scholarly journals Assurance of Myeloid Growth Factor Administration in an Infusion Center: Pilot Quality Improvement Initiative

2017 ◽  
Vol 13 (12) ◽  
pp. e1040-e1045 ◽  
Author(s):  
Pamela Maree Ramirez ◽  
Barry Peterson ◽  
Christine Holtshopple ◽  
Kristina Borja ◽  
Vincent Torres ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Six Sigma ◽  
Hospital Costs ◽  
Safety Net ◽  
Primary Objective ◽  
Lean Six Sigma ◽  
Quality Improvement Initiative ◽  
Six Sigma Methodology

Purpose: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0.5%. Methods: This quality improvement initiative was conducted at Chao Infusion Center as part of a Lean Six Sigma Green Belt Certification Program. Therefore, Lean Six Sigma principles and tools were used throughout each phase of the project. Retrospective and prospective medical record reviews and data analyses were performed to evaluate the extent of the identified problem and impact of the process changes. Improvements included systems applications, practice changes, process modifications, and safety-net procedures. Results: Preintervention, 24 missed doses (20.7%) required patient supportive care measures, resulting in increased hospital costs and decreased quality of care. Postintervention, from June 8, 2016, to August 7, 2016, zero of 489 MGF doses were missed after 2 months of intervention ( P < .001). Chao Infusion Center reduced missed doses from 3.52% to 0%, reaching the goal of < 0.5%. Conclusion: The establishment of simplified and standardized processes with safety checks for error prevention increased quality of care. Lean Six Sigma methodology can be applied by other institutions to produce positive outcomes and implement similar practice changes.

Abstract WP237: Improved Thrombolysis Rates and Quality of Care for Stroke Patients Through a Provincial Emergency Department Quality Improvement Initiative

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Devin R Harris ◽  
Robert Stenstrom ◽  
Eric Grafstein ◽  
Mark Collison ◽  
Grant Innes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Performance Measures ◽  
Large Scale ◽  
Primary Outcome ◽  
Baseline Data ◽  
Quality Improvement Initiative ◽  
Stroke Patients

Background: The care of stroke patients in the emergency department (ED) is time sensitive and complex. We sought to improve quality of care for stroke patients in British Columbia (B.C.), Canada, emergency departments. Objectives: To measure the outcomes of a large-scale quality improvement initiative on thrombolysis rates and other ED performance measures. Methods: This was an evaluation of a large-scale stroke quality improvement initiative, within ED’s in B.C., Canada, in a before-after design. Baseline data was derived from a medical records review study performed between December 1, 2005 to January 31, 2007. Adherence to best practice was determined by measuring selected performance indicators. The quality improvement initiative was a collaboration between multidisciplinary clinical leaders within ED’s throughout B.C. in 2007, with a focus on implementing clinical practice guidelines and pre-printed order sets. The post data was derived through an identical methodology as baseline, from March to December 2008. The primary outcome was the thrombolysis rate; secondary outcomes consisted of other ED stroke performance measures. Results: 48 / 81 (59%) eligible hospitals in B.C. were selected for audit in the baseline data; 1258 TIA and stroke charts were audited. For the post data, 46 / 81 (57%) acute care hospitals were selected: 1199 charts were audited. The primary outcome of the thrombolysis rate was 3.9% (23 / 564) before and 9.3% (63 / 676) after, an absolute difference of 5.4% (95% CI: 2.3% - 7.6%; p=0.0005). Other measures showed changes: administration of aspirin to stroke patients in the ED improved from 23.7% (127 / 535) to 77.1% (553 / 717), difference = 53.4% (95% CI: 48.3% - 58.1%; p=0.0005); and, door to imaging time improved from 2.25 hours (IQR = 3.81 hours) to 1.57 hours (IQR 3.0), difference = 0.68 hours (p=0.03). Differences were found in improvements between large and small institutions, and between health regions. Conclusions: Implementation of a provincial emergency department quality improvement initiative showed significant improvement in thrombolysis rates and adherence to other best practices for stroke patients. The specific factors that influenced improvement need to be further explored.

