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Journal Article > Commentary
Promoting patient safety with perioperative hand-off communication.
Robinson NL. J Perianesth Nurs. 2016;31:245-253.
Handoffs are comprised of a multitude of steps that are prone to communication error. This commentary describes how a hospital drew from Lean Six Sigma concepts to develop and implement a standardized handoff process. The effort achieved improvements and established a concrete method for nurses to apply safe communication and data sharing principles in the perioperative environment.
Journal Article > Study
Improving hand hygiene at eight hospitals in the United States by targeting specific causes of noncompliance.
- Classic
Chassin MR, Mayer C, Nether K. Jt Comm J Qual Patient Saf. 2015;41:4-12.
Although appropriate handwashing has been identified as an essential factor in preventing health care–associated infections, hand hygiene rates remain unacceptably low at many hospitals. This quality improvement project aimed to achieve adherence to hand hygiene practices at eight hospitals using change management methods drawn from human factors engineering. Each hospital investigated and identified specific causes of noncompliance with handwashing and developed specific interventions to address these barriers. These individualized efforts yielded a significant improvement in handwashing behavior. The authors argue that allowing each site to tailor the intervention to the specific causes of noncompliance led to the sustained improvements. This study suggests that local improvement may be a fruitful method to enhance the proven but incompletely implemented practice of hand hygiene. A recent AHRQ WebM&M interview and perspective discuss ways to enhance hand hygiene adherence.
Journal Article > Study
Using Lean "automation with a human touch" to improve medication safety: a step closer to the "perfect dose."
Ching JM, Williams BL, Idemoto LM, Blackmore CC. Jt Comm J Qual Patient Saf. 2014;40:341-350.
This study highlights the use of Lean methodologies to facilitate implementation of barcode medication administration (BCMA) for hospitalized patients at Virginia Mason Medical Center. The introduction of BCMA led to significantly fewer medication errors. The concepts presented may be helpful for organizations employing new health technologies.
Newspaper/Magazine Article
Using Six Sigma to improve patient safety in the perioperative process.
Galli BJ, Riebling N, Paraso C, Lehmann G, Yule M. Patient Saf Qual Healthc. July/August 2013;10:36-41.
Journal Article > Study
Using Lean to improve medication administration safety: in search of the "perfect dose."
Ching JM, Long C, Williams BL, Blackmore CC. Jt Comm J Qual Patient Saf. 2013;39:195-204.
Errors during administration are one of the most common types of medication errors, with one study showing that they occur in nearly 25% of doses in hospitalized patients. Lean methodology, derived from the Toyota Production System, is increasingly being used in health care as a way to design safer and more efficient systems of care. This study reports on the application of Lean approaches to improving medication administration safety. A redesigned medication administration system that incorporated human factors engineering techniques to minimize interruptions, implement barcode medication administration, and standardize nursing workflows resulted in a significant reduction in administration error rates. The study provides a useful example of how quality improvement techniques originally developed in other industries can be successfully applied in health care.
Journal Article > Study
Applying Lean methods to improve quality and safety in surgical sterile instrument processing.
Blackmore CC, Bishop R, Luker S, Williams BL. Jt Comm J Qual Patient Saf. 2013;39:99-105.
Use of Lean methodology helped restructure the surgical instrument sterilization and preparation process according to human factors engineering principles, resulting in a sustained decrease in the instrument processing error rate.
Newspaper/Magazine Article
Wrong-site surgery.
Butcher L. Hosp Health Netw. November 2011.
This article discusses wrong-site surgeries and efforts to prevent them.
Journal Article > Study
Improving insulin distribution and administration safety using Lean Six Sigma methodologies.
Yamamoto J, Abraham D, Malatestinic B. Hosp Pharm. 2010;45:212-224.
In this collaboration between a pharmaceutical company and a hospital, Six Sigma methodology was used to standardize and improve the efficiency of insulin dispensing and administration. The intervention resulted in cost savings and a reduction in clinical adverse events.
Journal Article > Study
The Henry Ford Production System: reduction of surgical pathology in-process misidentification defects by bar code-specified work process standardization.
Zarbo RJ, Tuthill JM, D'Angelo R, et al. Am J Clin Pathol. 2009;131:468-477.
Lean thinking strategies were applied to improve workflow and reduce misidentification errors in a surgical pathology laboratory.
Journal Article > Commentary
Implementation of patient safety rounds in a children's hospital.
Yee PL, Edwards ML, Dixon J, Gleason NS. Nurs Adm Q. 2009;33:48-53.
This article discusses how one children's hospital used patient safety rounds to identify 191 issues in its first year and then took measures to resolve them.
Audiovisual > Audiovisual Presentation
Reducing patient risk from prescription instruction errors—a six sigma approach.
O'Dell ML, Andell JL. Milwaukee, WI: American Society for Quality; 2008.
This Web presentation describes how one hospital's new prescription instructions caused errors and demonstrates how the six sigma approach allowed them to make the process safer.
Award > Award Recipient
New York-Presbyterian Hospital: translating innovation into practice.
Johnson T, Currie G, Keill P, Corwin SJ, Pardes H, Reich Cooper M. Jt Comm J Qual Patient Saf. 2005;31:554-560.
This 2005 American Hospital Association McKesson Quest for Quality Prize finalist reports on how using Six Sigma techniques, along with clinical information and business intelligence systems, facilitates strategic quality and safety alignment at their hospital.
Journal Article > Commentary
Lean Six Sigma reduces medication errors.
Esimai G. Qual Prog. April 2005;38:51-57.
The authors analyze one hospital's quality management program. Using a Six Sigma methodology, the program identified policy and practice changes that needed to be implemented in order to reduce harm.
Journal Article > Commentary
On the quest for Six Sigma.
Moorman DW. Am J Surg. 2005;189:253-258.
This discussion of patient safety from a surgical perspective highlights issues involving hierarchy, human factors, and multidisciplinary team training as opportunities to reduce medical errors in surgery.