A Lean Six Sigma Quality Improvement Project to Increase Discharge Paperwork Completeness for Admission to a Comprehensive Integrated Inpatient Rehabilitation Program

Abstract

Lean Six Sigma (LSS) process analysis can be used to increase completeness of discharge summary reports used as a critical communication tool when a patient transitions between levels of care. The authors used the LSS methodology as an intervention to improve systems process. Over the course of the project, 8 required elements were analyzed in the discharge paperwork. The authors analyzed the discharge paperwork of patients (42 patients preintervention and 143 patients postintervention) of a comprehensive integrated inpatient rehabilitation program (CIIRP). Prior to this LSS project, 61.8% of required discharge elements were present. The intervention improved the completeness to 94.2% of the required elements. The percentage of charts that were 100% complete increased from 11.9% to 67.8%. LSS is a well-established process improvement methodology that can be used to make significant improvements in complex health care workflow issues. Specifically, the completeness of discharge documentation required for transition of care to CIIRP can be improved.

Application of Lean Manufacturing in Hospitals—the Need to Consider Maturity, Complexity, and the Value Concept

“…Many papers paint a rather positive picture of the application of lean in hospitals (see, for example, Ballé & Régnier, 2007;Ben-Tovim et al, 2007;Graban, 2008;Neufeld et al, 2013). A number of books add to this picture.…”

Decreasing the dispatch time of medical reports sent from hospital to primary care with Lean Six Sigma

“…Currently, various hospitals have incorporated Six Sigma, Lean Management or Lean Six Sigma in their organization and have published several cases describing improvement projects [13,14,18,26,28,[31][32][33]. Like the current study, these studies mostly implement LSS for singular improvement projects [12,14,17,[26][27][28][29].…”

“…The project was set up according to the Lean Six Sigma (LSS) methodology. Lean Six Sigma, a combination of Lean Manufacturing and Six Sigma, is a trend in the quality improvement of the organization of health care [11][12][13][14][15][16][17][18][19][20][21]. Lean Manufacturing provides standard analysis tools and techniques with the intention of mapping out and removing inefficiencies, while Six Sigma offers a structured roadmap to reduce variation in organizational processes by analysing performance metrics and uncovering root causes [22].…”

Evaluating Lean Thinking and Facility Design in Two University Hospitals

“…This could make work physically and mentally straining, and work ergonomics repetitive and deteriorating. To quell these doubts, a vast collection of positive results attained by Lean implementation projects -improved work processes, staff and customer satisfaction, decreased inventory and treatment costs and improved productivity in HC organizations -has strengthened the notion of Lean [13][14][15][16]. Information on the basics of Lean can be found in, for example, Liker and Meier [17].…”