1. Define the problem - that is wait time and the high number of non-emergency patients
2. Develop a solution - in an emergency room situation, this can include adding beds by expanding the department or decreasing the size of current rooms; outsourcing certain testing and radiology services; and/or adding an ‘express care’ program to deal with non-emergency patients
3. Form a plan for improving the process, measuring improvements to the process, and reducing deviations from the goal - many hospitals have found that Lean Six Sigma practices are a particularly effective way of identifying and dealing with the challenges and problems inherent to health care .
1. concentrations prepared by the pharmacy
2. how physician orders were formatted
3. how nurses calculated drip rates
Improvements were initiated, including standardizing of drug concentrations, development of tables to improve the accuracy of drip calculations. Error rates and clinical discrepancies improved significantly.
2. medications that were kept in patient areas were standardized and limited colored labels were utilized to indicate non-standardized concentrations nurses were retrained in the more problematic steps of programming the pump
3. After these improvements were there were significantly fewer errors, and if errors did occur, they were less severe and were discovered more quickly.
1. Patient falls in the rehabilitation unit
2. Reducing the time a physician orders an antibiotic and the patient’s receiving it
3. Elapsed time from when a patient diagnosed with a heart attack arrives at the hospital to treatment in the catheterization lab
4. Frequency and severity of low glucose readings in insulin recipients
5. Post-operative narcotic sedation
1. pacemaker billing and reimbursement
2. length of stay for percutaneous coronary intervention (PCI)
3. use of Omnicell non-narcotic
4. medical record retrieval
5. room availability cycle time,
6. lab supply management.