Sigma values of total protein, CK, total cholesterol, GLU and ALB were in the range of 3 to 6. Sigma values of urea and sodium were below 3. Sigma metrics were calculated using total allowable error, precision and percent bias for the above-mentioned parameters. The five-months data of internal quality control were harvested for the parameters: amylase (AMY), lactate dehydrogenase (LD), potassium, total bilirubin (TBIL), triglyceride, aspartate aminotransferase (AST), uric acid, high density lipoprotein-cholesterol (HDL-C), alanine aminotransferase (ALT), urea, sodium, chlorine, magnesium, alkaline phosphatase (ALP), creatinine (CRE), total protein, creatine kinase (CK), total cholesterol, glucose (GLU), albumin (ALB). This study was conducted in the clinical chemistry laboratory of Shandong Provincial Hospital. In this paper, we aim to evaluate the process performance of our laboratory by using Sigma metrics, thereby choosing the correct analytical quality control approach for each parameter. Nowadays, many large companies, such as General Healthcare, Siemens, etc., have applied Six Sigma to clinical medicine and achieved satisfactory results. In recent years, Six Sigma metrics has became the hotspot in all trades and professions, which contributes a general procedure to explain the performance on sigma scale. This article reviews the different Westgard control rules and their implications in pointing towards a particular error, as well as basic principles of Six Sigma methodology & their practical utility in the clinical laboratory. The goal is to attain the highest possible sigma scale within the acceptable limits of total allowable error. Six sigma metrics is used in combination with total allowable error (CLIA '88 proficiency testing criteria), method imprecision and bias. To achieve the similar high quality and near zero defect rates in healthcare system, six sigma metrics is being used in many clinical laboratories and diagnostic industry. It has improved the production efficiency of different industries. Six Sigma methodology is a manufacturing strategy first pioneered by Motorola Company in 1980s, with the goal of decreasing the defect rates in production. Quality control in healthcare system is still less understood because of the relative complexity in choosing an appropriate Westgard rule.
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