Six Sigma Methodology in Increasing Spirulina Production

Minerva ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 23-28
Author(s):  
Daniel Freire ◽  
Omar Flor ◽  
Gabriela Alvarez
Keyword(s):  
Six Sigma ◽  
Culture Media ◽  
Arthrospira Platensis ◽  
Lean Six Sigma ◽  
Growth Monitoring ◽  
Current State ◽  
Physical And Chemical Variables ◽  
Six Sigma Methodology ◽  
Physical And Chemical

This work presents results of improvement in the productivity of Arthrospira platensis (spirulina) in a company dedicated to its production. The six sigma methodology was applied in production processes that require the use of bioreactors. Starting from the analysis of the current state, aspects, physical and chemical variables that directly influence the productivity achieved were identified. Various culture media were tested and subsequently scaled for industrial production. In addition, the incorporation of carbon into the culture medium was controlled, optimizing the range of potential hydrogen pH. The identified parameters were measured and six sigma methodology strategies were assigned. An improvement in productivity corresponding to 66% was verified with the same quality of final product. Keywords: Six sigma, Bioreactors, Productivity, Arthrospira platensis. References [1]E. Ariawan and A. Makalew, “Smart Micro Farm: Sustainable Algae Spirulina Growth Monitoring System” in 10th International Conference on Information Technology and Electrical Engineering (ICITEE), Bali, 2018, pp.1-4. [2]L. Socconini and C. Reato, Lean six sigma: sistema de gestión para liderar empresas. Primera edición. Barcelona: Marge Books, 2019. [3]H. Gutiérrez, Calidad and productividad. Cuarta edición. México D.F.: McGraw-Hill Interamericana, 2014. [4]G. Usharani, P. Saranraj and D. Kanchana, “Spirulina Cultivation: A Review” in International Journal of Pharmaceutical & Biological Archives, vol. 3, no. 6, pp. 1327-1336, December 2012. [5]J. Udin, O. Gani, A. Mahato, I. Sakib and M. Rakiuzzaman, SPIRULINA (Spirulina platensis) PRODUCTION IN DIFFERENT PHOTOBIOREACTORS ON ROOFTOP, International Journal of Business, Social and Scientific Research, vol. 8, no. 1, pp. 15-19, January 2020. [6]M. Arredondo, Contabilidad y análisis de costos. Primera edición. México D.F.: Grupo Editorial Patria, 2015. [7]J. García, Contabilidad de costos. Cuarta edición. México D.F.: McGraw-Hill Interamericana, 2014. [8]L. Socconini, Certificación Lean Six Sigma Green Belt para la excelencia en los negocios. Primera edición. Barcelona: Marge Books, 2015. [9]A. Vian, Introducción a la Química Industrial. Segunda edición. Buenos Aires: Reverté, 2012. [10]S. Milton, Estadística para Biología y Ciencias de la Salud. Tercera edición. Madrid: McGraw-Hill Interamericana, 2014.

Community oncology care delivery staffing model.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 87-87
Author(s):  
David C. Fryefield ◽  
Roberta Kafora ◽  
Lori Bradshaw-Hucko ◽  
Chris Tribble ◽  
Terry Jensen ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Six Sigma ◽  
Care Delivery ◽  
Core Competencies ◽  
Lean Six Sigma ◽  
Advisory Council ◽  
Physician Services ◽  
Staffing Model ◽  
Community Oncology

