Journal article
Guiding Inpatient Quality Improvement: A Systematic Review of Lean and Six Sigma
Joint Commission journal on quality and patient safety, Vol.36(12), pp.533,AP1-540,AP5
12/2010
DOI: 10.1016/S1553-7250(10)36081-8
PMID: 21222355
Abstract
Two popular quality improvement (QI) approaches in health care are Lean and Six Sigma. Hospitals continue to adopt these QI approaches—or the hybrid Lean Sigma approach—with little knowledge on how well they produce sustainable improvements. A systematic literature review was conducted to determine whether Lean, Six Sigma, or Lean Sigma have been effectively used to create and sustain improvements in the acute care setting.
Databases were searched for articles published in the health care, business, and engineering literatures. Study inclusion criteria required identification of a Six Sigma, Lean, or Lean Sigma project; QI efforts focused on hospitalized patients; descriptions of project improvements; and reported results. Depending on the quality of data reported, articles were classified as summary reports, pre-post observational studies, or time-series reports.
Database searches identified 539 potential articles. After review of titles, abstracts, and full text, 47 articles met inclusion criteria—10 articles summarized multiple projects, 12 reported Lean projects, 20 reported Six Sigma projects, and 5 reported Lean Sigma projects. Generally, the studies provided limited data, with only 15 articles providing any sort of follow-up data; of the 15, only 3 report a follow-up period greater than two years.
Lean, Six Sigma, and Lean Sigma as QI approaches can aid institutions in tackling a wide variety of problems encountered in acute care. However, the true impact of these approaches is difficult to judge, given that the lack of rigorous evaluation or clearly sustained improvements provides little evidence supporting broad adoption. There is still a need for future work that will improve the evidence base for understanding more about QI approaches and how to achieve sustainable improvement.
Details
- Title: Subtitle
- Guiding Inpatient Quality Improvement: A Systematic Review of Lean and Six Sigma
- Creators
- Justin M Glasgow - Graduate Research Assistant, the Center for Research in the Implementation of Innovative Strategies in Practice (CRIISP), Iowa City Department of Veterans Affairs (VA) Medical Center, Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaJill R Scott-Caziewell - College of Nursing, the University of IowaPeter J Kaboli - Core Investigator, CRIISP
- Resource Type
- Journal article
- Publication Details
- Joint Commission journal on quality and patient safety, Vol.36(12), pp.533,AP1-540,AP5
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S1553-7250(10)36081-8
- PMID
- 21222355
- ISSN
- 1553-7250
- eISSN
- 1938-131X
- Grant note
- name: Center for Research in the Implementation of Innovative Strategies in Practice, award: HFP 04–149; name: University of Iowa Clinical and Translational Science Program, award: 5TL1RR024981-02
- Language
- English
- Date published
- 12/2010
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9984094665802771
Metrics
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