Quality Improvement, Performance Management, and Outcomes: Lean Six Sigma for Integrated Behavioral Health

2018 ◽  
pp. 79-101
Author(s):  
Ronald O’Donnell ◽  
Rodger Kessler
Keyword(s):  
Quality Improvement ◽  
Performance Management ◽  
Behavioral Health ◽  
Six Sigma ◽  
Lean Six Sigma ◽  
Integrated Behavioral Health

scholarly journals Application of Lean Six Sigma to Improve Service in Healthcare Facilities Management: A Case Study

2017 ◽  
Vol 1 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Will T. Shirey ◽  
Kenneth Timothy Sullivan ◽  
Brian Lines ◽  
Jake Smithwick
Keyword(s):  
Quality Improvement ◽  
Six Sigma ◽  
Healthcare Organization ◽  
Research Literature ◽  
Lean Six Sigma ◽  
Facilities Management ◽  
Post Intervention ◽  
Healthcare Facilities ◽  
Computerized Maintenance Management System

ABSTRACT The purpose of this paper is to present a case study on the application of the Lean Six Sigma (LSS) quality improvement methodology to facilities management (FM) services at a healthcare organization. Research literature was reviewed concerning whether or not LSS has been applied in healthcare-based FM, but no such studies have been published. This paper aims to address the lack of an applicable methodology for LSS intervention within the context of healthcare-based FM. The Define, Measure, Analyze, Improve, and Control (DMAIC) framework was followed to test the hypothesis that LSS can improve the service provided by an FM department responsible for the maintenance and repair of furniture and finishes at a large healthcare organization in the southwest United States of America. Quality improvement curricula and resources offered by the case study organization equipped the FM department to apply LSS over the course of a five-month period. Qualitative data were gathered from pre- and post-intervention surveys while quantitative data were gathered with the Organization's computerized maintenance management system (CMMS) software. Overall, LSS application proved to be useful for the intended purpose. The authors proposes that application of LSS by other FM departments to improve their services could also be successful, which is noteworthy and deserving of continued research.

Addressing Behavioral Health Concerns in Trauma: Using Lean Six Sigma to Implement a Depression Screening Protocol in a Level I Trauma Center

2020 ◽  
Vol 29 (4) ◽  
pp. 218-225
Author(s):  
Mary E. Moran ◽  
Ashley Sedorovich ◽  
Jamie Kish ◽  
Andrew Gothard ◽  
Richard L. George
Keyword(s):  
Behavioral Health ◽  
Six Sigma ◽  
Trauma Center ◽  
Lean Six Sigma ◽  
Depression Screening ◽  
Health Concerns ◽  
Screening Protocol ◽  
Level I

Poster 411 Pre- and Postanalysis of a Lean Six Sigma Quality Improvement Project to Increase Discharge Paperwork Completeness to a Comprehensive Integrated Inpatient Rehabilitation Program

PM&R ◽  
2011 ◽  
Vol 3 ◽  
pp. S317-S317
Author(s):  
Nathan J. Neufeld ◽  
Phillippines Cabahug ◽  
Marlís González Fernández ◽  
R. Samuel Mayer ◽  
Megha Mehta ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Six Sigma ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Program ◽  
Lean Six Sigma ◽  
Quality Improvement Project ◽  
Improvement Project

scholarly journals MON-LB301 Application of Lean Six-Sigma DMAIC Tool for Improvement and Sustainability of Diabetes Management in Outpatient Clinics

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Mario C Rivera Bernuy ◽  
Kollipara Usha ◽  
Jessica Burks ◽  
Jason Fish ◽  
Sadia Ali
Keyword(s):  
Diabetes Mellitus ◽  
Quality Improvement ◽  
Six Sigma ◽  
Diabetes Management ◽  
Waiting Times ◽  
Lean Six Sigma ◽  
Control Phase ◽  
Modifiable Factors ◽  
Patients With Diabetes ◽  
The Mean

Abstract DMAIC: Define, Measure, Analyze, Improve, Control. LSL: Lower specified limit. USL: Upper specified limit. Lean Six Sigma DMAIC is quality improvement methodology used for strategic business management. Frequent applications of this methodology in healthcare include improvement of patient satisfaction, reduction of emergency department waiting times, prescription error reduction and monetary recovery by reducing waste. Patients with a HgbA1c testing frequency of >6 months have poorer glycemic control. The American Diabetes Association recommends HgbA1c test quarterly in patients whose therapy has changed or who are not meeting glycemic goals and at least two times a year in patients who are meeting treatment goals. We hypothesized that the Lean Six-Sigma DMAIC tools can be used in the outpatient clinic setting to improve frequency of HgbA1c testing in patients with diabetes mellitus. At baseline, 19% of our patients with diabetes mellitus had HgbA1c tested infrequently, defined as more than 6 months. This high percentage is a concern as it could lead to poor diabetes control. The aim was to increase percentage of patients having an HgbA1c tested between 3 to 6 months before an appointment in our clinic, to a goal of 90%. Target population included all patients with diabetes mellitus seen in outpatient endocrinology clinic. A baseline analysis of existing processes was done through brainstorming with the clinic staff using a fish bone diagram. Lack of follow up and HgbA1c testing orders were some of the modifiable factors identified. The new processes implemented include nurse driven standing medical orders for HgbA1c testing and pre-visit planning. Control phase included regular audits to sustain the improvements. The percentage of patients with a HgbA1c testing within 3-6 months of appointment improved from a baseline of 76.7% (LSL:70%, USL:94%) to 92.2% (LSL:88%, USL:93.7%). The improvement was noticeable within 1 month of new process implementation and continues to sustain. The mean had an absolute improvement of 15.5%. The variation from the mean decreased from 25% at baseline to 6% at the end of the control phase. The reduction in variation made our future results more predictable. The use of Lean Six-Sigma DMAIC quality improvement tools are an effective method to improve quality of care in the outpatient setting. These strategies can be replicated for other clinical quality outcomes.

