Applying Lean Six Sigma to improve medication management

2016 ◽  
Vol 29 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Preethy Nayar ◽  
Diptee Ojha ◽  
Ann Fetrick ◽  
Anh T Nguyen
Keyword(s):  
Health Care ◽  
Six Sigma ◽  
Medical Center ◽  
Medication Management ◽  
Significant Proportion ◽  
Lean Six Sigma ◽  
Veterans Health ◽  
Health Administration ◽  
Content Type ◽  
Current Process

Purpose – A significant proportion of veterans use dual care or health care services within and outside the Veterans Health Administration (VHA). In this study conducted at a VHA medical center in the USA, the authors used Lean Six Sigma principles to develop recommendations to eliminate wasteful processes and implement a more efficient and effective process to manage medications for dual care veteran patients. The purpose of this study is to: assess compliance with the VHA’s dual care policy; collect data and describe the current process for co-management of dual care veterans’ medications; and draft recommendations to improve the current process for dual care medications co-management. Design/methodology/approach – Input was obtained from the VHA patient care team members to draw a process map to describe the current process for filling a non-VHA prescription at a VHA facility. Data were collected through surveys and direct observation to measure the current process and to develop recommendations to redesign and improve the process. Findings – A key bottleneck in the process that was identified was the receipt of the non-VHA medical record which resulted in delays in filling prescriptions. The recommendations of this project focus on the four domains of: documentation of dual care; veteran education; process redesign; and outreach to community providers. Research limitations/implications – This case study describes the application of Lean Six Sigma principles in one urban Veterans Affairs Medical Center (VAMC) in the Mid-Western USA to solve a specific organizational quality problem. Therefore, the findings may not be generalizable to other organizations. Practical implications – The Lean Six Sigma general principles applied in this project to develop recommendations to improve medication management for dual care veterans are applicable to any process improvement or redesign project and has valuable lessons for other VAMCs seeking to improve care for their dual care veteran patients. Originality/value – The findings of this project will be of value to VA providers and policy makers and health care managers who plan to apply Lean Six Sigma techniques in their organizations to improve the quality of care for their patients.

Improving logistics supplier selection process using lean six sigma – an action research case study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Huay Ling Tay ◽  
Hui Sen Aw
Keyword(s):  
Health Care ◽  
Six Sigma ◽  
Supplier Selection ◽  
Selection Process ◽  
Lean Six Sigma ◽  
Content Type ◽  
Logistics Services ◽  
Health Care Company ◽  
Care Company

Purpose Outsourcing logistical activities have become a widely used approach for firms to avoid high fixed costs and heavy investment requirements and to achieve competitive advantages. Lean six sigma (LSS) has been accepted globally across sectors as a management strategy for achieving process excellence. The purpose of this paper is to feature the application of LSS for improving the supplier selection process (SSP) of outsourced logistics services in a multinational health-care company. Design/methodology/approach This study is based on an action research case study conducted on the SSP of the freight and distribution department in a multinational health-care company. This paper reports on the application of the LSS define-measure-analyze-improve-control (DMAIC) approach for reducing supplier selection lead time. Findings The study features a real-world case study of the LSS DMAIC application to improve the supplier selection process of a large health-care company. The key issues that were identified are lack of information visibility, top-down changes and unclear communication lines. To counteract these three root causes, the lean six sigma techniques that are implemented are the 5S, stakeholder analysis and standard operating procedure. Research limitations/implications This research provided empirical evidence of how practical challenges in SSP can be managed with the use of LSS. It further proposed plausible solutions for reducing and sustaining improved outcomes. As the study is limited to one case, the validity of the results can be improved by including more organisations and more case studies from other similar organisations. Originality/value Research in supplier selection processes rarely links continuous improvement ideology such as LSS to support strategic selection and procurement of logistics services. This paper could serve as a resource for both practitioners to derive useful implications and to academicians as it contributes to the LSS body of knowledge for further theory testing.

