Using Lean Six Sigma to Improve Delayed Intracranial Hemorrhage Screening in a Geriatric Trauma Population

Birmingham, Lauren E.; Sedorovich, Ashley; Mann, Nolan; George, Richard L.

doi:10.1097/qmh.0000000000000186

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…Regarding the journals, the articles were published in 26 different journals, all described in Appendix A. Of the 33 analyzed studies, 21 (63.3%) were carried out in the hospital environment, four (12.1%) did not clearly describe the place of study [20][21][22][23] and in two (6.1%) articles, the study was conducted in more than one place [24,25]. The other places where the studies were carried out are presented Figure 4.…”

Section: Resultsmentioning

confidence: 99%

“…Among these interventions, we can highlight reorganization of the physical structure [19,30,39,41,45], review of work processes [38,[46][47][48][49], development and standardization of documents [29,[50][51][52][53] and team training [24,25,41,54,55], among others. A single article that aimed to evaluate the current process of a service did not present any type of intervention [22].…”

Section: Discussionmentioning

confidence: 99%

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Lean Healthcare Tools for Processes Evaluation: An Integrative Review

Barros

Bassi

Caldas

et al. 2021

IJERPH

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Several health services have used lean healthcare to seek continuous improvement of their processes. Therefore, it is important to investigate the evidence available in the literature about the most used lean tools in the health area to review processes and the main results achieved by the researchers. As an integrative literature review methodology was used, it was conducted in five databases, using the descriptor “quality improvement” and the keyword “Lean Healthcare”. A total of 33 complete articles were selected for analysis. The most recurrent tools were: define, measure, analyze, improve and control (DMAIC); value stream map (VSM); suppliers, inputs, process, outputs, customers analysis (SIPOC), Ishikawa Diagram and 5S. Through the analysis of waste, different interventions were implemented and the main results achieved were reduction in times (processing, waiting, cycle and total), costs, workload and increase in the number of calls. The findings enabled the identification of the main lean tools used in the health area to achieve better results. In particular, we highlight recent studies that have explored the lean six sigma healthcare approach. The results, in addition to contributing to the literature, will also assist managers in choosing the best tool to achieve continuous improvement in hospitals and other health services.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lean Healthcare Tools for Processes Evaluation: An Integrative Review

Barros

Bassi

Caldas

et al. 2021

IJERPH

View full text Add to dashboard Cite

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“…Several publications about successful applications of LSS to various aspects in healthcare exist. LSS has been effectively applied to introduce care pathways, 20 32 improve OR efficiency, 16 18 19 33 shorten RTT, 16 streamline discharge procedure, 31 improve patient outcomes 34 and improve financial performance. 16 17 For reducing OR cancellations, we found only one study using Six Sigma.…”

Section: Discussionmentioning

confidence: 99%

Reducing surgical cancellations: a successful application of Lean Six Sigma in healthcare

et al. 2021

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ObjectiveThe COVID-19 pandemic emphasises the need to use healthcare resources efficient and effective to guarantee access to high-quality healthcare in an affordable manner. Surgical cancellations have a negative impact on these. We used the Lean Six Sigma (LSS) methodology to reduce cardiac surgical cancellations in a University Medical Center in the Netherlands, where approximately 20% of cardiac surgeries were being cancelled.MethodA multifunctional project team used the data-driven LSS process improvement methodology and followed the ‘DMAIC’ improvement cycle (Define, Measure, Analyse, Improve, Control). Through all DMAIC phases, real-world data from the hospital information system supported the team during biweekly problem-solving sessions. This quality improvement study used an ‘interrupted time series’ study design. Data were collected between January 2014 and December 2016, covering 20 months prior and 16 months after implementation. Outcomes were number of last-minute coronary artery bypass graft cancellations, number of repeated diagnostics, referral to treatment time and patient satisfaction. Statistical process control charts visualised the change and impact over time. Students two-sample t-test was used to test statistical significance. A p<0.05 was considered as statistically significant.ResultsLast-minute cancellations were reduced by 50% (p=0.010), repeated preoperative diagnostics (X-ray) declined by 67% (p=0.021), referral to treatment time reduced by 35% (p=0.000) and patient Net Promoter Score increased by 14% (p=0.005).ConclusionThis study shows that LSS is an effective quality improvement approach to help healthcare organisations to deliver more safe, timely, effective, efficient, equitable and patient-centred care. Crucial success factors were the use of a structured data-driven problem-solving approach, focus on patient value and process flow, leadership support and engagement of involved healthcare professionals through the entire care pathway. Ongoing monitoring of key performance indicators is helpful in engaging the organisation to maintain continuous process improvement and sustaining long-term impact.

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