• Rev Calid Asist · Nov 2013

    Observational Study

    [Improving inpatient pharmacoterapeutic process by Lean Six Sigma methodology].

    • I Font Noguera, M J Fernández Megía, A J Ferrer Riquelme, S Balasch I Parisi, M D Edo Solsona, and J L Poveda Andres.
    • Servicio de Farmacia, Hospital Universitari i Politècnic La Fe, Valencia, España. Electronic address: Font_isa@gva.es.
    • Rev Calid Asist. 2013 Nov 1; 28 (6): 370-80.

    BackgroundLean Six Sigma methodology has been used to improve care processes, eliminate waste, reduce costs, and increase patient satisfaction.ObjectiveTo analyse the results obtained with Lean Six Sigma methodology in the diagnosis and improvement of the inpatient pharmacotherapy process during structural and organisational changes in a tertiary hospital.Material And MethodsScope1.000 beds tertiary hospital.Designprospective observational study. The define, measure, analyse, improve and control (DMAIC), were deployed from March to September 2011. An Initial Project Charter was updated as results were obtained.Population And Sample131 patients with treatments prescribed within 24h after admission and with 4 drugs.Variablessafety indicators (medication errors), and efficiency indicators (complaints and time delays).ResultsProportion of patients with a medication error was reduced from 61.0% (25/41 patients) to 55.7% (39/70 patients) in four months. Percentage of errors (regarding the opportunities for error) decreased in the different phases of the process: Prescription: from 5.1% (19/372 opportunities) to 3.3% (19/572 opportunities); Preparation: from 2.7% (14/525 opportunities) to 1.3% (11/847 opportunities); and administration: from 4.9% (16/329 opportunities) to 3.0% (13/433 opportunities). Nursing complaints decreased from 10.0% (2119/21038 patients) to 5.7% (1779/31097 patients). The estimated economic impact was 76,800 euros saved.ConclusionsAn improvement in the pharmacotherapeutic process and a positive economic impact was observed, as well as enhancing patient safety and efficiency of the organization. Standardisation and professional training are future Lean Six Sigma candidate projects.Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

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