87 Background: In 2010, the US Oncology Network’s Clinical Advisory Council (CAC), a practice-based clinical leadership team, reviewed the care delivery process at 5 pilot community oncology clinics to determine how licensed and unlicensed clinical resources were used. The Lean Six Sigma methodology, which employs statistical analysis within a structured approach to problem-solving, was used to understand the required clinical activities of the practices within 3 primary areas. The objective of this pilot was to ensure patients receive timely, effective treatment from qualified personal in a cost-efficient model. Methods: A team led by a certified Master Black Belt studied tasks performed by licensed vs. non-licensed staff in the areas of physician services, treatment services and triage services at each practice. Based on the findings, tasks were realigned to maintain quality of care but to deliver care more efficiently. Results: Care Delivery processes comprised 95 tasks at baseline vs. 80 tasks in the redefined model. Within physician services, changes to workflow included rooming and clinic support (vitals, cleaning, and patient comfort) to be provided by Medical Assistants (MAs) instead of RN. RN duties were changed to MA supervision and tasks that require licensure. Changes to triage services included use of RNs to coordinate care and MAs for phone call screening, centralized triage (non-patient facing), and normal lab follow-up. Increased clarity of tasks and re-assignment of responsibilities reduced RN work load by 17% or 16.6 hours/day based on 120 patient visits. Each pilot site realized an annualized labor savings in excess of $100,000. This prospective, patient volume-based Care Delivery Staffing Model was adopted by the CAC as Network standard after completion of the pilot. Conclusions: Using Lean Six Sigma methods, the care delivery process was successfully re-designed such that clinical staff were re-aligned to better utilize each resource’s core competencies. Implementation of this care delivery model resulted in improved cost effectiveness while maintaining quality of care and also enabled prospective staff planning so that costs can be kept competitive in the future.

Reducing medication errors using lean six sigma methodology in a Thai hospital: an action research study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yaifa Trakulsunti ◽  
Jiju Antony ◽  
Mary Dempsey ◽  
Attracta Brennan
Keyword(s):  
Patient Safety ◽  
Action Research ◽  
Teaching Hospital ◽  
Six Sigma ◽  
Improve Patient Safety ◽  
Lean Six Sigma ◽  
Content Type ◽  
Six Sigma Methodology ◽  
Dispensing Errors

PurposeThe purpose of this paper is to illustrate the use of Lean Six Sigma (LSS) and its associated tools to reduce dispensing errors in an inpatient pharmacy of a teaching hospital in Thailand.Design/methodology/approachThe action research methodology was used to illustrate the implementation of Lean Six Sigma through the collaboration between the researcher and participants. The project team followed the Lean Six Sigma Define, Measure, Analyze, Improve, Control (DMAIC) methodology and applied its tools in various phases of the methodology.FindingsThe number of dispensing errors decreased from 6 to 2 incidents per 20,000 inpatient days per month between April 2018 and August 2019 representing a 66.66% reduction. The project has improved the dispensing process performance resulting in dispensing error reduction and improved patient safety. The communication channels between the hospital pharmacy and the pharmacy technicians have also been improved.Research limitations/implicationsThis study was conducted in an inpatient pharmacy of a teaching hospital in Thailand. Therefore, the findings from this study cannot be generalized beyond the specific setting. However, the findings are applicable in the case of similar contexts and/or situations.Originality/valueThis is the first study that employs a continuous improvement methodology for the purpose of improving the dispensing process and the quality of care in a hospital. This study contributes to an understanding of how the application of action research can save patients' lives, improve patient safety and increase work satisfaction in the pharmacy service.

scholarly journals Improving the Quality of the Goods Delivery Supply Chain System with the Integration of Lean Six Sigma and AHP Methods

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Muhammad Iqbal Maulana ◽  
Hana Catur Wahyuni
Keyword(s):  
Supply Chain ◽  
Quality Improvement ◽  
Six Sigma ◽  
Lean Six Sigma ◽  
Research Needs ◽  
Supply Chain System ◽  
Chain System ◽  
Logistics Service ◽  
Selection For

