Increasing Capacity for Quality Improvement in Underresourced Primary Care Settings

Hudson, Shannon M.; Hiott, Deanna B.; Cole, Jeff; Davis, Robert I.; Egan, Brent M.; Laken, Marilyn

doi:10.1097/qmh.0000000000000031

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…Lean Six Sigma is mainly focused on efficiency outcomes; for instance, it has been utilized to improve operating room efficiency, reduce patient waiting time in an outpatient department, improve primary care practices, and reduce the length of stay associated with liver transplants …”

Section: Introductionmentioning

confidence: 99%

“…Lean Six Sigma is mainly focused on efficiency outcomes; for instance, it has been utilized to improve operating room efficiency, 31 reduce patient waiting time in an outpatient department, 32 improve primary care practices, 33 and reduce the length of stay associated with liver transplants. 34 In addition, it has been applied to reduce turnaround time by improving a hospital medical records department, 35 improve the quality and costs of hip replacement surgery, 36 increase patient satisfaction, 37,38 and reduce hospital registration processing times.…”

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confidence: 99%

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Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy)

Improta¹,

Cesarelli

Montuori³

et al. 2017

Evaluation Clinical Practice

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Rationale, aims, and objectivesLean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare‐associated infections (HAIs), a critical quality parameter in the healthcare sector.MethodsLean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016. Following the LSS define, measure, analyse, improve, and control cycle, the factors influencing the risk of HAI were identified by using typical LSS tools (statistical analyses, brainstorming sessions, and cause‐effect diagrams). Finally, corrective measures to prevent HAIs were implemented and monitored for 1 year after implementation.ResultsLean Six Sigma proved to be a useful tool for identifying variables affecting the risk of HAIs and implementing corrective actions to improve the performance of the care process. A reduction in the number of patients colonized by sentinel bacteria was achieved after the improvement phase.ConclusionsThe implementation of an LSS approach could significantly decrease the percentage of patients with HAIs.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy)

Improta¹,

Cesarelli

Montuori³

et al. 2017

Evaluation Clinical Practice

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show abstract

“…Therefore, the elimination of unnecessary instruments has led to a setup time reduction of 37%. 22 More generally, the use of this methodology in the healthcare arena is focused mainly on efficiency outcomes, 23 eg, the improvement of operating room efficiency, 24 the reduction of patient waiting time in the outpatient department, 25 the improvement of primary care practices, 26 and the reduction of the length of hospital stay. 27 Several applications concerning the combination of both methodologies, i.e.…”

Section: Introductionmentioning

confidence: 99%

The application of Lean Six Sigma methodology to reduce the risk of healthcare–associated infections in surgery departments

Montella

Cicco²,

Ferraro³

et al. 2016

Evaluation Clinical Practice

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“…Literature reviews reveal that smaller clinics require the most motivation and resources to implement new care processes for the purpose of QI. 9 , 10 , 11 Therefore, we will describe IC3’s efforts to improve patients’ diabetes outcomes at these 21 independent clinics.…”

Section: Introductionmentioning

confidence: 99%

The Utah Beacon Experience: Integrating Quality Improvement, Health Information Technology, and Practice Facilitation to Improve Diabetes Outcomes in Small Healthcare Facilities

Tennison¹,

Rajeev²,

Woolsey³

et al. 2014

eGEMs

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Purpose:The Utah Improving Care through Connectivity and Collaboration (IC3) Beacon community (2010–2013) was spearheaded by HealthInsight, a nonprofit, community-based organization. One of the main objectives of IC3 was to improve health care provided to patients with diabetes in three Utah counties, collaborating with 21 independent smaller clinics and two large health care enterprises. This paper will focus on the use of health information technology (HIT) and practice facilitation to develop and implement new care processes to improve clinic workflow and ultimately improve patients’ diabetes outcomes at 21 participating smaller, independent clinics.Innovation:Early in the project, we learned that most of the 21 clinics did not have the resources needed to successfully implement quality improvement (QI) initiatives. IC3 helped clinics effectively use data generated from their electronic health records (EHRs) to design and implement interventions to improve patients’ diabetes outcomes. This close coupling of HIT, expert practice facilitation, and Learning Collaboratives was found to be especially valuable in clinics with limited resources.Findings:Through this process we learned that (1) an extensive readiness assessment improved clinic retention, (2) clinic champions were important for a successful collaboration, and (3) current EHR systems have limited functionality to assist in QI initiatives. In general, smaller, independent clinics lack knowledge and experience with QI and have limited HIT experience to improve patient care using electronic clinical data. Additionally, future projects like IC3 Beacon will be instrumental in changing clinic culture so that QI is integrated into routine workflow.Conclusion and Discussion:Our efforts led to significant changes in how practice staff optimized their EHRs to manage and improve diabetes care, while establishing the framework for sustainability. Some of the IC3 Beacon practices are currently smoothly transitioning to new models of care such as Patient-Centered Medical Homes. Thus, IC3 Beacon has been instrumental in creating a strong community partnership among various organizations to meet the shared vision of better health and lower costs, and the experience over the last few years has helped the community prepare for the changing health care landscape.

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Increasing Capacity for Quality Improvement in Underresourced Primary Care Settings

Cited by 12 publications

References 13 publications

Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy)

Reducing the risk of healthcare‐associated infections through Lean Six Sigma: The case of the medicine areas at the Federico II University Hospital in Naples (Italy)

The application of Lean Six Sigma methodology to reduce the risk of healthcare–associated infections in surgery departments

The Utah Beacon Experience: Integrating Quality Improvement, Health Information Technology, and Practice Facilitation to Improve Diabetes Outcomes in Small Healthcare Facilities

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