ORLANDO, FL—Applying Lean Six Sigma principles—long used in manufacturing to eliminate waste related to energy, money, and time—increased patient satisfaction scores for call light responsiveness for the surgical oncology division above the previous year’s benchmark, according to a study presented at the ONS 40th Annual Congress.
Lean Six Sigma principles, which focus on solving a problem, “can be applied in health care with goals to decrease cost, increase quality, and increase staff and patient satisfaction,” said Vickie Thomas Januska, MBA, BSN, RN, NE-BC, of Seidman Cancer Center, Case Medical Center, University Hospitals, Cleveland, Ohio.
She explained that in 2013, call light responsiveness, a key factor in patient satisfaction, ranked in the 19th percentile when measured on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for the surgical oncology division. A goal was set for an interdisciplinary team to apply Lean Six Sigma interventions and solutions to increase patient satisfaction scores for call light responsiveness above the 60th percentile.
The team used Lean Six Sigma tools, worksheets, and formulas to collect data, including the current call light responsiveness process, which was mapped out on paper. This current state “allowed the team to analyze work flow, discover communication breakdowns, hand off failures, delays, omissions, lack of standardized work, and prioritizations related to patient requests,” Januska said.
With respect to call light responsiveness outcomes, they found that 63% of nursing assistants were busy. A total of 46% of calls occurred on the day shift, with 7% of the calls related to toileting. The highest number of calls was from patients who could not speak. The current state contained 33 steps, 14 handoffs, six decisions, and 20 delays, with varied staff and patient perceptions relating to call light responsiveness.
They created a “fishbone diagram” to use when brainstorming what might cause time variations in response. After the data were analyzed, a “future state value stream map” was created to minimize hand-offs and standardize work so that patient requests were completed logically and continuously.
“The team assessed ease of implementation, cost, time, and impact for effective solutions,” she said, and also created staff checklists, a rounding tool, a call light response log, a buddy system, triage criteria, a patient satisfaction committee, par levels for supplies, and welcome letters.
The floor sustained HCAHPS scores greater than the 60th percentile in 2014, increased scores for call light responsiveness in 2014, and created financial savings for the institution.
“As more research is completed on Lean Six Sigma in healthcare, principles can be incorporated into evidence-based practice to support call light responsiveness,” she concluded.