Abstract #272 Collaborative Interventions and Lean Six Sigma Methods Increase the Frequency of Hemoglobin A1C Measurements among Hospitalized Patients with Diabetes at a Community Hospital

2019 ◽  
Vol 25 ◽  
pp. 107-108
Author(s):  
Mihail Zilbermint ◽  
Lee Ann Alexander ◽  
Isha Misra ◽  
Iniuboho Akpandak ◽  
Wilson Lamy
Keyword(s):  
Six Sigma ◽  
Hemoglobin A1c ◽  
Community Hospital ◽  
Lean Six Sigma ◽  
Hospitalized Patients ◽  
Patients With Diabetes ◽  
Collaborative Interventions

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.

Using Safety Barrier Analysis to Facilitate Quality Improvement in Health Care: Improving Venous Thromboembolism Prophylaxis as a Proof of Concept

2019 ◽  
Vol 35 (2) ◽  
pp. 147-154 ◽  
Author(s):  
Carlton Moore ◽  
G. Cameron Coleman ◽  
Jamison Chang ◽  
Max Nagle ◽  
May-Britt Sten
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Venous Thromboembolism ◽  
Six Sigma ◽  
Lean Six Sigma ◽  
Hospitalized Patients ◽  
Thromboembolism Prophylaxis ◽  
Venous Thromboembolism Prophylaxis ◽  
Safety Barrier ◽  
Barrier Analysis

Effective quality improvement is a key factor in optimizing the care of hospitalized patients. Unfortunately, the US health care system has a poor safety record when compared to other major industries. For example, at 250 000 per year, medical errors are the third leading cause of death in the United States. Safety barrier management, a widely used methodology in high-risk industries such as commercial airline transportation and oil drilling, has not been widely used in traditional quality improvement efforts in health care, which rely more on standard lean Six Sigma quality approaches. The authors describe a quality improvement project that uses safety barrier analysis to help inform solutions to improve venous thromboembolism prophylaxis in hospitalized patients. This study found that safety barrier analysis helped inform solutions to improve venous thromboembolism prophylaxis at the study institution and can be a useful adjunct to standard lean Six Sigma methodologies for quality improvement in health care.

Nurse Satisfaction Using Insulin Pens in Hospitalized Patients

2009 ◽  
Vol 35 (5) ◽  
pp. 799-809 ◽  
Author(s):  
Estella M. Davis ◽  
Anne Bebee ◽  
LeaAnne Crawford ◽  
Chris Destache
Keyword(s):  
Community Hospital ◽  
Hospitalized Patients ◽  
Insulin Administration ◽  
Needlestick Injuries ◽  
Delivery Method ◽  
Nursing Time ◽  
Nurse Satisfaction ◽  
Patients With Diabetes ◽  
Quasi Experimental ◽  
Insulin Pens

Purpose The purpose of this study was to evaluate nurse satisfaction using pen devices compared with vials/syringes to administer insulin to hospitalized patients with diabetes. Methods A quasi-experimental 1-group posttest only study design was utilized to distribute a satisfaction survey to 54 registered nurses in a community hospital after implementation of insulin pen devices from July 2005 to May 2006 on 2 medical-surgical floors. Nurses completed a voluntary, anonymous, self-administered, postassessment, investigator-developed survey asking about the number of years practiced as a nurse and experience administering insulin to patients. The survey also asked about insulin administration satisfaction questions comparing insulin pen devices to vials/syringes, and estimated time to teach patients to self-inject insulin using either delivery method during the study period. Results In comparison to vials/syringes, the majority of nurses agreed that insulin pens were more convenient, simple and easy to use, and an overall improvement compared with conventional vials/syringes. There were no insulin-related needlestick injuries using the insulin pens and safety needles. Conclusion Nurses were satisfied with multiple aspects of insulin pens compared with vials/syringes. Implementation of insulin pen devices does not increase nursing time spent to teach patients to self-inject insulin and does not increase insulin-related needlestick injuries.

EMPLOYEE ENGAGEMENT FOR HIGH FIRM PERFORMANCE: THE CASE OF LEAN SIX SIGMA AT A MALAYSIA TRADING COMPANY

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Hadijah Iberahim ◽  
Izmahariz Azman ◽  
Mohd Haniff Shahri ◽  
Nur Fara Ellyanie Abdul Hamid
Keyword(s):  
Knowledge Sharing ◽  
Employee Engagement ◽  
Six Sigma ◽  
Relevant Literature ◽  
Lean Six Sigma ◽  
Successful Implementation ◽  
Management Support ◽  
High Productivity ◽  
Trading Company ◽  
Goal Clarity

Lean Six Sigma (LSS) is a method that helps an organization to maximize profit and minimize cost. One of the essential factors for a successful LSS project is the availability of employees who are willing to engage. Employee engagement brings about a strong sense of belonging and high productivity. Consequently, engaged employees will work harder to achieve the mission of the organization. This paper discusses a case of LSS project with a low level of employee engagement. As a result, LSS was less likely helpful in sustaining company’s performance. The purpose of this study is to identify factors that contribute to employee engagement in LSS practices. Review of the relevant literature suggests four variables, which include goal clarity, management support and trust, knowledge sharing and transfer, and teamwork. The questionnaire survey applied census in collecting feedback from 80 respondents. Statistical analysis results indicate that goal clarity, management support, and trust are significant to employee engagement. However, knowledge sharing and transfer as well as teamwork are not substantial. It is recommended for the organization to give attention to all the four factors. This paper extended understandings on critical inputs to a successful implementation of LSS for sustainable company’s performance and growth. Keywords: Lean Six Sigma, Employee Engagement, Goal Clarity, Management Support and Trust, Teamwork, Knowledge Sharing.

Sign in / Sign up

Export Citation Format

Share Document