scholarly journals Quality Improvement With Pay-for-Performance Incentives in Integrated Behavioral Health Care

2012 ◽  
Vol 102 (6) ◽  
pp. e41-e45 ◽  
Author(s):  
Jürgen Unützer ◽  
Ya-Fen Chan ◽  
Erin Hafer ◽  
Jessica Knaster ◽  
Anne Shields ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Behavioral Health ◽  
Pay For Performance ◽  
Behavioral Health Care ◽  
Performance Incentives ◽  
Integrated Behavioral Health

scholarly journals Lean Six Sigma and Athletic Training: A Primer for Athletic Training Educators

2020 ◽  
Vol 15 (4) ◽  
pp. 259-268 ◽  
Author(s):  
Christine Noller ◽  
David C. Berry
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Athletic Training ◽  
Process Improvement ◽  
Six Sigma ◽  
Athletic Trainers ◽  
Lean Six Sigma ◽  
Health Care Facilities ◽  
Athletic Training Educators ◽  
Robust Process

Context Lean as a quality improvement philosophy is new to athletic training despite widespread use in health care for many years. Objective To introduce the concepts of Lean and Lean Six Sigma and create a primer document for athletic training educators in the classroom. Background Lean requires organizations to exercise effort along with several dimensions simultaneously to improve patient quality and efficiency while controlling costs and reducing waste. When appropriately executed, Lean transforms how an organization and its employees work, creating an avid quest for quality improvement and, ultimately, patient safety. Synthesis Lean is a cultural transformation that changes how an organization operates. It requires new habits, skills, and attitudes throughout the organization, from executives to front-line staff. Lean is a journey, not a destination. The culture of Lean involves the relentless pursuit of continuous quality improvement and is composed of 6 principles and numerous tools. Recommendation(s) Whether athletic trainers approach Lean or Lean Six Sigma in a leadership role, or as a stakeholder in a Kaizen event, all should have a working knowledge of the principles, methods, elements, philosophy, and tools of robust process improvement. Moreover, while no best-practice statement exists about how to incorporate Lean Six Sigma into a curriculum, addressing process improvement early may allow immersive-experience students an opportunity to engage in a process improvement initiative, facilitating a greater appreciation of the content, and offer opportunities to engage professionals from other disciplines. Conclusion(s) Lean is reproducible in sports medicine clinics, orthopedic practices, and outpatient and athletic health care facilities, but only when athletic trainers understand the application. Moreover, for this reason, athletic training programs should strongly consider adding a robust process improvement course/content to their graduate curriculums.

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

2021 ◽  
Vol 10 (3) ◽  
pp. e001342
Author(s):  
Stijn Schretlen ◽  
Paulien Hoefsmit ◽  
Suzanne Kats ◽  
Geofridus van Merode ◽  
Jos Maessen ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Problem Solving ◽  
Process Improvement ◽  
Six Sigma ◽  
Treatment Time ◽  
Statistical Significance ◽  
Continuous Process ◽  
Bypass Graft ◽  
Lean Six Sigma ◽  
Data Driven

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.

scholarly journals Optimizing nursing time in a day care unit: Quality improvement using Lean Six Sigma methodology

2019 ◽  
Author(s):  
Carmel Davies ◽  
Caroline Lyons ◽  
Regina Whyte
Keyword(s):  
Quality Improvement ◽  
Six Sigma ◽  
Day Care ◽  
Private Hospital ◽  
Positive Impact ◽  
Value Added ◽  
Lean Six Sigma ◽  
Added Value ◽  
Staff Satisfaction ◽  
Nursing Time

Abstract Objective This study applies Lean Six Sigma (LSS) to improve the efficiency of a private hospital day care unit and generate a positive impact on optimizing nursing time and improving personalized patient care and staff satisfaction. Design A prospective interventional study using pre- and post-evaluation. Setting A day care unit at a private hospital. Participants Nurses and patients from the day unit. Intervention(s) Define, Measure, Analyze, Improve and Control was used as an overarching problem-solving framework. All front line staff, clinical leaders and managers were supported as active change agents in the quality improvement (QI) initiative. Multiple interventions were adopted across the service that aimed to de-implement non-value added activities and enhance processes with activities that added value. Main outcome measures Patient turnaround times (PTTs), nursing time, nurse-patient ratio, nurse and patient survey. Results A post-implementation evaluation highlighted significant improvements in service performance and patient and staff satisfaction. Significant added value includes a reduction in PTTs, an increase in nursing care time and improvement in the nurse-patient ratio. Conclusion This project identified that utilizing LSS that relies on collaborative team effort is effective in creating a positive organizational culture for improvement and change. The Six Sigma tools and techniques provide evidence-based approaches that support QI in practice.

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