Use of Six Sigma for Eliminating Missed Opportunities for Prevention Services

Husaini, Baqar A.; Hull, Pamela C.; Emerson, Janice S.; Tropez-Sims, Suzanne; Reece, Michelle; Zoorob, Roger; Levine, Robert S.

doi:10.1097/ncq.0000000000000113

Cited by 7 publications

(10 citation statements)

References 29 publications

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Section: Resultsmentioning

confidence: 99%

“…Of the 10 studies identified within the process dimension, six (Baillie et al, 2015;Gittner et al, 2015;Goldstein et al, 1982;Graudins et al, 2015;Lytle et al, 2015;Terrell et al, 2005) dealt mainly with multifaceted interventions aimed at optimizing, standardizing or otherwise changing care processes to reduce missed medication doses (Table 4). Goldstein et al (1982) to 0.011 (p < .005) doses omitted per patient day (postintervention) (Goldstein et al, 1982).…”

Section: Changing the Processes Of Carementioning

confidence: 99%

“…In the control group, no significant change was observed (Baillie et al, 2015). Gittner et al (2015) evaluated the effect of preventive care service interventions, which included a dedicated nurse and a protocol for the delivery of preventive care services to patients using US outpatient clinics. After the intervention's implementation, all patients in the intervention group received preventive education/counselling, immunizations and preventive screenings.…”

Section: Changing the Processes Of Carementioning

confidence: 99%

“…In the routine care group, as many as 87% of patients did not receive one or more preventive services (service offered: education (missed: 5.1%), immunization (missed: 31%), screening (missed: 52%). Differences were both clinically relevant and statistically significant (p < .001) (Gittner et al, 2015). Lytle et al (2015) investigated the effect of a clinical decision support tool for fall risk identification and fall prevention via patient fall risk assessment documentation in a US university hospital.…”

Section: Changing the Processes Of Carementioning

confidence: 99%

“…These included the use of 1) electronic devices, for example nursing care reminders (Piscotty & Kalisch, 2014;Piscotty et al, 2015), 2) musical reminders and 3) verbal reminders delivered by authorized RNs (Harmon et al, 2016;Yap et al, 2013). The second group included interventions aimed at reducing the number of missed medication doses (Goldstein et al, 1982), while increasing venous thromboembolism prophylaxis (Baillie et al, 2015), preventive care services (Gittner et al, 2015), fall risk identification, assessment and prevention (Lytle et al, 2015) and documentation of essential data (Terrell et al, 2005). As regards structural interventions, some of these interventions might not be feasible or acceptable in every country or setting.…”

Section: Process Interventionsmentioning

confidence: 99%

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Interventions to prevent or reduce rationing or missed nursing care: A scoping review

Schubert

Ausserhofer

Bragadóttir

et al. 2020

Journal of Advanced Nursing

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Aims: To collate and synthesize published research on interventions developed and tested to prevent or reduce the rates of rationed or missed nursing care in healthcare institutions. Background: Rationed and missed nursing care has been widely studied, including its predictors and associations with patient and nurse outcomes. Design: Scoping review. Data sources: We searched for eligible studies, published between 1980-2019, in six electronic databases. Review methods: Researchers independently screened the abstracts of the retrieved studies using the inclusion and exclusion criteria. The decision of whether or not to include any given study was consensus-based. Results: The search yielded 1,815 records, of which 13 were included. Three studies reported structural interventions, namely increased nurse staffing and improved nursing teamwork, both resulted in significant reductions in the rates of rationed or missed nursing care. The remaining 10 studies reported on process interventions: four concerned reminders (via technology or designated persons) and seven described interventions to change or optimize the relevant care processes. All 10 process interventions contributed to significant reductions in the rates of missed nursing care. Conclusions: The results of the scoping review indicate that specific interventions can positively influence the performance of a selected nursing care activity, for example fall prevention. There is no evidence of a global reduction of rationed and missed nursing care through these interventions. Impact: Clinicians, managers and researchers can use the results for adapting and implementing interventions to reduce rationed and missed nursing care. K E Y W O R D S decision-making, interventions, nurse staffing, nursing care, prevention, quality of care, rationed and missed nursing care, scoping review, teamwork | 551 SCHUBERT ET al.

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Section: Resultsmentioning

confidence: 99%