Modelling of readiness factors for the implementation of Lean Six Sigma in healthcare organizations

2020 ◽  
Vol 11 (4) ◽  
pp. 597-633 ◽  
Author(s):  
V. Vaishnavi ◽  
M. Suresh
Keyword(s):  
Health Care ◽  
Six Sigma ◽  
Health Care Industry ◽  
Lean Six Sigma ◽  
Interaction Matrix ◽  
Successful Implementation ◽  
Care Organization ◽  
Content Type ◽  
Care Industry ◽  
Expert Opinions

Purpose This paper aims to identify, analyze and categorize the major readiness factors for implementing Lean Six Sigma (LSS) in health-care organizations using total interpretive structural modelling technique. The readiness factors are identified would help the managers to recognize the areas that lack and provide importance to the successful implementation of LSS in those areas. The paper further intends to understand the hierarchical interrelationships among the readiness factors identified using dependence and driving power. Design/methodology/approach In total, 16 readiness factors are identified from the literature review and expert opinions are collected from hospitals. The scheduled interview is conducted based on a questionnaire survey in hospitals in the Indian context to identify the relevance of the relations among the readiness factors. The expert opinions are used in the initial reachability matrix and interpretative interaction matrix. Matrix impact cross multiplication applied to classification (MICMAC) analysis uses dependence and driving power to understand the hierarchical relationship among the readiness factors identified. Findings The result indicates that customer-oriented and goal management cultures are the key readiness factors for LSS. The execution technique and training are given according to the current demand of customers and goal change of organization. The manager needs to concentrate more on readiness factors to formulate the execution process of LSS for continuous improvement of the health-care organization. The readiness level helps the manager to identify the target area for LSS execution. Research limitations/implications This research focuses mainly on readiness factors for the implementation of LSS in the health-care industry. Practical implications This study would be useful for researchers and practitioners to understand the readiness factors before starting the implementation process of LSS. Originality/value Many research studies are being done on the success and failure rate of implementation of factors. The present study identifies the readiness factors related to LSS, especially for the health-care industry.

Supporting older military veterans in the rural US

2018 ◽  
Vol 19 (4) ◽  
pp. 286-297
Author(s):  
Bret Hicken ◽  
Kimber Parry
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Veterans Health ◽  
Health Administration ◽  
Care Needs ◽  
Content Type ◽  
Access To Health ◽  
The Us

Purpose The purpose of this paper is to provide an overview of rural older veterans in the US and discuss how the US Department of Veterans Affairs (VA) is increasing access to health care for older veterans in rural areas. Design/methodology/approach This is a descriptive paper summarizing population and program data about rural veterans. Findings VA provides a variety of health care services and benefits for older veterans to support health, independence, and quality of life. With the creation of the Veterans Health Administration Office of Rural Health (ORH) in 2006, the needs of rural veterans, who are on average older than urban veterans, are receiving greater attention and support. ORH and VA have implemented several programs to specifically improve access to health care for rural veterans and to improve quality of care for older veterans in rural areas. Originality/value This paper is one of the first to describe how VA is addressing the health care needs of older, rural veterans.

Process mining and lean six sigma: a novel approach to analyze the supply chain quality of a hospital

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Francisco Ramires ◽  
Paulo Sampaio
Keyword(s):  
Health Care ◽  
Supply Chain ◽  
Six Sigma ◽  
Process Mining ◽  
Lean Six Sigma ◽  
Content Type ◽  
Study Approach ◽  
Novel Approach

PurposeThis paper aims to depict the practical execution of the problem-solving structure provided by the define, measure, analyze, improve and control (DMAIC) framework in combination with the analytical power provided by process mining capabilities, to improve the supply chain quality of a health-care provider. Design/methodology/approachPrior to the study, a literature review was conducted to identify existing frameworks combining six sigma with process mining. The authors use a descriptive case study approach to explain how the two methodologies blend across the different phases of DMAIC in a health-care setting. FindingsThis case study describes how analyzing data extracted from core information systems has significant value to improvement initiatives when complemented by traditional quality methods. By intersecting process mining techniques with lean six sigma tools, the researchers found 65% of orders not complying with the target ordering time and 200 redundant purchases with high operational costs. Research limitations/implicationsBy depicting how the two methodologies can be intertwined, this paper complements existing research by presenting it as a viable quality improvement approach. Practical implicationsThis paper provides insights for six sigma and process mining practitioners on the benefits of combining both methodologies within the DMAIC structure. Implementing this blended approach can bring visibility to operations and accelerate process improvement initiatives. Originality/valueThe prime value of this paper lies in the integration of traditional six sigma methods with process mining as a technological approach in a health-care context, going beyond existing research, which, to the best of the knowledge, lacks descriptive case studies.

scholarly journals Implementation and evaluation of a pharmacist-run mental health treatment clinic via clinical video telehealth