Astrans Putra Logistik Ltd. is a logistics service company with shipping routes in Sidoarjo, Denpasar, Lombok and NTB. Some of the problems that occur, such as delays in the pick-up process of goods to the load that large but not enough for departure, cause the quality of the supply chain system to be poor. So this research needs to be done with the aim of knowing the point of waste in the supply chain, identifying the sigma value, and determining the priority for its improvement. Quality improvement is carried out using the Lean Six Sigma method with AHP integration as a priority selection for improvement. From the research results, it was found that there was waste that caused 3 (three) CTQ, namely delivery was delayed, goods were damaged or leaked, and there was a difference in the number of goods. The company's DPMO value is 34272 with a sigma value of 3.34. The priority for improvements that can be made based on AHP weight, namely check the package packages before they are sent (0,353), make SOP for the preparation of goods (0,167), and apply SOP for goods checking documents (0,142).

scholarly journals Implementasi Lean Six Sigma Dalam Penentuan Prioritas Perbaikan Kualitas Pelayanan Padarumah Sakit Di Kabupaten Lumajang

2018 ◽  
Vol 7 (2) ◽  
pp. 97-107
Author(s):  
Mohammad Ato’illah
Keyword(s):  
Quality Improvement ◽  
Service Quality ◽  
Six Sigma ◽  
Lean Six Sigma ◽  
Hospital Services ◽  
Validity And Reliability ◽  
Services Research ◽  
Analysis Technique ◽  
Six Sigma Approach

ABSTRACT. The study aims to determine  the priority  of quality improvement of hospital  service based  on perception,  expectations  and importance  of customers  by using lean six sigma approach. The results of the study are  expected to contribute  to hospital  management  in providing  the best service  for the community. This research  determines  the priority  of service  quality  improvement of hospital  based  on service  quality dimension consisting of (1) tangible,  (2) reliability,  (3) reponsiveness,  (4) assurance and (5) emphaty. This study is a qualitative  descriptive research  intended to analyze the responses of respondents  on the quality of hospital services based on perception,  expectations  and importance  will be used to determine the priority of improving the quality of hospital services. Research  respondents  were 240 service users in four hospitals in Lumajang  district.  Data  analysis  technique  using  lean  six sigma  approach by first  testing  the  research instrument  with validity and  reliability  test. The results  of the study there  are  differences  in the order  of priority of service quality improvement at four hospitals. Priority  improvement in dr Haryoto hospital is the ability and dexterity in dealing with patient complaints, at the Bhayangkara hospital is the timeliness of open counter service, at Wijaya Kusuma hospital is completeness of examination equipment, and Islam hospital is the ability of the officer to explain thhe results of the examination.

Improving university facilities services using Lean Six Sigma: a case study

2015 ◽  
Vol 13 (1) ◽  
pp. 70-84 ◽  
Author(s):  
Mohsen F. Mohamed Isa ◽  
Mumtaz Usmen
Keyword(s):  
Six Sigma ◽  
Value Added ◽  
Lean Six Sigma ◽  
Content Type ◽  
General Improvement ◽  
Six Sigma Methodology ◽  
Construction Services ◽  
Design And Construction

Purpose – The purpose of this paper is to present a case study on the use of Lean Six Sigma principles and tools to study the improvement in design and construction services at a university. The quality of facilities services at universities has been criticized by users calling for improvement. Design/methodology/approach – Quality of facilities services at universities has been criticized by users calling for improvement. The purpose of this paper is to present a case study on using Lean Six Sigma principles and tools to study improving design and construction services at a university. Findings – It was found that non-value-added general improvement review form (GIRF) process steps involving revisions and rework for the design and construction result in time delays, cost increases and quality deficiencies and render cost estimates unreliable; these are unnecessary and should be minimized or eliminated. It was additionally noted that administrative reviews and approvals embedded in GIRF processes slow down work flow, leading to similar problems. Because such steps may be needed for institutional reasons precluding elimination, it was recommended that efforts be directed toward reducing their durations and costs. Overall, the Lean Six Sigma methodology proved to be successful for the intended purpose. Originality/value – Although universities are aware of their facilities services’ quality issues and have been addressing them, no published information is available on how to systematically evaluate and improve such services to increase customer satisfaction. This paper aims at filling this gap.

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