Using Lean Six Sigma to improve rates of day of surgery admission in a national thoracic surgery department

Brown, Rachel; Grehan, Petra; Brennan, Marie; Carter, Denise; Brady, Aoife; Moore, Eoin; Teeling, Seán Paul; Ward, Marie; Eaton, Donna

doi:10.1093/intqhc/mzz083

Cited by 37 publications

(50 citation statements)

References 18 publications

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“…Future work can also extend the findings of this research and the implementation framework to other quality initiatives, by using the proposed framework including the use of PII and simulation. This is in line with recently published research in other quality initiatives such as six sigma [ 53 ], balanced scorecard [ 54 , 55 ], and business process management [ 56 , 57 ].…”

Section: Discussionsupporting

confidence: 89%

Healthcare Engineering: A Lean Management Approach

Abdallah

2020

Journal of Healthcare Engineering

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This work tries to answer the following question: can healthcare be engineered using lean management tools? Lean is known to achieve successful results when implemented in the manufacturing sector. Typical results are operational cost reduction, cycle time reduction, and higher customer satisfaction. The service sector, however, has seen mixed results. For the last two decades, educators and healthcare professionals are trying to implement lean tools in healthcare. Some reported success and many did not, for variety of reasons. In this paper, we search the literature and reveal the special nature of healthcare services, success factors, and barriers facing implementation of lean in healthcare. We then conduct a survey of 18 elite Jordanian hospitals to study the case holistically. Statistical analysis of the survey results confirmed some of what the literature revealed; organizational leadership seems to be the most dominant factor, followed by knowledge of employees about lean, training, and patient satisfaction (customer focus). Another important finding, not captured by the literature, is that lean implementation success depends on educating physicians about continuous improvement and lean and ensuring they are part of the improvement team. Based on the revealed enablers and obstacles, we created a full lean implementation framework. This framework was then used along with selected engineering tools to implement lean in a major hospital successfully. Implementation results showed 60% of reduction in cycle time, 80% reduction in operational cost, and many other benefits.

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Section: Discussionsupporting

confidence: 89%

Healthcare Engineering: A Lean Management Approach

Abdallah

2020

Journal of Healthcare Engineering

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“…In addition, the free lung and esophagus are often stabbed or irritated to the lung hilum and bronchi, which reflexively causes respiratory secretions to increase. Moreover, postoperative diaphragm injury and chest and stomach dilatation reduce the effective breathing area, which inevitably leads to a decline in respiratory function and respiratory complications [4]. e literature in [5] believed that cricothyrocentesis can improve the ability of patients to expectoration after thoracotomy.…”

Section: Related Workmentioning

confidence: 99%

Application of Rapid Rehabilitation Nursing in Thoracic Surgery Nursing

Liang

Huang

Tong

et al. 2021

Journal of Healthcare Engineering

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To study the application effect of rapid rehabilitation nursing intervention in thoracic surgery nursing, this paper researches controlled trials. First, this paper sets up a control group and a test group. The control group uses traditional nursing methods for thoracic surgical nursing intervention, and the test group adds rapid rehabilitation nursing intervention based on traditional nursing intervention. In addition, the operation and rehabilitation conditions of the control group and the test group are the same. Moreover, this paper records rehabilitation information in real time, performs data processing through statistical methods, and conducts follow-up surveys on the rehabilitation process of patients. In addition, this paper compares nursing effects through data comparison and histogram comparison. From the research results, various parameters of the patient’s recovery process and the user satisfaction of the rapid rehabilitation can be seen. Furthermore, nursing is higher than those of the control group, which shows that the rapid rehabilitation nursing method can positively affect the nursing of thoracic surgery.

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“…Other more complex models, such as Six Sigma, or combinations of other models with Six Sigma, are highly rigorous, and although application of the methodology is observed in very specific instances, there is no evidence to date that this method is a widely applicable overall method for QI within an organization [ 11 ]. There are also some niche approaches such as the Comprehensive Unit-Based Safety Program (CUSP), but CUSP is typically not applied beyond surgical specialties, and even among those, other methods are employed to address particular quality problems [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Development and evaluation of a quality improvement framework for healthcare

Hamilton

Jennings

Forster

2020

International Journal for Quality in Health Care

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Objective Develop and evaluate a framework for quality improvement which will provide a common approach, terminology, and greater likelihood of success in achieving demonstrable and sustained improvement. Design Descriptive with mixed methods evaluation. Setting Tertiary care academic hospital in Ottawa, Canada. Participants Students enrolled in the Quality and Patient Safety Leadership Executive Program at the local university. Methods The Quality Improvement (QI) framework was developed though comparison and coding of key strengths across four commonly applied quality improvement frameworks. Effectiveness of the framework was evaluated through a satisfaction survey of students who were taught the framework, and independent assessment of student improvement initiatives that followed the QI Framework versus initiatives from a prior year who did not. Main Outcome Measures Acceptability and effectiveness of the QI Framework. Results All participants found the QI Framework to be useful and easy to follow. Independent evaluation of improvement initiatives following the QI Framework, as compared to those that did not, scored higher (95% CI: 3.0 ± 0.49) than the projects completed without the QI Framework (95% CI: 2.2 ± 0.30), P value < 0.01. Scores were higher for cohort 2017/18 in all criteria except scaling & spreading, in which there was no change (2015/16 95% CI: 1.2 ± 0.24, 2017/18 95% CI: 1.2 ± 0.38). Conclusions The method we have developed is acceptable and helpful to users, and overall application resulted in higher quality initiatives. We believe this method, which we have branded as The Ottawa Hospital Innovation Framework, can be beneficial in healthcare settings for a variety of change initiatives.

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Using Lean Six Sigma to improve rates of day of surgery admission in a national thoracic surgery department

Cited by 37 publications

References 18 publications

Healthcare Engineering: A Lean Management Approach

Healthcare Engineering: A Lean Management Approach

Application of Rapid Rehabilitation Nursing in Thoracic Surgery Nursing

Development and evaluation of a quality improvement framework for healthcare

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