2016 ◽  
Vol 6 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Molly Leach ◽  
Guadalupe Garcia ◽  
Nicole Ganzer
Keyword(s):  
Mental Health ◽  
Rural Areas ◽  
Mental Health Treatment ◽  
Medical Center ◽  
Medication Management ◽  
Health Resources ◽  
Cost Savings ◽  
Veterans Health ◽  
Health Administration ◽  
Potential Cost

Abstract Introduction: The Veterans Health Administration is extending its mental health services to reach those in rural areas who find it difficult to travel to a Veterans Affairs Medical Center (VAMC). This project aimed to outline implementation of a Pharmacy Mental Health Clinical Video Telehealth (MHCVT) clinic for veterans. Secondary endpoints were to assess patient satisfaction with MHCVT, describe the potential benefits of this clinic regarding travel saved, and summarize no-show rates. Methods: Veterans received mental health disease state medication management from a mental health clinical pharmacy specialist via clinical video telehealth (CVT) in place of an in-clinic appointment and were asked to complete a satisfaction survey after the initial CVT appointment. Data collected from all veterans enrolled in the CVT clinic from September 8, 2014, through March 23, 2015 included: patient demographics, service connection percentage, number of CVT visits, travel miles saved, travel reimbursement, no-show rate, and documentation of medication management therapy. Results: As of March 23, 2015, there were 22 veterans enrolled in the MHCVT clinic, of whom, 19 completed their appointments. Of the 48 potential encounters, 7 were considered a no-show (17%). On average veterans saved 34 travel miles per visit with cumulative savings of 1432.6 miles. Of those who were eligible to receive travel reimbursement (n = 13), the medical center potentially saved $674.50 in a 7-month period. Overall clinic satisfaction per survey (n = 14) was 100% (strongly agreed or agreed). A majority (93%) would recommend the clinic to other veterans. Conclusions: This project successfully implemented a MHCVT pilot clinic. The veterans were satisfied with the services. The 41 clinic visits resulted in a potential cost savings. Expansion of this clinic in the future will expand more mental health resources to veterans.

Exploring expanded interdisciplinary roles in goals of care conversations in a national goals of care initiative: A qualitative approach

2021 ◽  
pp. 026921632110204
Author(s):  
Jessica E Ma ◽  
Marie Haverfield ◽  
Karl A Lorenz ◽  
David B Bekelman ◽  
Cati Brown-Johnson ◽  
...  
Keyword(s):  
Health Care ◽  
Role Theory ◽  
Medical Center ◽  
Veterans Health Administration ◽  
The United States ◽  
Veterans Health ◽  
Health Administration ◽  
Goals Of Care ◽  
Organizational Role ◽  
Provider Role

Background: The United States Veterans Health Administration National Center for Ethics in Health Care implemented the Life-Sustaining Treatment Decisions Initiative throughout the Veterans Health Administration health care system in 2017. This policy encourages goals of care conversations, referring to conversations about patient’s treatment and end-of-life wishes for life-sustaining treatments, among Veterans with serious illnesses. A key component of the initiative is expanding interdisciplinary provider roles in having goals of care conversations. Aim: Use organizational role theory to explore medical center experiences with expanding interdisciplinary roles in the implementation of a goals of care initiative. Design: A qualitative thematic analysis of semi-structured interviews. Setting/participants: Initial participants were recruited using purposive sampling of local medical center champions. Snowball sampling identified additional participants. Participants included thirty-one interdisciplinary providers from 12 geographically diverse initiative pilot and spread medical centers. Results: Five themes were identified. Expanding provider roles in goals of care conversations (1) involves organizational culture change; (2) is influenced by medical center leadership; (3) is supported by provider role readiness; (4) benefits from cross-disciplinary role agreement; and (5) can “overwhelm” providers. Conclusions: Organizational role theory is a helpful framework for exploring interdisciplinary roles in a goals of care initiative. Support and recognition of provider role expansion in goals of care conversations was important for the adoption of a goals of care initiative. Actionable strategies, including multi-level leadership support and the use of interdisciplinary champions, facilitate role change and have potential to strengthen uptake of a goals of care initiative.

scholarly journals An exploratory study into the use of Lean Six Sigma to reduce medication errors in the Norwegian public healthcare context

2019 ◽  
Vol 32 (4) ◽  
pp. 509-524 ◽  
Author(s):  
Jiju Antony ◽  
Shirin Charlotte Forthun ◽  
Yaifa Trakulsunti ◽  
Thomas Farrington ◽  
Julie McFarlane ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Medication Errors ◽  
Six Sigma ◽  
Lean Six Sigma ◽  
Public Health Care ◽  
Public Healthcare ◽  
Content Type ◽  
Health Care Practitioners ◽  
Health Care Context

