Decision Making trial and evaluation laboratory)-ANP in a public medical centre to establish the mostsuitable six sigma project and finally, these methods were compared to evaluate their performance in the decisionmaking process.Methods: ANP and DEMATEL-ANP were used to evaluate 6 six sigma project alternatives under an evaluationmodel composed by 3 strategies, 4 criteria and 15 sub-criteria. Judgement matrixes were completed by the sixsigma team whose participants worked in different departments of the medical centre.Results: The improving of care opportunity in obstetric outpatients was elected as the most suitable six sigmaproject with a score of 0,117 as contribution to the organization goals. DEMATEL-ANP performed better at decisionmaking process since it reduced the error probability due to interactions and feedback.Conclusions: ANP and DEMATEL-ANP effectively supported six sigma project selection processes, helping to createa complete framework that guarantees the prioritization of projects that provide maximum benefits to healthcareorganizations. As DEMATEL- ANP performed better, it should be used by practitioners involved in decisions relatedto the implementation of six sigma programs in healthcare sector accompanied by the adequate identification ofthe evaluation criteria that support the decision making model. Thus, this comparative study contributes tochoosing more effective approaches in this field. Suggestions of further work are also proposed so that thesemethods can be applied more adequate in six sigma project selection processes in healthcare.BackgroundThe application of six sigma methodology in the optimi-zation of healthcare processes is a relevant aspect formedical industry since health caring has become in acomplex problem where several factors converge such as:high operating costs in medical centres, high costs inmedical treatments and drugs, high labour costs, increaseof medical services demand, the establishment of healthas a fundamental right; among others [1-3]. Upon givingsolutions to each of these problems through Six Sigmaapproach; it is required to make effective decisions thatmake possible to focus the human and financial resourcesappropriately on projects whose contribution lead to theimprovement of organizations performance [4-6].One of the key factors of Six Sigma methodology is thecorrect selection of projects [7-10]. This process consistsabout identifying, prioritizing and selecting the project(s)that provide(s) the highest impact on organization goals[11], and is done through the evaluation of a set of cri-teria such as: Impact on product or service quality,impact on customer satisfaction, impact on revenue* Correspondence: mortiz1@cuc.edu.co† Contributed equally1 Department of Industrial Engineering, Universidad de la Costa CUC,Barranquilla, ColombiaFull list of author information is available at the end of the articleOrtíz et al. BMC Medical Informatics and Decision Making 2015, 15(Suppl 3):S3http://www.biomedcentral.com/1472-6947/15/S3/S3© 2015 Ortíz et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided theoriginal work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