Purpose Medication errors are a significant cause of injury in Norwegian hospitals. The purpose of this study is to explore how Lean Six Sigma (LSS) has been used in the Norwegian public health-care context to reduce medication errors. Design/methodology/approach A mixed method approach was used to gather data from participants working in the four regions served by the Norway health authorities. A survey questionnaire was distributed to 38 health-care practitioners and semi-structured interviews were conducted with 12 health-care practitioners. Findings The study finds that the implementation of LSS in the Norwegian public health-care context is still in its infancy. This is amidst several challenges faced by Norwegian hospitals such as the lack of top-management support, lack of LSS training and coaching and a lack of awareness around the benefits of LSS in health care. Research limitations/implications Because of the large geographical area, it was difficult to reach participants from all health regions in Norway. However, the study managed to assess the current status of LSS implementation through the participants’ perspectives. This is a fruitful area for future research whereby an action research methodology could be used. Originality/value To the best of the authors’ knowledge, this is the first empirical study into the use of LSS methodology in reducing medication errors. In addition, this study is valuable for health-care practitioners and professionals as a guideline to achieve the optimal benefit of LSS implementation to reduce medication errors.

Can Lean Six Sigma be used to reduce medication errors in the health-care sector?

2018 ◽  
Vol 31 (4) ◽  
pp. 426-433 ◽  
Author(s):  
Yaifa Trakulsunti ◽  
Jiju Antony
Keyword(s):  
Health Care ◽  
Medication Errors ◽  
Health Care Professionals ◽  
Six Sigma ◽  
Success Factors ◽  
Lean Six Sigma ◽  
Successful Implementation ◽  
Content Type ◽  
Case Examples ◽  
Medication Process

Purpose The purpose of this paper is to present the implementation of Lean Six Sigma (LSS) to reduce medication errors, by using four case examples. The paper will also suggest appropriate Lean and Sigma tools to improve the medication process. Design/methodology/approach The authors critically analyze four case examples that used LSS projects, to demonstrate the approach, benefits, success factors and lessons learnt. Findings LSS is a powerful process improvement methodology that could be applied by health-care sectors to reduce medication errors, increase patient safety and reduce operational costs. Common Lean and Six Sigma tools play a significant role in improving and sustaining the medication process. Practical implications It is necessary for the project team to select the most appropriate LSS tools to address medication process problems. Adoption of a LSS roadmap could help health-care organizations in the successful implementation of LSS. Originality/value The paper is valuable for health-care professionals seeking to reduce errors in the medication process or other processes that need to be improved.

Knowledge-based lean six sigma system for enhancing quality management performance in healthcare environment

2019 ◽  
Vol 10 (1) ◽  
pp. 211-233 ◽  
Author(s):  
Yousuf Nasser Al Khamisi ◽  
M. Khurshid Khan ◽  
J. Eduardo Munive-Hernandez
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Quality Management ◽  
Six Sigma ◽  
Best Practice ◽  
Lean Six Sigma ◽  
Health Care Environment ◽  
Care Environment ◽  
Content Type ◽  
Knowledge Based

PurposeThis paper aims to present the development of a knowledge-based system (KBS) to support the implementation of Lean Six Sigma (L6s) principles applied to enhance quality management (QM) performance within a health-care environment. Design/methodology/approachThe process of KBS building has been started by acquiring knowledge from experts in field of L6σ and QM in health care. The acquired knowledge has been represented in a rule-based approach for capturing L6σ practices. These rules are produced in IF […].THEN way where IF is the premise and THEN is the action. The produced rules have been integrated with gauging absence pre-requisites (GAP) technique to facilitate benchmarking of best practice in a health-care environment. A comprehensive review of the structure of the system is given, detailing a typical output of the KBS. FindingsImplementation of L6s principles to enhance QM performance in a health-care environment requires a pre-assessment of the organisation’s competences. The KBS provides an enhanced strategic and operational decision-making hierarchy for achieving a performance benchmark. Research limitations/implicationsThe KBS needs validation in real health-care environment, which will be done in Oman’s hospitals. Practical implicationsThe paper is intended to benefit QM practitioners in the health-care sector during decision-making to achieve performance improvement against a best practice benchmark. Originality/valueThis research presents a novel application of a hybrid KBS with GAP methodology to support the implementation of L6s principles to enhance QM performance in a health-care environment.

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